Article
Resection of the primary face motor area in brain tumors
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Authors
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G. Neuloh
- Neurochirurgische Klinik, Universität Bonn und Neurochirurgische Klinik, Universität Aachen
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H. Clusmann
- Neurochirurgische Klinik, Universität Bonn und Neurochirurgische Klinik, Universität Aachen
| Published: | April 28, 2011 |
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Outline
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Objective: In brain tumor surgery, considerable effort is devoted to the preservation of the primary face motor area, potentially at the expense of maximum cytoreduction. In epilepsy surgery it had been argued previously that this cortical area can be resected safely without significant sequelae. There are hardly any corresponding data in brain tumors. Here, we analyze a series of brain tumor cases where the lateral-most primary motor area was resected.
Methods: In 18 consecutive cases undergoing surgery for brain tumors, the infiltrated lateral (face) primary motor area was partially or totally resected up to four cm above the sylvian fissure. There were six glioblastomas, eight anaplastic gliomas WHO grade III, three low-grade gliomas, and one metastasis. In seven cases, tumor location was in the language-dominant hemisphere.
Results: In seven cases, there was a transient mild facial weakness postoperatively. In five cases, a moderate hemiparesis (upper and lower extremity) occurred, which resolved to a level of mild weakness in four out of five patients. Postoperative imaging yielded deep white matter ischemia in these cases. There was no new motor deficit in the remaining cases. Aphasia occurred in one case after resection within Broca’s area.
Conclusions: Resection of the primary face motor area is safely possible in brain tumors, even in the language-dominant hemisphere. In some cases, mild and transient facial weakness does occur. However, there is a significant risk of deep stroke and hemiparesis from affection of perisylvian vessels in these patients.
