as soon as is submitted to ZB.
Neurosurgery for eloquent lesions in children: State-of-the-art rationale and technical implications of perioperative neurophysiology.
Neurosurg. Focus 53:E4 (2022)
OBJECTIVE: In adult patients, an increasing group of neurosurgeons specialize entirely in the treatment of highly eloquent tumors, particularly gliomas. In contrast, extensive perioperative neurophysiological workup for pediatric cases has been limited essentially to epilepsy surgery. METHODS: The authors discuss radio-oncological and general oncological considerations based on the current literature and their personal experience. RESULTS: While several functional mapping modalities facilitate preoperative identification of cortically and subcortically located eloquent areas, not all are suited for children. Direct cortical intraoperative stimulation is impractical in many young patients due to the reduced excitability of the immature cortex. Behavioral requirements also limit the utility of functional MRI and magnetoencephalography in children. In contrast, MRI-derived tractography and navigated transcranial magnetic stimulation are available across ages. Herein, the authors review the oncological rationale of function-guided resection in pediatric gliomas including technical implications such as personalized perioperative neurophysiology, surgical strategies, and limitations. CONCLUSIONS: Taken together, these techniques, despite the limitations of some, facilitate the identification of eloquent areas prior to tumor surgery and radiotherapy as well as during follow-up of residual tumors.
Altmetric
Additional Metrics?
Edit extra informations
Login
Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Epilepsy Surgery ; Glioma ; Language ; Motor ; Neuromonitoring ; Neurophysiology ; Preoperative Mapping; Transcranial Magnetic Stimulation; Brain-tumor Surgery; Cortical Stimulation; Motor; Improves; Plasticity; Resection; Adult
ISSN (print) / ISBN
1092-0684
e-ISSN
1092-0684
Journal
Neurosurgical Focus
Quellenangaben
Volume: 53,
Issue: 6,
Article Number: E4
Publisher
American Association of Neurological Surgeons
Publishing Place
5550 Meadowbrook Drive, Rolling Meadows, Il 60008 Usa
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Radiation Medicine (IRM)