Lemée Jean-Michel, Bernard Florian, Ter Minassian Aram, Menei Philippe
Service de Neurochirurgie, CHU d'Angers, Angers, France; CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.
Service de Neurochirurgie, CHU d'Angers, Angers, France; Laboratoire d'Anatomie, Faculté de Médecine d'Angers, Angers, France.
World Neurosurg. 2018 Oct;118:360-367. doi: 10.1016/j.wneu.2018.07.099. Epub 2018 Jul 20.
The nondominant hemisphere (usually right) is determinant for main cognitive functions such as visuospatial and social cognitions. Awake surgery using direct electrical stimulation for right cerebral tumor removal remains challenging due to the complexity of the functional anatomy and the difficulties in adapting the classical bedside tasks for awake surgery conditions. An understanding of semiology, anatomical bases, and an analysis of the available cognitive tasks for visuospatial and social cognition per operative mapping will allow neurosurgeons to better appreciate the functional anatomy of the right hemisphere and its application to tumor surgery. In this second review of 2 parts, we discuss the pertinence of the neuropsychological tests available for the study of nondominant hemisphere functions for the surgery on right-sided tumors in awake surgery conditions. In conjunction with part I of the review, which focuses primarily on the anatomical, functional, and semiological basis of the right hemisphere function, this article provides a comprehensive review of current knowledge supporting the awake surgery in the right hemisphere.
非优势半球(通常为右侧)对诸如视觉空间认知和社会认知等主要认知功能起决定性作用。由于功能解剖结构的复杂性以及难以使经典床边任务适应清醒手术条件,使用直接电刺激进行右侧脑肿瘤切除的清醒手术仍然具有挑战性。了解符号学、解剖学基础,并对每个手术图谱中用于视觉空间和社会认知的现有认知任务进行分析,将使神经外科医生能够更好地理解右侧半球的功能解剖及其在肿瘤手术中的应用。在这篇分两部分的第二篇综述中,我们讨论了在清醒手术条件下,可用于研究非优势半球功能以进行右侧肿瘤手术的神经心理学测试的相关性。结合综述的第一部分,其主要关注右侧半球功能的解剖学、功能和符号学基础,本文全面回顾了支持右侧半球清醒手术的当前知识。