The resection of tumors within the primary motor cortex is a constant challenge.
Although tractography may help in preoperative planning, it has limited application. While it
can give valuable information on subcortical fibers, it is less accurate in the cortical layer of the brain.
A 38-year-old patient presented with paresis of the right hand and focal epileptic seizures due to
a tumor in the left precentral gyrus. Transcranial magnetic stimulation was not applicable due to
seizures, so microsurgical resection was performed with preoperative tractography and intraoperative
direct electrical stimulation. A histopathological assessment revealed a diagnosis of glioblastoma.
Postoperative magnetic resonance imaging (MRI) showed complete resection. The paresis dissolved
completely during follow-up. Surgery within the precentral gyrus is of high risk and requires multimodal
functional planning. If interpreted with vigilance and consciousness of the underlying physical
premises, tractography can provide helpful information within its limitations, which is especially
subcortically. However, it may also help in the identification of functional cortex columns of the brain
in the presence of a tumor.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:89204 |
| Date | 23 January 2024 |
| Creators | Wende, Tim, Wilhelmy, Florian, Kasper, Johannes, Prasse, Gordian, Franke, Christian, Arlt, Felix, Frydrychowicz, Clara, Meixensberger, Jürgen, Nestler, Ulf |
| Publisher | MDPI |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
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