Intraoperative magnetic resonance for the surgical treatment of lesions producing seizures

Walker, David G.; Talos, Florin; Bromfield, Edward B; Black, Peter McL.

doi:10.1054/jocn.2002.1134

Cited by 26 publications

(11 citation statements)

References 15 publications

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“…In epilepsy-associated benign lesions such as GGs, use of this technique may decrease the instances of poor seizure control resulting from incomplete resection. 3,11,22,28 In this analysis, complete resection was accomplished in 87% of the patients, as seen in late follow-up MR scans. Moreover, in 91% of the patients who underwent surgery including neuronavigation/ iopMRI, use of iopMRI determined complete resection.…”

Section: Discussionmentioning

confidence: 81%

Resection of cerebral gangliogliomas causing drug-resistant epilepsy: short- and long-term outcomes using intraoperative MRI and neuronavigation

Wimmer¹,

Coras

Blümcke

et al. 2015

FOC

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OBJECT Cerebral gangliogliomas (GGs) are highly associated with intractable epilepsy. Incomplete resection due to proximity to eloquent brain regions or misinterpretation of the resection amount is a strong negative predictor for local tumor recurrence and persisting seizures. A potential method for dealing with this obstacle could be the application of intraoperative high-field MRI (iopMRI) combined with neuronavigation. METHODS Sixty-nine patients (31 female, 38 male; median age 28.5 ± 15.4 years) suffering from cerebral GGs were included in this retrospective study. Five patients received surgery twice in the observation period. In 48 of the 69 patients, 1.5-T iopMRI combined with neuronavigational guidance was used. Lesions close to eloquent brain areas were resected with the implementation of preoperative diffusion tensor imaging tractography and blood oxygenation level–dependent functional MRI (15 patients). RESULTS Overall, complete resection was accomplished in 60 of 69 surgical procedures (87%). Two patients underwent biopsy only, and in 7 patients, subtotal resection was accomplished because of proximity to critical brain areas. Excluding the 2 biopsies, complete resection using neuronavigation/iopMRI was documented in 33 of 46 cases (72%) by intraoperative imaging. Remnant tumor mass was identified intraoperatively in 13 of 46 patients (28%). After intraoperative second-look surgery, the authors improved the total resection rate by 9 patients (up to 91% [42 of 46]). Of 21 patients undergoing conventional surgery, 14 (67%) had complete resection without the use of iopMRI. Regarding epilepsy outcome, 42 of 60 patients with seizures (70%) became completely seizure free (Engel Class IA) after a median follow-up time of 55.5 ± 36.2 months. Neurological deficits were found temporarily in 1 (1.4%) patient and permanently in 4 (5.8%) patients. CONCLUSIONS Using iopMRI combined with neuronavigation in cerebral GG surgery, the authors raised the rate of complete resection in this series by 19%. Given the fact that total resection is a strong predictor of long-term seizure control, this technique may contribute to improved seizure outcome and reduced neurological morbidity.

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Section: Discussionmentioning

confidence: 81%

Resection of cerebral gangliogliomas causing drug-resistant epilepsy: short- and long-term outcomes using intraoperative MRI and neuronavigation

Wimmer¹,

Coras

Blümcke

et al. 2015

FOC

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“…The volume of the residual lesion can be easily assessed especially in deep or eloquent area tumors (3, 13,14). Intraoperative MR imaging guidance has also proven to be useful in stereotactic surgery, epilepsy surgery, transsphenoidal surgery and spine surgery (5,6,9,11,21).…”

Section: Discussionmentioning

confidence: 99%

Use of an ultra-low field intraoperative MRI system for pediatric brain tumor cases: initial experience with ?polestar n20?

Kaya¹,

Deniz²,

Düz³

et al. 2012

Turkish Neurosurgery

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AIm: Use of intraoperative MRI (iMRI) is the highest contemporary supportive means for brain tumor surgery. In this article we describe the issues related to iMRI use in pediatric cranial operations. mAterIAl and methOds: Pediatric cases operated with the aid of Polestar N20 iMRI system are defined and the pros and cons of the system are emphasized. BulGulAr: Özellikle posterior fossa tümörleri için pediatrik olgularda hasta pozisyonlanması daha rahat ve elde edilen görüntü kalitesi daha iyi idi. sOnuÇ: Pediatrik beyin tümörü operasyonlarında iMRI mümkün olduğunca kullanılmalıdır.

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“…Intraoperative MR imaging may be helpful in this setting, and it has been shown to be useful as an adjunct in cases of lesional epilepsy. 3,4,14,23 In nonlesional epilepsy, intraoperative MR imaging has also been used to tailor the extent of resection. It may be especially useful in identifying the resection margins of the amygdala.…”

Section: Neurosurg Focus / Volume 25 / September 2008mentioning

confidence: 99%

Selective amygdalohippocampectomy: the trans-middle temporal gyrus approach

Wheatley¹

2008

FOC

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The most common surgical procedure for the mesial temporal lobe is the standard anterior temporal resection or what is commonly called the anterior temporal lobectomy. There are, however, a number of other more selective procedures for removal of the mesial temporal lobe structures (amygdala, hippocampus, and parahippocampal gyrus) that spare much of the lateral temporal neocortex. Included in these procedures collectively referred to as selective amygdalohippocampectomy are the transsylvian, subtemporal, and transcortical (trans-middle temporal gyrus) selective amygdalohippocampectomy. In this manuscript the author reviews some of the surgical details of the trans-middle temporal gyrus approach to the mesial temporal structures.

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Intraoperative magnetic resonance for the surgical treatment of lesions producing seizures

Cited by 26 publications

References 15 publications

Resection of cerebral gangliogliomas causing drug-resistant epilepsy: short- and long-term outcomes using intraoperative MRI and neuronavigation

Resection of cerebral gangliogliomas causing drug-resistant epilepsy: short- and long-term outcomes using intraoperative MRI and neuronavigation

Use of an ultra-low field intraoperative MRI system for pediatric brain tumor cases: initial experience with ?polestar n20?

Selective amygdalohippocampectomy: the trans-middle temporal gyrus approach

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