Lessons from brain mapping in surgery for low-grade glioma: insights into associations between tumour and brain plasticity

被引:472
作者
Duffau, H [1 ]
机构
[1] Dept Neurosurg, Paris, France
关键词
D O I
10.1016/S1474-4422(05)70140-X
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Surgical treatment of low-grade gliomas (LGGs) aims to maximise the amount of tumour tissue resected, while minimising the risk of functional sequelae. In this review I address the issue of how to reconcile these two conflicting goals. First, I review the natural history of LGG-growth, invasion, and anaplastic transformation. Second, I discuss the contribution of new techniques, such as functional mapping, to our understanding of brain reorganisation in response to progressive growth of LGG. Third, I consider the clinical implications of interactions between tumour progression and brain plasticity. In particular, I show how longitudinal studies (preoperative, intraoperative, and postoperative) could allow us to optimise the surgical risk-to-benefit ratios. I will also discuss controversial issues such as defining surgical indications for LGGs, predicting the risk of postoperative deficit, aspects of operative surgical neuro-oncology (eg, preoperative planning and preservation of functional areas and tracts), and postoperative functional recovery.
引用
收藏
页码:476 / 486
页数:11
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