大脑运动区皮质下占位性病变的外科治疗

Surgical treatment for subcortical mass around cerebral motor region

目的 探讨大脑运动区皮质下占位性病变的外科治疗.方法 19例患者均采用B超定位病变,皮层直接电刺激定位运动区,合理脑沟入路切除病变.结果 病变全切除16例,近全切除3例;术后17例临床症状改善,2例无改善,16例术后随访时间3-33个月,平均19个月,复发3例,其中1例死亡.结论 在B超、皮层直接电刺激的辅助下,选择合理的脑沟入路、精细的显微操作切除大脑运动区附近病变,可以获得较好的临床疗效.

Objective To investigate the surgical management of subcortical mass around cerebral motor region. Method 19 patients were performed appropriate trans - sulcus approach to resect the subcortical mass, with the mass identified by ultrasound and motor region identified by direct cortical electrical stimulation. Results 16 of 19 patients were received gross total resection and three were subtotal resection. 17 patients were improved after operation while 2 still had preoperative neurological deficits. 16 patients received regularly follow -up in the subsequent 3-33 months,average 19 months. 3 of them had recurred lesions, one was dead. Conclusions The outcome of patients, who had lesions around motor region, may be improved by appropriate trans - sulcus approach, careful manipulation, assistance of ultrasound and direct cortical electrical stimulation.