-
- Lorenzo Bello, Marco Riva, Enrica Fava, Valentina Ferpozzi, Antonella Castellano, Fabio Raneri, Federico Pessina, Alberto Bizzi, Andrea Falini, and Gabriella Cerri.
- Neurosurgical Oncology, Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Humanitas Clinical and Research Center, Milan, Italy (L.B., M.R., E.F., F.R., F.P.); Laboratory of Motor Control, Department of Medical Biotechnology and Translational Medicine, University of Milan, Humanitas Clinical and Research Center, Milan, Italy (V.F., G.C.); Scientific Institute and University, Ospedale San Raffaele IRCCS, Neuroradiology, CERMAC, Milan, Italy (A.C., A.F.); Neuroradiology, Humanitas Clinical and Research Center, Milan, Italy (A.B.).
- Neuro-oncology. 2014 Aug 1;16(8):1110-28.
BackgroundResection of motor pathway gliomas requires the intraoperative recognition of essential cortical-subcortical motor structures. The degree of involvement of motor structures is variable, and increases as result of treatments patients are submitted to. Intraoperative neurophysiology offers various stimulation modalities, which efficiency is based on the ability to recognize essential sites with the highest possible resolution in most clinical conditions. Two stimulation paradigms evolved for intraoperative guidance of motor tumors removal: the 60 Hz-technique [low frequency (LF)] and the pulse-technique [high frequency-(HF)], delivered by bipolar or monopolar probe respectively. Most surgical teams rely on to either of the 2 techniques. The key point is the integration of the choice of the stimulation modality with the clinical context.MethodsIn 591 tumors involving the corticospinal tract, the use of HF and LF was tailored to the clinical context defined by patient clinical history and tumor features (by imaging). The effect was evaluated on the feasibility of mapping, the impact on immediate and permanent morbidity, the extent of resection, and the number of patients treated.ResultsBy integrating the choice of the probe and the stimulation protocol with patient clinical history and tumor characteristics, the best probe-frequency match was identified for the different sets of clinical conditions. This integrative approach allows increasing the extent of resection and patient functional integrity, and greatly expands the number of patients who could benefit from surgery.ConclusionsThe integration of stimulation modalities with clinical context enhances the extent and safety of resection and expands the population of patients who could benefit from surgical treatment.© The Author(s) 2014. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.