Functional plasticity of language confirmed with intraoperative electrical stimulations and updated neuronavigation: Case report of low-grade glioma of the left inferior frontal gyrus

Taiichi Saito, Yoshihiro Muragaki*, Isamu Miura, Manabu Tamura, Takashi Maruyama, Masayuki Nitta, Kaoru Kurisu, Hiroshi Iseki, Yoshikazu Okada

*この研究の対応する著者

研究成果: Article査読

14 被引用数 (Scopus)

抄録

Removal of glioma from the dominant side of the inferior frontal gyrus (IFG) is associated with a risk of permanent language dysfunction. While intraoperative cortical and subcortical electrical stimulations can be used for functional language mapping in an effort to reduce the risk of postoperative neurological impairment, the extent of resection is limited by the functional boundaries. Recent reports proposed that a two-stage surgical approach for low-grade glioma in eloquent areas could avoid permanent deficits via the functional plasticity that occurs between the two operations. The report describes a patient with World Health Organization (WHO) grade II oligoastrocytoma in the left IFG, in functional plasticity of language occurred in the interval between two consecutive surgeries. Intraoperative electrical stimulations suggested that a language area and related subcortical fiber crossed the pre-central sulcus during tumor progression owing to functional plasticity. In the present case, we integrated neurophysiological data into the intraoperative neuronavigation system. We also confirmed the peri-lesional shift of language area and related subcortical fiber on image findings. Consequently, the tumor was sub-totally removed with two separate resections. Permanent language disturbance did not occur, and this favorable outcome was attributed to functional plasticity. The present experience sustains the multistage approach for lowgrade gliomas in the language area. A combination of intraoperative electrical stimulations and updated neuronavigation may facilitate the characterization of brain functional plasticity.

本文言語English
ページ(範囲)587-592
ページ数6
ジャーナルNeurologia Medico-Chirurgica
54
7
DOI
出版ステータスPublished - 2014 7月 15
外部発表はい

ASJC Scopus subject areas

  • 外科
  • 臨床神経学

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