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ムラガキ ヨシヒロ
MURAGAKI Yoshihiro
村垣 善浩 所属 医学部 医学科（東京女子医科大学病院） 職種 客員教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 招待の有無 | 招待あり |
| 表題 | Localization and symptoms associated with removal of negative motor area during awake surgery. |
| 掲載誌名 | 正式名：British journal of neurosurgery 略 称：Br J Neurosurg ISSNコード：1360046X/02688697 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.1-9-** |
| 著者・共著者 | TSUZUKI Shunsuke†, MURAGAKI Yoshihiro, MARUYAMA Takashi, SAITO Taiichi, NITTA Masayuki, TAMURA Manabu, KAWAMATA Takakazu |
| 発行年月 | 2023/10/19 |
| 概要 | BACKGROUND:In awake surgery, cortical mapping may identify the negative motor area (NMA). However, since speech arrest occurs regardless of whether the NMA or the frontal language area (FLA) is stimulated, the presence of speech arrest alone does not distinguish the NMA from the FLA. Furthermore, the exact location and function of the NMA is not well understood. The purpose of this study was to more accurately locate the NMA in a group of cases in which the NMA and FLA could be identified in different brain gyri, and to describe symptoms in cases in which the NMA was removed.METHODS:There were 18 cases of awake surgery at our institution between 2000 and 2013 in which cortical stimulation allowed identification of FLA and NMA in separate brain gyri. In these cases, the pre- and post-removal mapping results were projected onto a 3D model postoperatively. We investigated the symptoms and social rehabilitation in a case in which the tumour invaded the same brain gyrus as the NMA and the NMA had to be resected in combination with the tumour.RESULTS:In cases where the NMA and FLA could be identified in different brain gyri, NMA was localized inferior to the precentral gyrus in all cases. In four cases where NMA was removed with the tumour, apraxia of speech was observed during the surgery; the same symptoms persisted after it, but it improved within a few months, and the patients were able to return to work.CONCLUSION:In cases where NMA and FLA could be identified separately by awake mapping, the NMA was commonly localized inferior to the precentral gyrus. When NMAs were resected in combination with tumour invasion, they did not lead to serious, long-term complications. |
| DOI | 10.1080/02688697.2023.2271082 |
| PMID | 37855108 |