RESUMO
Introduction: Gliomas are the second most frequent primary brain tumors. Surgical resection remains a crucial part of treatment, as well as maximum preservation of neurological function. For this reason awake surgery has an important role.The objectives of this article are to present our experience with awake surgery for gliomas in a South American center and to analyze how intraoperative functional findings may influence the extent of resection and neurological outcomes. Materials and methods: Retrospective single center study of a cohort of adult patients undergoing awake surgery for brain glioma, by the same neurosurgeon, between 2012 and 2022 in the city of Buenos Aires, Argentina. Results: A total of 71 patients were included (mean age 34 years, 62% males). Seventy seven percent of tumors were low grade, with average extent of resection reaching 94% of preoperative volumetric assessment. At six months follow up, 81.7% of patients presented no motor or language deficit.Further analysis showed that having a positive mapping did not have a negative impact in the extent of resection, but was associated with short term postoperative motor and language deficits, among other variables, with later improvement. Conclusion: Awake surgery for gliomas is a safe procedure, with the proper training. In this study it was observed that guiding the resection by negative mapping did not worsen the results and that positive subcortical mapping correlated with short term postoperative neurological deficits with posterior improvement within six months in most cases.
RESUMO
Objetivo: comunicar el caso de una paciente de 53 años, oriunda de zona endemica de America Latina, con signos de compresion medular dorsal secundarios a una cisticercosis espinal. Descripcion: paciente de sexo femenino, cuadro progresivo de compresion medular dorsal, con antecedentes de neurocisticercosis. Las neuroimagenes mostraron una lesion intradural - extramedular D5-D6. Intervencion: se abordo quirurgicamente en posicion lateral, verificandose aracnoiditis reaccional y quiste de cisticerco que fue resecado, completandose el tratamiento con Albendazol oral, con regresion de la paraparesia severa preoperatoria y satisfactorio con control imagenologico. Conclusion: la forma espinal es infrecuente en el curso de la neurocisticercosis. La terapeutica implementada en nuestro caso fue concordante con los pocos casos descriptos en la literatura mundial (AU)
Assuntos
Humanos , Adulto , Feminino , Aracnoidite , Traumatismos da Medula Espinal , Neurocisticercose/diagnóstico , Neurocisticercose/complicações , Neurocisticercose/terapiaRESUMO
Objetivo: comunicar el caso de una paciente de 53 años, oriunda de zona endemica de America Latina, con signos de compresion medular dorsal secundarios a una cisticercosis espinal. Descripcion: paciente de sexo femenino, cuadro progresivo de compresion medular dorsal, con antecedentes de neurocisticercosis. Las neuroimagenes mostraron una lesion intradural - extramedular D5-D6. Intervencion: se abordo quirurgicamente en posicion lateral, verificandose aracnoiditis reaccional y quiste de cisticerco que fue resecado, completandose el tratamiento con Albendazol oral, con regresion de la paraparesia severa preoperatoria y satisfactorio con control imagenologico. Conclusion: la forma espinal es infrecuente en el curso de la neurocisticercosis. La terapeutica implementada en nuestro caso fue concordante con los pocos casos descriptos en la literatura mundial