al-Rodhan N R, Kelly P J, Cascino G D, Sharbrough F W
Department of Neurosurgery, Mayo Clinic, Rochester, Minn.
Stereotact Funct Neurosurg. 1992;58(1-4):172-7. doi: 10.1159/000098992.
A retrospective analysis was performed in 30 patients who underwent computer-assisted stereotactic resection of intra-axial mass lesions with intractable partial epilepsy. Mean follow-up was 4.1 years (2-5.5), mean age 21 years (3-45) and mean duration of seizures 8.4 years (1-26). Pathology consisted of vascular malformations in 11, glial neoplasms in 11, cortical dysplasia in 4 and gliosis in 3, and no diagnostic abnormality was found in 2 patients. The location of the lesions in some cases may have precluded a standard craniotomy and cortical resection, e.g. precentral gyrus (5), post-central gyrus (5) and deep-seated left posterior temporal region (4). Operative morbidity involved 3 patients who developed motor or language deficits. Four patients were lost to follow-up. Thirteen patients out of 26 (50%) were class I, 3 (12%) were class II, 4 (15%) were class III and 6 (23%) were class IV. These findings suggest that stereotactic lesion resection in selected cases (e.g. where lesions are located in eloquent brain regions) can be useful in providing a histological diagnosis of the epileptogenic foci and result in a favorable reduction in seizure activity without the need for a standard cortical resection.
对30例因难治性部分性癫痫接受计算机辅助立体定向切除脑内肿块病变的患者进行了回顾性分析。平均随访4.1年（2 - 5.5年），平均年龄21岁（3 - 45岁），平均癫痫发作持续时间8.4年（1 - 26年）。病理结果包括11例血管畸形、11例神经胶质瘤、4例皮质发育异常、3例胶质增生，2例未发现诊断异常。在某些情况下，病变的位置可能使标准开颅和皮质切除术无法进行，例如中央前回（5例）、中央后回（5例）和左颞叶深部（4例）。手术并发症包括3例出现运动或语言功能障碍的患者。4例患者失访。26例患者中，13例（50%）为Ⅰ级，3例（12%）为Ⅱ级，4例（15%）为Ⅲ级，6例（23%）为Ⅳ级。这些结果表明，在某些选定的病例中（例如病变位于脑功能区），立体定向病变切除术有助于对致痫灶进行组织学诊断，并在无需标准皮质切除术的情况下有效减少癫痫发作活动。
