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Neurologic Outcome After Resection of Parietal Lobe Including Primary Somatosensory Cortex: Implications of Additional Resection of Posterior Parietal Cortex.
- Source :
-
World neurosurgery [World Neurosurg] 2017 Oct; Vol. 106, pp. 884-890. Date of Electronic Publication: 2017 Jul 19. - Publication Year :
- 2017
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Abstract
- Objective: Postoperative neurologic outcomes after primary somatosensory cortex (S1) resection have not been well documented. This study was designed to evaluate the neurologic deterioration that follows resection of the S1 areas and to assess the risk factors associated with these morbidities.<br />Methods: We reviewed 48 consecutive patients with medically intractable epilepsy who underwent resection of the S1 and/or the adjacent cortex. The 48 patients were categorized into 4 groups according to the resected area as seen on postoperative magnetic resonance images: group 1 (resection of S1 only; n = 4), 2 (the posterior parietal cortex [PPC] only; n = 24), 3 (S1 and PPC; n = 10), and 4 (S1 and precentral gyrus; n = 10).<br />Results: After the resection of S1 areas, 19 patients (40%) experienced neurologic worsening, including 6 (13%) with permanent and 13 (27%) with transient deficits. Patients with permanent deficits included 2 with motor dysphasia, 1 with dysesthesia, 2 with equilibrium impairments, and 1 with fine movement disturbance of the hand. The overall and permanent neurologic risks were 25% and 0% in group 1, 17% and 4% in group 2, 80% and 20% in group 3, and 60% and 30% in group 4, respectively. Multivariate analysis determined that the resection of both S1 and PPC was the only significant risk factor for neurologic deficits (P = 0.002).<br />Conclusions: The neurologic risk of the resection of S1 and/or its adjacent cortical areas was 40%. The additional resection of the PPC was significantly associated with the development of postoperative neurologic impairments.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Drug Resistant Epilepsy diagnostic imaging
Drug Resistant Epilepsy surgery
Female
Humans
Male
Middle Aged
Nervous System Diseases etiology
Neurosurgical Procedures adverse effects
Postoperative Complications etiology
Treatment Outcome
Young Adult
Nervous System Diseases diagnostic imaging
Parietal Lobe diagnostic imaging
Parietal Lobe surgery
Postoperative Complications diagnostic imaging
Somatosensory Cortex diagnostic imaging
Somatosensory Cortex surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 106
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 28735133
- Full Text :
- https://doi.org/10.1016/j.wneu.2017.07.066