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MURAGAKI Yoshihiro
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Visiting Professor |
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| Article types | Original article |
| Language | English |
| Peer review | Peer reviewed |
| Title | “Apathetic look” is a valuable indicator of intraoperative supplementary motor area syndrome during awake craniotomy |
| Journal | Formal name：Neurosurgical review Abbreviation：Neurosurg Rev ISSN code：03445607/14372320 |
| Domestic / Foregin | Foregin |
| Publisher | Springer |
| Volume, Issue, Page | 47,pp.651 |
| Author and coauthor | SAITO Taiichi†, MURAGAKI Yoshihiro, LYU Wendong, TSUZUKI Shunsuke, KORIYAMA Shunichi, MASAMUNE Ken, HORIE Nobutaka, KAWAMATA Takakazu |
| Publication date | 2024/09/21 |
| Summary | Resection of a glioma from the dorsomedial frontal lobe, including the supplementary motor area (SMA), can result in postoperative SMA syndrome. SMA syndrome may occur during awake craniotomies. However, it is often difficult to intraoperatively distinguish between motor dysfunction due to pyramidal tract damage from that due to SMA syndrome. Patients with suspected intraoperative SMA syndrome are indifferent to their surroundings, have stiff facial muscles, and maintain a fixed gaze. We defined this condition as “apathetic look.” The present study aimed to investigate whether intraoperative “apathetic look” is useful for identifying intraoperative SMA syndrome in patients with glioma close to motor-related areas, including the SMA, during awake craniotomy. This study included 33 consecutive patients with glioma included in the SMA.
We excluded patients whose tumors extended to motor-related areas. We also assessed whether intraoperative SMA syndrome occurred in each patient. We evaluated the correlation between the occurrence of intraoperative SMA syndrome and various clinical factors, including intraoperative “apathetic look.” Of the 33 patients, 12 had intraoperative SMA syndrome. Intraoperative “apathetic look” showed strong correlation with intraoperative SMA syndrome (p < 0.0001). Additionally, higher extent of resection (EOR) and resection of the corpus callosum showed a significantly higher incidence of intraoperative “apathetic look.” All 12 patients with intraoperative SMA syndrome showed intraoperative “apathetic look” and recovered from SMA syndrome with high EOR. In conclusion, intraoperative “apathetic look” shows strong correlation with intraoperative SMA syndrome. Therefore, “apathetic look” may be a valuable indicator of intraoperative SMA syndrome during awake craniotomy. |
| DOI | 10.1007/s10143-024-02844-9 |