Cortical and subcortical motor mapping in rolandic and perirolandic glioma surgery: Impact on postoperative morbidity and extent of resection

G. Carrabba, E. Fava, C. Giussani, F. Acerbi, F. Portaluri, V. Songa, N. Stocchetti, V. Branca, S. M. Gaini, L. Bello

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Abstract

Aim. Surgery for gliomas located inside or in proximity of motor cortex or tracts requires cortical and subcortical mapping to locate motor function; direct electrical stimulation of brain cortex or subcortical pathways allows identification and preservation of motor function. In this study we evaluated the effect which subcortical motor mapping had on postoperative morbidity and extent of resection in a series of patients with gliomas involving motor areas or pathways. Methods. One hundred and forty-six patients were included in the study. Intraoperative findings of primary motor cortex or subcortical tracts were reported, together with incidence of new postoperative deficits at short (1 week) and long term (1 month) examination. The relationship between intraoperative identification of subcortical motor tracts and extent of resection was reported. Results. The motor strip was found in 133 patients (91%) and subcortical motor tracts in 91 patients (62.3%). New immediate postoperative motor deficits were documented in 59.3% of patients in whom a subcortical motor tract was identified intra-operatively and in 10.9% of those in whom subcortical tracts were not observed; permanent deficits were observed in 6.5% and 3.5%, respectively. A total resection was achieved in 94.4% of patients with high-grade gliomas and in 46.1% of those with low-grade gliomas. Conclusion. Cortical and subcortical motor areas are identified in a high percentage of patients. Identification of subcortical tracts is associated with a higher incidence of immediate postoperative deficits and a low incidence of definitive morbidity. Total resection was performed in a considerable percentage of patients.

Original languageEnglish
Pages (from-to)45-51
Number of pages7
JournalJournal of Neurosurgical Sciences
Volume51
Issue number2
Publication statusPublished - Jun 2007

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Glioma
Motor Cortex
Morbidity
Incidence
Efferent Pathways
Deep Brain Stimulation

Keywords

  • Brain mapping
  • Glioma
  • Surgery

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Cortical and subcortical motor mapping in rolandic and perirolandic glioma surgery : Impact on postoperative morbidity and extent of resection. / Carrabba, G.; Fava, E.; Giussani, C.; Acerbi, F.; Portaluri, F.; Songa, V.; Stocchetti, N.; Branca, V.; Gaini, S. M.; Bello, L.

In: Journal of Neurosurgical Sciences, Vol. 51, No. 2, 06.2007, p. 45-51.

Research output: Contribution to journalArticle

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title = "Cortical and subcortical motor mapping in rolandic and perirolandic glioma surgery: Impact on postoperative morbidity and extent of resection",
abstract = "Aim. Surgery for gliomas located inside or in proximity of motor cortex or tracts requires cortical and subcortical mapping to locate motor function; direct electrical stimulation of brain cortex or subcortical pathways allows identification and preservation of motor function. In this study we evaluated the effect which subcortical motor mapping had on postoperative morbidity and extent of resection in a series of patients with gliomas involving motor areas or pathways. Methods. One hundred and forty-six patients were included in the study. Intraoperative findings of primary motor cortex or subcortical tracts were reported, together with incidence of new postoperative deficits at short (1 week) and long term (1 month) examination. The relationship between intraoperative identification of subcortical motor tracts and extent of resection was reported. Results. The motor strip was found in 133 patients (91{\%}) and subcortical motor tracts in 91 patients (62.3{\%}). New immediate postoperative motor deficits were documented in 59.3{\%} of patients in whom a subcortical motor tract was identified intra-operatively and in 10.9{\%} of those in whom subcortical tracts were not observed; permanent deficits were observed in 6.5{\%} and 3.5{\%}, respectively. A total resection was achieved in 94.4{\%} of patients with high-grade gliomas and in 46.1{\%} of those with low-grade gliomas. Conclusion. Cortical and subcortical motor areas are identified in a high percentage of patients. Identification of subcortical tracts is associated with a higher incidence of immediate postoperative deficits and a low incidence of definitive morbidity. Total resection was performed in a considerable percentage of patients.",
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T1 - Cortical and subcortical motor mapping in rolandic and perirolandic glioma surgery

T2 - Impact on postoperative morbidity and extent of resection

AU - Carrabba, G.

AU - Fava, E.

AU - Giussani, C.

AU - Acerbi, F.

AU - Portaluri, F.

AU - Songa, V.

AU - Stocchetti, N.

AU - Branca, V.

AU - Gaini, S. M.

AU - Bello, L.

PY - 2007/6

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N2 - Aim. Surgery for gliomas located inside or in proximity of motor cortex or tracts requires cortical and subcortical mapping to locate motor function; direct electrical stimulation of brain cortex or subcortical pathways allows identification and preservation of motor function. In this study we evaluated the effect which subcortical motor mapping had on postoperative morbidity and extent of resection in a series of patients with gliomas involving motor areas or pathways. Methods. One hundred and forty-six patients were included in the study. Intraoperative findings of primary motor cortex or subcortical tracts were reported, together with incidence of new postoperative deficits at short (1 week) and long term (1 month) examination. The relationship between intraoperative identification of subcortical motor tracts and extent of resection was reported. Results. The motor strip was found in 133 patients (91%) and subcortical motor tracts in 91 patients (62.3%). New immediate postoperative motor deficits were documented in 59.3% of patients in whom a subcortical motor tract was identified intra-operatively and in 10.9% of those in whom subcortical tracts were not observed; permanent deficits were observed in 6.5% and 3.5%, respectively. A total resection was achieved in 94.4% of patients with high-grade gliomas and in 46.1% of those with low-grade gliomas. Conclusion. Cortical and subcortical motor areas are identified in a high percentage of patients. Identification of subcortical tracts is associated with a higher incidence of immediate postoperative deficits and a low incidence of definitive morbidity. Total resection was performed in a considerable percentage of patients.

AB - Aim. Surgery for gliomas located inside or in proximity of motor cortex or tracts requires cortical and subcortical mapping to locate motor function; direct electrical stimulation of brain cortex or subcortical pathways allows identification and preservation of motor function. In this study we evaluated the effect which subcortical motor mapping had on postoperative morbidity and extent of resection in a series of patients with gliomas involving motor areas or pathways. Methods. One hundred and forty-six patients were included in the study. Intraoperative findings of primary motor cortex or subcortical tracts were reported, together with incidence of new postoperative deficits at short (1 week) and long term (1 month) examination. The relationship between intraoperative identification of subcortical motor tracts and extent of resection was reported. Results. The motor strip was found in 133 patients (91%) and subcortical motor tracts in 91 patients (62.3%). New immediate postoperative motor deficits were documented in 59.3% of patients in whom a subcortical motor tract was identified intra-operatively and in 10.9% of those in whom subcortical tracts were not observed; permanent deficits were observed in 6.5% and 3.5%, respectively. A total resection was achieved in 94.4% of patients with high-grade gliomas and in 46.1% of those with low-grade gliomas. Conclusion. Cortical and subcortical motor areas are identified in a high percentage of patients. Identification of subcortical tracts is associated with a higher incidence of immediate postoperative deficits and a low incidence of definitive morbidity. Total resection was performed in a considerable percentage of patients.

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