Transcortical or transcallosal approach to ventricle-associated lesions: a clinical study on the prognostic role of surgical approach |
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Authors: | Asgari Siamak Engelhorn Tobias Brondics Anja Sandalcioglu Ibrahim Erol Stolke Dietmar |
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Institution: | (1) Department of Neurosurgery, University Hospital of Essen, Hufelandstrasse 55, 45147 Essen, Germany,;(2) Department of Neuroradiology, University Hospital of Essen, Hufelandstrasse 55, 45147 Essen, Germany, |
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Abstract: | Most entities in and around the anterior two-thirds of the supratentorial ventricles can be reached via transcortical or transcallosal
approach. This study examined the effect of surgical approach on the postoperative neurological outcome. Thirty-eight patients
with intra- and periventricular supratentorial lesions were operated on by either frontal transcortical or anterior transcallosal
approach. Postoperative diencephalic damage occurred in 22% of patients in the transcortical group and in 36% in the transcallosal
group; transient mutism was virtually equivalent in the two groups. Postoperative epilepsy (26%) and subdural fluid collections
(30%) occurred only in the transcortical group. The incidence of postoperative hemiparesis was higher in the transcallosal
group. There was a high correlation between postoperative Glasgow Outcome Score of 5 and preoperative severity of neurological
disease but no correlation between postoperative Glasgow Outcome Score of 5 and location of the lesion or between postoperative
clinical course and surgical approach. Surgical outcome of ventricle-associated lesions depends mainly on the severity of
preoperative symptoms and not on surgical approach. Additionally, the incidence of postoperative seizures and subdural fluid
collections after transcortical surgery is high. |
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Keywords: | Approach Transcallosal Transcortical Ventricle-associated lesions |
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