脑磁图神经导航引导下的脑功能区手术

目的 研究大脑半球功能区的手术治疗,提高神经功能的保护.方法 本组15例大脑半球内病灶包括:脑胶质瘤、脑膜瘤、海绵状血管瘤、脑脓肿,涉及运动区及语言区.手术前均行脑磁图功能定位,采取脑磁图-神经导航引导下的手术切除.结果 术前肢体运动功能正常的8例中7例术后肌力依然正常,1例对侧肌力减弱;术前肌力减弱的4例中3例术后恢复正常,无变化1例;2例语言区的肿瘤术后功能正常.结论 脑磁图可以准确定位神经功能区域,与神经导航联合应用可以设计合理的手术入路;对皮层表面的腩胶质瘤采用经硬脑膜病灶-脑界面栅栏分隔法,可有效地防止手术早期脑移位的误差,提高手术的准确性,有效地保护神经功能.

Cerebral focus located in functional area:surgical removing under the guidance of magnetoencephalography and neuronavigational system

Objective To study the surgical treatment for focus located on functional area,improve the protection of neurofunction.Methods There are 15 cases of hemisphere domain focus including glioma,meningioma,cavernous hemangioma and abscess,involving the momr area and the linguistic community.Magnetoencephalography was used to locate the functional domain preoperatively,neuronavigation system combining with magnetoencephalography was used during the operations.Results Seven of eight patients have the normal upper limbs function whose limbs function were normal before operation,one patient's muscular strength become weak,in 4 patients whose muscular strength Was weak,3 of them recovered.And one patient has no change,two patients who have the tumor border on the linguistic community recovered postoperatively.Conclusions Magnetoencephalography system can accurately locate the functional area,the reasonable surgical approach will be designed with the help of Magnetoencephalography and neuronavigation system.By the means of the fence which were inserted through dura into the interface between the cerebra and focus,brain shift during the eady operation can be prevented effectively,which will improve the accuracy of operation and protect the ncurofunction.