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Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2015; 34(04): 280-290
DOI: 10.1055/s-0035-1564422
Original Article | Artigo Original
Thieme Publicações Ltda Rio de Janeiro, Brazil.

The Role of the Intraoperative Auxiliary Methods in the Resection of Motor Area Lesions

O papel dos métodos auxiliares intraoperatórios na ressecção de lesões em área motora
Stênio Abrantes Sarmento
1   Instituto Paraibano do Cérebro, João Pessoa, PB, Brazil
2   Universidade Federal da Paraíba (UFPB) and Faculdade de Medicina Nova Esperança (FAMENE), João Pessoa, PB, Brazil
,
Emerson Magno de Andrade
1   Instituto Paraibano do Cérebro, João Pessoa, PB, Brazil
,
Helder Tedeschi
3   Department of Neurosurgery, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
› Author Affiliations
Further Information

Publication History

30 March 2015

07 August 2015

Publication Date:
28 October 2015 (online)

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Abstract

Objective In recent years, technologies have advanced considerably in improving surgical outcome following treatment of lesions in eloquent brain areas. The aim of this study is to explore which method is best in the resection of motor area lesions.

Methods Prospective, non-randomized study Evaluate on 74 patients who underwent surgery to remove lesions around the motor area.

Results Total lesion removal was achieved in 68 patients (93.1%). Fifty-four patients (73.9%) presented normal motor function in the preoperative period; of these, 20 (37.3%) developed transitory deficits. Nevertheless, 85% of these patients later experienced a complete recovery. Nineteen patients presented with motor deficits preoperatively; of these, five presented deteriorating motor abilities. Intraoperative stimulation methods were used in 65% of the patients, primarily in cases of glioma.

Conclusions The morbidity in patients submitted to resections of motor area lesions is acceptable and justify the surgical indication with the purpose of maximal resection. Intraoperative stimulation is an important tool that guides glioma resection in many cases.

Resumo

Objetivo Nos últimos anos, consideráveis avanços tecnológicos têm surgido no sentido de melhorar os resultados cirúrgicos no tratamento de lesões em áreas eloquentes do cérebro. O objetivo deste estudo é investigar qual o melhor método para ressecção de lesões em área motora.

Método Estudo prospectivo não aleatório que avaliou os resultados pós-operatórios em 74 pacientes submetidos à ressecção de lesões em área motora ou adjacente.

Resultados A ressecção cirúrgica foi considerada total em 68 (93,1%) pacientes. 54 pacientes (73,9%) apresentavam força muscular normal no pré-operatório. Destes, 20 (37,3%) apresentaram déficit no pós-operatório imediato, sendo que 17 (85%) recuperaram completamente o déficit. 19 pacientes apresentavam déficit no pré-operatório, sendo que 05 apresentaram piora do déficit no pós-operatório imediato. A estimulação intraoperatória foi utilizada em 65% dos casos, principalmente nos gliomas.

Conclusão A morbidade em pacientes operados de lesões em área motora é bastante aceitável e justifica a indicação cirúrgica com objetivo de ressecção máxima. A estimulação intraoperatória é uma ferramenta importante para guiar a resseção dos gliomas em muitos casos.

Keywords

motor cortex - brain neoplasms - stereotaxic techniques - neuronavigation

Palavras-chave

córtex motor - neoplasia cerebral - técnicas estereotáxicas - neuronavegação
 

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