Park Young Seok, Kim Dong-Seok, Shim Kyu-Won, Kim Jung-Hee, Choi Joong-Uhn
Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, Seodaemoon-Gu, Seoul, Republic of Korea.
Clin Neurol Neurosurg. 2008 Jul;110(7):667-73. doi: 10.1016/j.clineuro.2008.03.017. Epub 2008 May 21.
The purpose of this retrospective study was to evaluate causes contributing to surgical resectability and seizure outcomes depending on various clinical and surgical factors.
The records of 44 patients with gangliogliomas surgically treated between April 1986 and March 2007, were retrospectively reviewed to assess presenting symptoms, resectability and seizure outcomes.
Tumors were located in the supratentorial areas in 33 cases, the infratentorial area in 9 cases and the spinal cord in 2 cases. Thirty-five cases underwent gross total removal and 9 cases underwent subtotal resection. Only 2 cases underwent postoperative radiotherapy and 2 cases underwent gamma knife surgery. Twenty-six patients presented seizure symptoms of which 22 cases were located in temporal lobe and 4 cases were located in the extratemporal lobe. Twenty-three patients (88.5%) were seizure-free after surgery. Two patients were Engel class II and another was Engel class III.
We concluded that tumor location and seizure-presenting symptoms are good predictors of gross total removal. Gross total removal of ganglioglioma had a better chance of leaving the patient seizure free after surgery rather incomplete resection. Our data do not support the concept that surgical methods, invasive monitoring and surrounding cortical malformation correlated with seizure-free outcome.
本回顾性研究的目的是根据各种临床和手术因素评估影响手术可切除性及癫痫发作结果的因素。
回顾性分析1986年4月至2007年3月间接受手术治疗的44例神经节胶质瘤患者的病历，以评估其临床表现、可切除性及癫痫发作结果。
肿瘤位于幕上区域33例，幕下区域9例，脊髓2例。35例行肿瘤全切，9例行次全切除。仅2例术后接受放疗，2例接受伽玛刀手术。26例患者有癫痫症状，其中22例位于颞叶，4例位于颞叶外。23例患者（88.5%）术后无癫痫发作。2例为恩格尔分级II级，另1例为恩格尔分级III级。
我们得出结论，肿瘤位置及癫痫发作症状是肿瘤全切的良好预测指标。神经节胶质瘤全切术后患者无癫痫发作的几率高于不完全切除。我们的数据不支持手术方式、侵入性监测及周围皮质畸形与无癫痫发作结果相关的观点。
