Tybor Krzysztof, Komuński Piotr, Ciechomska Agata, Majos Agata, Góraj Bozena, Zawirski Marek
Kliniki Neurochirurgii AM, Zakładu Radiologii AM w łodzi.
Neurol Neurochir Pol. 2003 Jan-Feb;37(1):89-98.
Malignant brain tumours are incurable at present. Since none of the hitherto used treatment methods allows to significantly extend these patients' survival time, the basic aim is to improve their quality of life. Intraoperative brain mapping seems to be an approach enabling to minimize the risk of irreversible damages to functionally important structures of the brain. In the Department of Neurosurgery of the Medical University of Łódź awake craniotomy with stimulation of eloquent cortex was attempted from May 1999 to July 2000 in 13 patients aged 16 to 77 years. In two patients the attempt of intraoperative awakening was unsuccessful. In 8 out of the 11 awakened patients intraoperative brain mapping had a significant effect on the course of surgery (i.e. on the resection magnitude and "safe corridor"). Out of six patients with tumors situated in the neighbourhood of motor cortex--one developed a severe and permanent paresis of the upper limb. On the grounds of the literature and the authors' own experience an algorithm of awake craniotomy and intraoperative brain mapping was worked out.
恶性脑肿瘤目前无法治愈。由于迄今为止所采用的任何治疗方法都无法显著延长这些患者的生存时间，因此基本目标是提高他们的生活质量。术中脑图谱似乎是一种能够将对大脑功能重要结构造成不可逆损伤的风险降至最低的方法。在罗兹医科大学神经外科，1999年5月至2000年7月对13名年龄在16至77岁的患者尝试了清醒开颅并刺激明确皮层。有两名患者术中唤醒尝试未成功。在11名被唤醒的患者中，有8名患者的术中脑图谱对手术过程（即切除范围和“安全通道”）产生了显著影响。在6名肿瘤位于运动皮层附近的患者中，有1名出现了严重且永久性的上肢麻痹。基于文献和作者自身经验，制定了清醒开颅和术中脑图谱的算法。
