Surgical treatment of adult patients with thalamic tumors with the aid of tractography, fMRI, transcranial electrical stimulation and direct electrical stimulation of the subcortical white matter

Publication date: Available online 17 July 2018Source: Neurologia i Neurochirurgia PolskaAuthor(s): Krzysztof Majchrzak, Barbara Bobek-Billewicz, Anna Hebda, Piotr Adamczyk, Henryk Majchrzak, Piotr ŁadzińskiAbstractThe aim of investigation was to assess treatment outcomes in adult patients with thalamic tumors, operated on with the aid of tractography (DTI) and monitoring of motor evoked potentials (MEPs) generated due to transcranial electrical stimulation (TES) and direct electrical stimulation (DES) of the subcortical white matter.38 subsequent patients with thalamic tumors were operated on using tractography (DTI)-integrated neuronavigation, transcranial electrical stimulation (TES) and direct electrical stimulation (DES). The volumetric method was used to calculate pre- and postoperative tumor volume.Total tumor resection (100%) was performed in 18 (47%) patients, subtotal in 9 (24%) (mean extent of resection −89.4%) and partial in 11 (29%) patients (mean extent of resection −77.18%). The mean extent of resection for all surgical patients was 86.5%.Two (5.2%) patients died postoperatively. Preoperative hemiparesis was present in 18 (47%) patients. Postoperative hemiparesis was observed in 11 (29%) patients of whom only in 5 (13%) new paresis was noted due to surgical intervention. In patients with hemiparesis significantly more frequently larger tumor volume was detected preoperatively. Low mean normal fractional anisotropy (nFA) values in the internal capsule were...
Source: Polish Journal of Neurology and Neurosurgery - Category: Neurosurgery Source Type: research