Long-term seizure outcomes in adult patients undergoing primary resection of malignant brain astrocytomas Clinical article
Long-term seizure outcomes in adult patients undergoing primary resection of malignant brain astrocytomas Clinical article
复制标题
DOI：
10.3171/2009.2.jns081132
复制
发表时间：
2009-08-01
影响因子：
4.1
通讯作者：
Quinones-Hinojosa, Alfredo
中科院分区：
文献类型：
--
作者：
Chaichana, Kaisorn L.;Parker, Scott L.;Quinones-Hinojosa, Alfredo
Object.癫痫发作是恶性星形细胞瘤患者的常见症状和发病原因。作者着手确定恶性星形细胞瘤患者术前癫痫发作特征、手术对癫痫发作控制的影响以及与癫痫发作控制时间延长相关的因素。回顾性分析了1996年至2006年在约翰霍普金斯医疗机构接受半球间变性星形细胞瘤（AA）或多形性胶质母细胞瘤（GBM）一期切除术的成人患者病例。多变量逻辑回归分析用于确定与术前癫痫发作的相关性，多变量比例风险回归分析用于确定与切除术后癫痫控制时间延长的相关性。在该系列的648例患者（505例GBM，143例AA）中，153例（24%）出现癫痫发作。与术前癫痫发作相关的因素通常是AA病理（p = 0.03）、颞叶受累（p = 0.04）和皮质位置（p = 0.04），而与术前癫痫发作相关性较低的因素是年龄较大（p = 0.03）和肿瘤较大（p = 0.05）。
Object. Seizures are a common presenting symptom and cause of morbidity for patients with malignant astrocytomas. The authors set out to determine preoperative seizure characteristics, effects of surgery on seizure control, and factors associated with prolonged seizure control in patients with malignant astrocytomas.Methods. Cases involving adult patients who underwent primary resection of a hemispheric anaplastic astrocytoma (AA) or glioblastoma multiforme (GBM) at the Johns Hopkins Medical Institutions between 1996 and 2006 were retrospectively reviewed. Multivariate logistical regression analysis was used to identify associations with preoperative seizures, and multivariate proportional hazards regression analyses were used to identify associations with prolonged seizure control following resection.Results. Of the 648 patients (505 with GBM, 143 with AA) in this series, 153 (24%) presented with seizures. The factors more commonly associated with preoperative seizures were AA pathology (p = 0.03), temporal lobe involvement (p = 0.04), and cortical location (p = 0.04), while the factors less commonly associated with preoperative seizures were greater age (p = 0.03) and larger tumor size (p