PDF(Pubmed)
Abstract：
Awake craniotomy is a surgical procedure that has been gaining significance over the past decades. Neuronavigation is an intraoperative technology that locates tumors and monitors the brain cortex during awake craniotomy. The presence of cerebral low-grade gliomas in the frontal lobe creates a risk of affecting vital centers of the brain cortex during surgery. We present a clinical case of a 42-year-old male patient who entered the neurosurgery clinic with a clinical manifestation of headache for two months. MRI showed evidence of the recurrence of a left frontal glioma. Differential diagnoses of frontal gliomas include metastases, abscesses, and cysts. The pathophysiologic background of the disease is the mutation of neuroglial cells, which leads to an abnormal and uncontrollable proliferation. Under sleep-awake anesthesia, operative treatment was performed through left frontal awake craniotomy under neuronavigation. As a result, a total excision was achieved. Motor functions of the right limbs and speech have been preserved. The patient was mobilized on the day after the intervention. Surgery-related complications were not observed. The patient had relief from the symptoms and was discharged on the fifth day. Awake craniotomy combined with neuronavigation was the most efficient and the least harmful method for the excision of the tumor. For low-grade gliomas localized in the frontal area of the encephalon, awake craniotomy is the only secure option for surgery.
摘要：
清醒开颅手术是一种外科手术，在过去的几十年中一直具有重要意义。神经导航是一种术中技术，可在清醒开颅手术中定位肿瘤并监测大脑皮层。额叶中脑低级别神经胶质瘤的存在会在手术期间影响大脑皮层的重要中心。我们介绍了一名42岁的男性患者的临床病例，该患者进入神经外科诊所，临床表现为头痛两个月。MRI显示左额神经胶质瘤复发的证据。额叶胶质瘤的鉴别诊断包括转移，脓肿,和囊肿。该疾病的病理生理背景是神经胶质细胞的突变，导致异常和无法控制的扩散。在睡眠清醒的麻醉下，在神经导航下通过左额清醒开颅术进行手术治疗。因此,实现了完全切除。右肢的运动功能和言语已得到保留。患者在干预后的第二天被动员起来。未观察到手术相关并发症。患者症状缓解，第五天出院。清醒开颅手术联合神经导航是切除肿瘤最有效，危害最小的方法。对于位于脑额叶区域的低级别神经胶质瘤，清醒开颅手术是手术的唯一安全选择。
