CAJ | 학술논문

目的介绍通过术中唤醒功能监测,定位及保护患者空间认知功能相关脑区的手术技术.方法对累及顶叶的9例脑肿瘤患者实施术中唤醒皮层及皮层下电刺激监测,通过观察患者在术中清醒状态下同步刺激过程中执行线段等分任务的表现,确定其空间认知功能相关脑区,并予以保护.通过围手术期患者空间认知功能测试评价手术效果.结果 9例中7例于术中监测得到电刺激阳性脑区,主要分布于右侧顶叶及颞顶联合区.术后行为评价确定空间忽视1例,无新出现的视野缺损.结论本研究结果支持了空间认知功能相关脑区为明显的个体化分布,同时确定了线段等分任务是唤醒术中定位与保护患者空间认知功能,最大程度减少术后空间忽视症状的有效方法.
목적 개소통과술중환성공능감측,정위급보호환자공간인지공능상관뇌구적수술기술.방법 대루급정협적9례뇌종류환자실시술중환성피층급피층하전자격감측,통과관찰환자재술중청성상태하동보자격과정중집행선단등분임무적표현,학정기공간인지공능상관뇌구,병여이보호.통과위수술기환자공간인지공능측시평개수술효과.결과 9례중7례우술중감측득도전자격양성뇌구,주요분포우우측정협급섭정연합구.술후행위평개학정공간홀시1례,무신출현적시야결손.결론 본연구결과지지료공간인지공능상관뇌구위명현적개체화분포,동시학정료선단등분임무시환성술중정위여보호환자공간인지공능,최대정도감소술후공간홀시증상적유효방법.
Objective To introduce the application of intraoperative cortical functional mapping for spatial awareness in brain tumor cases.Methods Nine patients,with brain tumors involved in the parietal lobe,receiving intraoperative electrical cortical stimulation simultaneously performed the bisection task during awake surgery.Cortical areas that were responsible for spatial awareness were localized and protected.Cognitive functions of spatial awareness were evaluated before and after surgery.Results Seven cases in nine were observed to have line deviations that were induced by the cortical or subcortical electrical stimulation.These task-based positive sites were generally distributed at the right parietal lobe and the temporo-parietal junction area.One patient suffered from postoperative spatial neglect.There was no postoperative visual field defect.Conclusions Cortical mapping for spatial awareness showed various distribution of positive sites among individuals.The line bisection task is proved to be an efficient method for spatial functional mapping,which may minimize the risk of postoperative spatial neglect.