Evaluation Of Functional Recovery After Surgical Resection Of Low-Grade Gliomas In Eloquent Brain At A Tertiary Care Hospital
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 2631-2636
Abstract
Aim: To assess the functional recovery after surgical resection of low-grade gliomas in eloquent brain.Materials & methods: 30 patients with diagnosis of low-grade gliomas and undergoing resection with intra-operative electrical stimulations (IES) for the same were enrolled. The patients in which tumour involved right supplementary and primary motor areas, and the right insular lobe underwent surgery under general anaesthesia, with cortical and sub-cortical IES allowing the detection of the whole cortico-spinal pathways and vice-versa. Examination of all the patients was done immediately after surgery and after four months of surgery.
Results: Glioma was located in the supplementary motor area in 46.67 percent of the patients. Location was insular lobe in 40 percent of the patients while facial primary motor area was location the 10 percent of the patients. Glioma was located in Broca’s area in 1 patient. Presenting symptoms in all the patients was seizures. While evaluating the clinical outcome, it was seen that among 14 patients with supplementary motor area involvement, Recovery within 3 months; one patient with residual right lower limb monoparesia. Among 12 patients with insular lobe involvement, Recovery within 4 months; 2 patients with mild speech deficit, 2 patients with immediate motor deficits. Among 3 patients with facial primary motor area involvement; Recovery within 3 months; 1 patient with immediate facia palsy. The patient with Broca’s area involvement, recovery occurred within 1 week.
Conclusion: It is possible to carry out spatio-temporal functional re-organisation in peritumoural brain. This brain plasticity might be used to extend the limits of surgery in eloquent area.
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