唤醒状态下经颅切除术治疗语言中枢下的皮质下脑转移瘤：一例技术病例报告。
Awake Craniotomy for Subcortical Brain Metastasis Beneath the Speech Center: A Technical Case Report.
机构信息
Department of Neurosurgery, Nara Medical University, Kashihara, Japan
Department of Neurosurgery, Nara Medical University, Kashihara, Japan.
出版信息
Anticancer Res. 2022 Mar;42(3):1641-1644. doi: 10.21873/anticanres.15640.
BACKGROUND
To preserve language function, intraoperative functional brain mapping (IFBM) in and near the speech center is essential.
CASE REPORT
We present a case of a 73-year-old right-handed woman with colon cancer. She presented with mild speech disturbance. Magnetic resonance imaging revealed a ringed enhancing lesion in the frontal operculum. The preservation of language function was critical; therefore, she underwent awake craniotomy using IFBM. Thus, the speech site was elicited by cortical electrical stimulation at the surface, near the location of the tumor. We made a safe corticotomy on the surface of the lesion and performed the resection of brain metastasis (BM) via a safety corridor. We achieved gross total resection of the BM while preserving the language function. After surgery, she recovered from speech disturbance. She returned to her normal life with improved language function.
CONCLUSION
IFBM is a useful tool to undertake a safe approach via the speech center, avoiding permanent language deficits.
背景
为了保留语言功能，在言语中枢及其附近进行术中功能脑映射（IFBM）至关重要。
病例报告
我们报告了一例 73 岁的右利手女性结肠癌患者。她表现为轻度言语障碍。磁共振成像显示额盖有环状增强病变。保留语言功能至关重要；因此，我们使用 IFBM 进行了清醒开颅术。因此，通过在肿瘤附近的表面进行皮质电刺激来引出言语部位。我们在病变表面做了一个安全的皮质切开术，并通过安全通道进行脑转移瘤（BM）切除术。我们在保留语言功能的同时实现了 BM 的大体全切除。手术后，她的言语障碍得到恢复。她恢复了正常的生活，语言功能也得到了改善。
结论
IFBM 是一种通过言语中枢进行安全入路的有用工具，可避免永久性语言缺陷。
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