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Journals / Turkish Neurosurgery / 2014 / Cilt: 24 - Sayı: 4

Piramidal Traktus Haritalama, Mikroskopi Tabanlı Nöronavigasyon ve İntraoperatif Manyetik Rezonans Görüntülemenin Birleştirilmesi Sensorimotor Korteksteki Epilepsi Odakları Rezeksiyonunun Sonuçlarını İyileştirir

Combining Pyramidal Tract Mapping, Microscopic-Based Neuronavigation, and Intraoperative Magnetic Resonance Imaging Improves Outcome of epilepsy Foci Resection in the Sensorimotor Cortex

zhi-Qiang CUI
Zhi-Pei LING
Hui-Fang SONG
Shen HU
Guo-Chen SUN
Xiao-Lei CHEN
Long-Sheng PAN
Chong LI
Bai-Nan XU
Pages
538–545
DOI
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⚡ TL;DR(Too Long; Didn't Read)

CONCLUSION: The techniques of combining pyramidal tract mapping, microscopic-based neuronavigation and iMRI aid in precise mapping and hence resection of epileptic foci in sensorimotor cortex, which lead to improvement of surgical efficacy and significant reduction of postoperative loss of function.

📌 3 Key Takeaways

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Objective & Hypothesis:AIM: To explore the clinical value of combining pyramidal tract mapping, microscopic-based neuronavigation, and intraoperative magnetic resonance imaging (iMRI) in the surgical treatment of epileptic foci involving sensorimotor cortex.
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Key Findings & Data:MATERIAL and METHODS: We retrospectively analyzed 69 patients with focal epilepsy involving motor and sensory cortex.
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Conclusion & Impact:CONCLUSION: The techniques of combining pyramidal tract mapping, microscopic-based neuronavigation and iMRI aid in precise mapping and hence resection of epileptic foci in sensorimotor cortex, which lead to improvement of surgical efficacy and significant reduction of postoperative loss of function.
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

AIM: To explore the clinical value of combining pyramidal tract mapping, microscopic-based neuronavigation, and intraoperative magnetic resonance imaging (iMRI) in the surgical treatment of epileptic foci involving sensorimotor cortex. MATERIAL and METHODS: We retrospectively analyzed 69 patients with focal epilepsy involving motor and sensory cortex. The surgical operations in Group I (n=38) were performed under the guidance of conventional neuronavigation, and the operations of Group II (n=31) were aided by combining pyramidal tract mapping, microscopic-based neuronavigation and the iMRI technique. Chi square test was used to compare seizure outcome and neurological deficits across groups. RESULTS: 7 patients (18.4%) in Group I, and 3 patients (9.7%) in Group II didn t recover to the level of preoperative strength within one year post-operation. The 2-year follow-up survey showed that more patients in Group II compared to Group I (71% vs. 55.3%, p=0.181) had a good outcome (Engel class I ~ II). CONCLUSION: The techniques of combining pyramidal tract mapping, microscopic-based neuronavigation and iMRI aid in precise mapping and hence resection of epileptic foci in sensorimotor cortex, which lead to improvement of surgical efficacy and significant reduction of postoperative loss of function.

Özet

AMAÇ: Sensorimotor korteksle ilgili epileptik odakların cerrahi tedavisinde piramidal traktus haritalama, mikroskopi tabanlı nöronavigasyon ve intraoperatif manyetik rezonans görüntülemenin (iMRG) birleştirilmesinin klinik değerini incelemek. YÖNTEM ve GEREÇLER: Motor ve duyusal korteksle ilgili fokal epilepsili 69 hastayı retrospektif olarak inceledik. Grup Ideki (n = 38) cerrahi operasyonlar, geleneksel nöronavigasyon ile yapılırken, Grup II (n = 31) operasyonları piramidal traktus haritalama, mikroskopi tabanlı nöronavigasyon ve iMRG tekniği birleştirilerek yapıldı. Gruplar arasında epileptik nöbet açısından sonucu ve nörolojik defisitleri karşılaştırmak için Ki kare testi kullanıldı. BULGULAR: Grup Ide 7 hasta (%18,4) ve Grup IIde 3 hasta (% 9,7) operasyon sonrası bir yıl içinde preoperatif güç düzeyine ulaşamadı. 2 yıllık izlem anketi Grup I ile karşılaştırıldığında Grup IIde daha fazla hastanın iyi bir sonuç (Engel seviye I - II) elde ettiğini gösterdi. SONUÇ: Piramidal traktus haritalama, mikroskopi tabanlı nöronavigasyon ve iMRG hassas haritalamaya ve böylece sensorimotor kortekste epileptik odakların rezeksiyonuna, sonuçta da cerrahi etkinliğin artmasına ve postoperatif işlevsel kayıpta önemli azalmaya yardımcıdır.

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Cite This Article

CUI, Z., LING, Z., SONG, H., HU, S., SUN, G., CHEN, X., PAN, L., LI, C., XU, B. (2014). Piramidal Traktus Haritalama, Mikroskopi Tabanlı Nöronavigasyon ve İntraoperatif Manyetik Rezonans Görüntülemenin Birleştirilmesi Sensorimotor Korteksteki Epilepsi Odakları Rezeksiyonunun Sonuçlarını İyileştirir. Turkish Neurosurgery, Cilt: 24 - Sayı: 4, 538–545. https://ajindex.com/articles/405489

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References (1)

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