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1.
Journal of Regional Anatomy and Operative Surgery ; (6): 738-741, 2018.
Article in Chinese | WPRIM | ID: wpr-702295

ABSTRACT

Objective To evaluate the risk of microsurgery and reduce the incidence of postoperative complications in patients with lon-gitudinal fissure meningioma. Methods The clinical data of 106 patients with longitudinal fissure meningioma after microsurgery in the neu-rosurgery department of Xuzhou medical university from January 2011 to December 2017 were retrospectively analyzed.Longitudinal fissure meningioma were defined as the meningioma whose base were attached to the brain’s sickle sinus,sagittal sinus and the brain’s sickle sagit-tal sinus.Patients were divided into two groups according to whether there were postoperative complications.The gender,age,chief complaint symptoms,tumor base,tumor location,tumor size,tumor shape,MR enhancement,MR peritoneal edema, peritoneal adhesion of central sulcus vein and drainage vein,tumor invasiveness,tumor boundary,previous history of circulatory system were compared.Univariate analysis was per-formed on these factors to screen out the influencing factors of patients with postoperative complications.Binary logistic regression analysis was performed on the factors with statistical significance.Results Central sulcus vein and drainage vein adhesion were independent protective factors for postoperative complications.The risk of postoperative complications in patients without adhesion at peri-tumor stage was only 0.209 times of that in patients with adhesion.Conclusion For patients with longitudinal fissure meningioma,preoperative risk of postoperative com-plications can be assessed objectively according to the condition of central sulcus vein and drainage vein adhesion around the tumor.In the treatment of patients with obvious peritumoral vascular adhesion,the central sulcus vein and drainage vessels should be carefully protected to significantly reduce the incidence of postoperative complications.

2.
Arq. neuropsiquiatr ; 73(11): 934-938, Nov. 2015. tab, graf
Article in English | LILACS | ID: lil-762893

ABSTRACT

ABSTRACTThe central sulcus region is an eloquent area situated between the frontal and parietal lobes. During neurosurgical procedures, it is sometimes difficult to understand the cortical anatomy of this region.Objective Find alternative ways to anatomically navigate in this region during neurosurgical procedures.Method We analyzed eighty two human hemispheres using a surgical microscope and completed a review of the literature about central sulcus region.Results In 68/82 hemispheres, the central sulcus did not reach the posterior ramus of the lateral sulcus. A knob on the second curve of the precentral gyrus was reliably identified in only 64/82 hemispheres.Conclusion The morphometric data presented in this article can be useful as supplementary method to identify the central sulcus region landmarks.


RESUMOA região do sulco central é uma área eloquente posicionada entre os lobos frontal e parietal. Durante procedimentos neurocirúrgicos, em algumas ocasiões, torna-se difícil compreender a anatomia cortical desta região.Objetivo Encontrar métodos alternativos para uma navegaçāo anatômica desta regiāo durante procedimentos neurocirúrgicos.Método Analisamos oitenta e dois hemisférios humanos usando um microscópio cirúrgico, além de fazer uma revisão da literatura.Resultados Em 68/82 hemisférios, o sulco central não atingiu o ramo posterior do sulco lateral. Uma dilatação na segunda curva do giro precentral foi encontrada em apenas 64/82 hemisférios.Conclusão Os dados morfométricos apresentados neste artigo podem ser úteis como método suplementar para identificação dos reparos anatômicos na região do sulco central.


Subject(s)
Humans , Anatomic Landmarks/anatomy & histology , Frontal Lobe/anatomy & histology , Neurosurgical Procedures/methods , Parietal Lobe/anatomy & histology , Craniotomy , Magnetic Resonance Imaging , Neuroanatomy/methods , Reference Standards
3.
Arq. neuropsiquiatr ; 66(4): 868-871, dez. 2008. ilus, tab
Article in English | LILACS | ID: lil-500570

ABSTRACT

The surgical treatment of the lesions located in the central lobe is a very difficult task for the neurosurgeon. The overall aim of this study is to verify the correlation of the coronal suture and the structures of the central lobe in 32 cadaver hemisphere brains and the importance of this information in surgical planning. The measurement of the nasion to the coronal suture ranged from 11.5 to 13.5 cm. The distance between the coronal suture in the midline to the central, precentral and paracentral sulcus ranged from 5.0 to 6.6, 2.5 to 4.5 and 1.3 to 4.0 cm respectively. Particularly in the normal cortex these measurements can be used to guide the surgical access. However, the identification of the central sulcus is not easy when the anatomical pattern is distorted or displaced by a lesion or edema. In cases such as these the use of other tools becomes crucial for good surgical planning and cortical mapping or awake craniotomy for a safer resection of the lesion as well.


O tratamento cirúrgico de lesões localizadas no lobo central é difícil para o neurocirurgião. O objetivo deste estudo é verificar a relação da sutura coronária com as estruturas do lobo central utilizando-se de dissecção realizada em 32 hemisférios cerebrais de 16 cadáveres, assim como, a importância desta informação no planejamento cirúrgico. A medida da distância entre o nasion e a sutura coronária variou entre 11,5 e 13,5 cm. A distância da sutura coronária na linha média para os sulcos central, pré-central e paracentral variou de 5,0 a 6,6 cm, 2,5 a 4,5 cm e 1,3 a 4,0 cm respectivamente. O conhecimento destas medidas pode ser usado no planejamento cirúrgico principalmente num córtex normal. Porém, a identificação do sulco central é difícil quando as estruturas anatômicas estão deslocadas pela lesão ou quando há edema. Nestes casos a utilização de outros meios diagnósticos para o planejamento cirúrgico torna-se necessária, como também a estimulação cortical ou a craniotomia com o paciente acordado pode proporcionar uma ressecção mais segura da lesão.


Subject(s)
Humans , Cranial Sutures/anatomy & histology , Frontal Lobe/anatomy & histology , Cadaver , Craniotomy , Cranial Sutures/surgery , Frontal Lobe/surgery
4.
Arq. neuropsiquiatr ; 66(4): 872-875, dez. 2008. ilus
Article in English | LILACS | ID: lil-500571

ABSTRACT

Arteriovenous malformations (AVM) are neurovascular disorders that occur mainly in young adults. Their clinical presentation is variable and depends on its location, size and occurrence of bleeding. They can represent incidental findings in neuro radiological exams. The treatment of these lesions when located in eloquent areas, namely around the central sulcus, is controversial, with different therapeutical approaches presented in the literature. We consider that surgical extirpation of many of these lesions is feasible in selected cases , when supported by profound anatomical knowledge and refined microsurgical technique, achieving cure with minimal aditional deficit. In the present article, we elaborate a surgical technique for the approach of AVMs located in the central sulcus, specially in finding the topographic lesion location and craniotomy.


Malformações arteriovenosas (MAV) são uma entidade patológica que ocorre mais frequentemente em adultos jovens. Sua manifestação clínica é variável e depende de sua localização, tamanho e ocorrência ou não de sangramento. Podem também ser diagnoticadas como achados incidentais em investigações neurorradiólogicas . O tratamento destas lesões, quando localizadas em áreas eloqüentes, em particular aquelas lesões localizadas próximas ao sulco central do cérebro, é controverso e diferentes abordagens terapêuticas são relatadas. Consideramos que a ressecção cirúrgica destas lesões é viável em casos selecionados, quando realizada sob profundo conhecimento anatômico e técnica microcirúrgica refinada, pois deste modo, as lesões podem ser curadas sem agregar morbidade ao paciente. No presente artigo, discutimos a técnica cirúrgica para MAVs localizadas nas adjacências do sulco central do cérebro, especialmente a localização topográfica da lesão e craniotomia.


Subject(s)
Humans , Arteriovenous Malformations/surgery , Cerebral Cortex/surgery , Craniotomy/methods , Microsurgery/methods , Cerebral Angiography , Magnetic Resonance Imaging
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