Recovery of Visual Field After Awake Stimulation Mapping of the Optic Pathway in Glioma Patients
Recovery of Visual Field After Awake Stimulation Mapping of the Optic Pathway in Glioma Patients
复制标题
神经胶质瘤患者清醒刺激视路测绘后视野的恢复
DOI：
10.1007/s10548-022-00922-z
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发表时间：
2022
期刊：
影响因子：
2.7
通讯作者：
Nakada Mitsutoshi
中科院分区：
文献类型：
--
作者：
Ichinose Toshiya;Kinoshita Masashi;Nakajima Riho;Tanaka Shingo;Nakada Mitsutoshi
神经胶质瘤清醒开颅手术期间的大脑绘图有助于保留神经功能，包括维持中央和周边视力。然而，视野的连续变化仍然未知。我们回顾性评估了 14 名因神经胶质瘤浸润至视放射而接受清醒开颅手术的患者。术中应用皮质-皮质下直接电刺激（DES），直到引发并记录短暂的视觉症状。术前、术后亚急性期、慢性期连续检查视野。为了评估记录的解剖功能有效性，使用基于体素的形态测量 (VBM) 映射将所有 DES 引出的点叠加到包括视辐射的三维模板上。所有患者在 DES 期间均出现视觉症状，包括幻视、视力模糊或幻觉，手术切除仅限于功能范围内。在VBM中，几乎所有皮层下正映射点都与视辐射表面重叠，并且可以在解剖空间中区分上视野或下视野中诱发视觉现象的位点的分布。我们观察到 4 名患者 (29%) 没有术后视力缺陷，8 名患者中有 5 名出现暂时性象限盲或部分视觉缺陷（57% 中的 36%），并且两名枕叶病变患者出现永久性偏盲 (14%)。术中 DES 可在神经胶质瘤清醒开颅手术中识别并保留视辐射，是降低永久性缺陷风险的可靠且有效的技术，但对于枕叶受累的患者成功率较低。
Brain mapping during awake craniotomy for gliomas can help preserve neurological functions, including maintenance of central and peripheral vision. However, the consecutive changes in the visual field remain unknown. We retrospectively assessed 14 patients who underwent awake craniotomy for gliomas infiltrating into the optic radiation. Cortico-subcortical direct electrical stimulation (DES) was intraoperatively applied until transient visual symptoms were elicited and recorded. The visual fields were examined consecutively in the preoperative period and postoperative subacute and chronic periods. To evaluate the anatomo-functional validity of the recordings, all DES-elicited points were overlaid onto a three-dimensional template that included the optic radiation, using voxel-based morphometry (VBM) mapping. All patients experienced visual symptoms that were classified as phosphenes, blurred vision, or hallucinations during DES, and surgical resection was limited to within the functional boundaries. In VBM, almost all the subcortical positive mapping points overlapped with the surface of the optic radiation, and the distribution of sites that induced visual phenomena in the upper or lower visual fields could be differentiated in the anatomical space. We observed no postoperative visual deficit in four patients (29%), time-dependent improvements in five out of eight patients that presented transient quadrantanopia or partial visual defect (36% out of 57%), and permanent hemianopsia (14%) in two patients with occipital lesions. Intraoperative DES that identifies and preserves optic radiation in awake craniotomy for gliomas is a reliable and effective technique to reduce risk of permanent deficits, but has a low success rate in patients with occipital involvement.
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管理新理念。
DOI：
--
发表时间：
1962
期刊：
Hospital progress
影响因子：
--
作者：
E. Auer
通讯作者：
E. Auer
影响因子：
2.5
作者：
HUBEL, DH;WIESEL, TN
通讯作者：
WIESEL, TN
大脑后动脉分布梗死后同向偏盲的恢复模式
DOI：
--
发表时间：
1991
期刊：
影响因子：
--
作者：
K. And;H. W. Kolmel
通讯作者：
H. W. Kolmel
通过运动重组恢复初级运动区的激活，并在脑肿瘤切除后改善运动功能。
DOI：
--
发表时间：
2006
期刊：
AJNR. American journal of neuroradiology
影响因子：
--
作者：
N. Shinoura;Yuichi Suzuki;R. Yamada;T. Kodama;Masamichi Takahashi;K. Yagi
通讯作者：
K. Yagi
癫痫枕骨皮质切除术中保留中央视野的术中监测
影响因子：
2
作者：
J. Curatolo;R. Macdonell;S. Berkovic;G. Fabinyi
通讯作者：
G. Fabinyi