Facundo Villamil, Melanie Catena Baudo, Pablo S Paolinelli, Lucila Domecq, Andrés Cervio, Mariana Bendersky
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引用次数: 0
摘要
额叶斜束(FAT)连接着辅助运动区(SMA)和厣旁。它在语言中的作用及其对胶质瘤手术的影响仍在讨论中。我们对三例手术切除的病例进行了解剖学研究。我们对三例左额叶胶质瘤患者进行了手术,手术过程中患者保持清醒,采用皮层和皮层下映射技术,并进行了运动和语言评估。使用 DSI Studio 软件进行了牵张成像。通过对 FAT 的皮层下刺激,所有三位患者都表现出术中语言抑制。涉及 FAT 的切除与所有病例的语言障碍和两个病例的运动启动障碍有关。所有患者均在术后 6 个月恢复正常。总之,该神经束已被成功重建,显示出解剖和功能上的复杂性,支持在胶质瘤手术中绘制和保留该神经束的想法。未来有必要进行跨学科研究,以确定功能障碍的短暂性或永久性。
[Frontal aslant tract: Anatomy and implications in brain glioma neurosurgery].
The frontal aslant tract (FAT) connects the supplementary motor area (SMA) with the pars opercularis. Its role in language and its implications in glioma surgery remain under discussion. We present an anatomosurgical study of three cases with surgical resolution. Three patients with gliomas in the left frontal lobe were operated on using an awake patient protocol with cortical and subcortical mapping techniques, conducting motor and language evaluations. Tractography was performed using DSI Studio software. All three patients showed intraoperative language inhibition through subcortical stimulation of the FAT. Resection involving the FAT correlated with language deficits in all cases and movement initiation deficits in two cases. All patients recovered from their deficits at six months postoperatively. In conclusion, the tract has been successfully reconstructed, showing both anatomical and functional complexity, supporting the idea of its mapping and preservation in glioma surgery. Future interdisciplinary studies are necessary to determine the transient or permanent nature of the deficits.