Cortical stimulation of language fields under local anesthesia: optimizing removal of brain lesions adjacent to speech areas

Arquivos de Neuro-Psiquiatria

Robson Luis Oliveira De Amorim²  Antônio Nogueira De Almeida²  Paulo Henrique Pires De Aguiar²  Erich Talamoni Fonoff²  Suely Itshak²  Daniel Fuentes¹  Manoel Jacobsen Teixeira² 

[1] ,University of São Paulo School of Medicine Clinics Hospital Division of Functional NeurosurgerySão Paulo,Brazil

关键词: cortical mapping;    awake craniotomy;    tumor;    speech area;    mapeamento cortical;    craniotomia acordado;    tumor;    área da fala;   

DOI  :  10.1590/S0004-282X2008000400018

来源: SciELO

【 摘 要 】

OBJECTIVE: The main objective when resecting benign brain lesions is to minimize risk of postoperative neurological deficits. We have assessed the safety and effectiveness of craniotomy under local anesthesia and monitored conscious sedation for the resection of lesions involving eloquent language cortex. METHODS: A retrospective review was performed on a consecutive series of 12 patients who underwent craniotomy under local anesthesia between 2001 and 2004. All patients had lesions close to the speech cortex. All resection was verified by post-operative imaging. Six subjects were male and 6 female, and were aged between 14 and 52 years. RESULTS: Lesions comprised 7 tumour lesions, 3 cavernomas and 1 dermoid cyst. Radiological gross total resection was achieved in 66% of patients while remaining cases had greater than 80% resection. Only one patient had a post-operative permanent deficit, whilst another had a transient post-operative deficit. All patients with uncontrollable epilepsy had good outcomes after surgery. None of our cases subsequently needed to be put under general anesthesia. CONCLUSION: Awake craniotomy with brain mapping is a safe technique and the "gold standard" for resection of lesions involving language areas.

【 授权许可】

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