Corpus callosotomy: a quantitative study of the extent of resection, seizure control, and neuropsychological outcome.
Corpus callosotomy: a quantitative study of the extent of resection, seizure control, and neuropsychological outcome.
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胼胝体切开术：对切除范围、癫痫控制和神经心理学结果的定量研究。
DOI：
10.3171/jns.1993.79.5.0688
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发表时间：
1993
影响因子：
4.1
通讯作者：
K. Laxer
中科院分区：
文献类型：
--
作者：
A. N. Mamelak;N. Barbaro;John A. Walker;K. Laxer
胼胝体切开术对于控制适当患者的药物难治性全身性癫痫发作是有价值的，但术后语言障碍、神经心理障碍和运动功能障碍的发展都已被注意到。胼胝体切除的程度被认为是一个可能的决定性因素，但这一假设尚未得到正式的检验。对1986年至1991年在加州大学旧金山分校弗朗西斯科接受胼胝体切开术的所有患者的记录进行分析，结果显示，在15例接受前部或完全胼胝体切开术的患者中，7例完全或几乎无癫痫，4例癫痫发作频率至少减少50%，4例无变化。为了确定胼胝体的大小和胼胝体切开术的范围，术前和术后的磁共振图像用基于计算机的平面测量法进行测量。癫痫发作的结果与术前胼胝体大小或胼胝体切开术的范围无显著相关性。胼胝体切开术后智商评分无明显变化。即使在混合大脑优势或双侧语言表征的患者中，前部或完全胼胝体切开术后也没有严重的神经心理学缺陷。这些结果表明，在适当的患者中，胼胝体前部的二分之一至三分之二的分裂几乎与更广泛的前部切除或完全胼胝体切开术在减少跌倒发作和全身强直阵挛性癫痫发作方面一样有效，并且当至少50%至65%的胼胝体被分裂时，胼胝体切开术的程度不是结果的重要因素。混合性大脑优势和其他不寻常的语言和记忆组织模式似乎不会增加术后神经心理学缺陷的风险，无论前节的程度如何。
Corpus callosotomy is valuable for controlling medically intractable generalized seizures in appropriate patients, but postoperative development of language disorders, neuropsychological impairment, and motor dysfunction have all been noted. The extent of callosum resection has been implicated as a possible determinant of outcome, but this hypothesis has not been formally tested. Analysis of the records of all patients who underwent corpus callosotomy at the University of California, San Francisco, from 1986 to 1991 showed that, of 15 patients who underwent anterior or complete callosotomy, seven were entirely or nearly seizure-free, four had at least a 50% reduction in seizure frequency, and four had no change. To determine callosal size and extent of callosotomy, preoperative and postoperative magnetic resonance images were measured with computer-based planimetry. Seizure outcome was not significantly associated with preoperative callosal size or extent of callosotomy. Intelligence quotient scores did not change significantly after callosotomy. No severe neuropsychological deficits developed after anterior or complete callosotomy, even in patients with mixed cerebral dominance or bilateral language representation. These results indicate that division of the anterior one-half to two-thirds of the corpus callosum is nearly as effective as more extensive anterior sectioning or complete callosotomy in reducing drop-attack and generalized tonic-clonic seizures in appropriate patients, and that the extent of callosotomy is not an important factor on outcome when at least 50% to 65% of the callosum is divided. Mixed cerebral dominance and other unusual patterns of language and memory organization do not appear to increase the postoperative risk for neuropsychological deficits, regardless of the extent of anterior section.
交叉大脑优势患者胼胝体切开术后语言障碍。
影响因子：
4.1
作者：
Sass,KJ;Novelly,RA;Spencer,DD;Spencer,SS
通讯作者：
Spencer,SS
阶段性胼胝体切开术中的磁共振成像、脑电图和选定的神经心理学测试。
影响因子：
--
作者：
Gates,JR;Mireles,R;Maxwell,R;Sharbrough,F;Forbes,G
通讯作者：
Forbes,G