Guo-chen Sun1, Xiao-lei Chen1, Xin-guang Yu1, Meng Zhang1, Gang Liu2, Bao-ke Hou3, Xiao-dong Ma4. 1. Department of Neurosurgery, PLA General Hospital, Beijing, China. 2. Department of Ophthalmology, PLA General Hospital, Beijing, China. 3. Department of Radiology, PLA General Hospital, Beijing, China. 4. Department of Neurosurgery, PLA General Hospital, Beijing, China. Electronic address: sjwk8082@126.com.
Abstract
BACKGROUND: This study investigated whether functional neuronavigation can be used to remove lesions in the lateral ventricle while preserving patients' neurologic functionality. METHODS: A total of 60 patients with lateral ventricular meningiomas were divided into study and control groups (n = 30 each). Diffusion tensor and blood oxygenation level-dependent functional magnetic resonance imaging were used for fiber tracking and eloquent cortex localization, respectively, in the study group. The surgical approach was based on coregistered data sets from 3-D lesion and brain structure reconstructions. Patients in the control group underwent anatomic neuronavigation-guided surgery. The patients' demographics, degree of resection, visual field, language score, movement, preoperative and postoperative Karnofsky Performance Status (KPS) scores, and surgical complications were recorded. RESULTS: Tumors were completely removed in both groups. Patients in the study group had a higher rate of visual field preservation than controls (P = 0.01). The two groups had similar motor and language functions after surgery, except that fewer cases of transient aphasia were observed in the former (P < 0.05). KPS scores for the study and control groups were 80 (70-80) and 70 (60-70), respectively (P < 0.01), at 2 weeks and 90 (80-100) and 85 (70-90), respectively (P = 0.022), at 3 months after surgery. CONCLUSIONS: Functional neuronavigation preserved neurologic functionality and was especially beneficial for protecting optical functionality and for the rapid recovery of patients.
BACKGROUND: This study investigated whether functional neuronavigation can be used to remove lesions in the lateral ventricle while preserving patients' neurologic functionality. METHODS: A total of 60 patients with lateral ventricular meningiomas were divided into study and control groups (n = 30 each). Diffusion tensor and blood oxygenation level-dependent functional magnetic resonance imaging were used for fiber tracking and eloquent cortex localization, respectively, in the study group. The surgical approach was based on coregistered data sets from 3-D lesion and brain structure reconstructions. Patients in the control group underwent anatomic neuronavigation-guided surgery. The patients' demographics, degree of resection, visual field, language score, movement, preoperative and postoperative Karnofsky Performance Status (KPS) scores, and surgical complications were recorded. RESULTS:Tumors were completely removed in both groups. Patients in the study group had a higher rate of visual field preservation than controls (P = 0.01). The two groups had similar motor and language functions after surgery, except that fewer cases of transient aphasia were observed in the former (P < 0.05). KPS scores for the study and control groups were 80 (70-80) and 70 (60-70), respectively (P < 0.01), at 2 weeks and 90 (80-100) and 85 (70-90), respectively (P = 0.022), at 3 months after surgery. CONCLUSIONS: Functional neuronavigation preserved neurologic functionality and was especially beneficial for protecting optical functionality and for the rapid recovery of patients.
Authors: Christoph Schwartz; Behnam Rezai Jahromi; Kimmo Lönnrot; Ahmad Hafez; Hidetsugu Maekawa; Martin Lehecka; Mika Niemelä Journal: Acta Neurochir (Wien) Date: 2020-08-09 Impact factor: 2.216