論文

国際誌
2018年4月

Surgical strategy to avoid ischemic complications of the pyramidal tract in resective epilepsy surgery of the insula: technical case report.

Journal of neurosurgery
  • Naoki Ikegaya
  • ,
  • Akio Takahashi
  • ,
  • Takanobu Kaido
  • ,
  • Yuu Kaneko
  • ,
  • Masaki Iwasaki
  • ,
  • Nobutaka Kawahara
  • ,
  • Taisuke Otsuki

128
4
開始ページ
1173
終了ページ
1177
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.3171/2017.1.JNS161278

Surgical treatment of the insula is notorious for its high probability of motor complications, particularly when resecting the superoposterior part. Ischemic damage to the pyramidal tract in the corona radiata has been regarded as the cause of these complications, resulting from occlusion of the perforating arteries to the pyramidal tract through the insular cortex. The authors describe a strategy in which a small piece of gray matter is spared at the bottom of the periinsular sulcus, where the perforating arteries pass en route to the pyramidal tract, in order to avoid these complications. This method was successfully applied in 3 patients harboring focal cortical dysplasia in the posterior insula and frontoparietal operculum surrounding the periinsular sulcus. None of the patients developed permanent postoperative motor deficits, and seizure control was achieved in all 3 cases. The method described in this paper can be adopted for functional preservation of the pyramidal tract in the corona radiata when resecting epileptogenic pathologies involving insular and opercular regions.

リンク情報
DOI
https://doi.org/10.3171/2017.1.JNS161278
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28598277
ID情報
  • DOI : 10.3171/2017.1.JNS161278
  • PubMed ID : 28598277

エクスポート
BibTeX RIS