Delayed Deep White Matter Ischemia After Resection of Gliomas by Awake Surgery Article Swipe
Takahiro Tsuchiya
,
Masamichi Takahashi
,
Makoto Ohno
,
Shunsuke Yanagisawa
,
Sho Osawa
,
Shohei Fujita
,
Yoshitaka Narita
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1227/neuprac.0000000000000105
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1227/neuprac.0000000000000105
BACKGROUND AND OBJECTIVES: Deep white matter (DWM) is perfused by the medullary arteries from the cortex, and ischemia sometimes occurs after glioma resection. However, the clinical significance of postoperative medullary artery–related ischemia has not been well studied. We retrospectively reviewed cases of delayed DWM ischemia after awake craniotomy to elucidate the clinical characteristics, mechanisms, and management of delayed ischemia. METHODS: We identified 4 cases of intra-axial brain tumors, mainly gliomas, that underwent tumor resection by awake craniotomy at our hospital and developed DWM ischemic symptoms after surgery, despite no worsening of neurological symptoms at the end of surgery. RESULTS: Four patients (3 men and 1 woman) presented with glioblastoma, oligodendroglioma, astrocytoma, and brain metastasis. The median age at surgery was 47.5 years (41-73 years). The tumors were located in the watershed area in the frontal lobe ( n = 2) and the parietal lobe ( n = 2), all of which were left-sided ( n = 4). DWM ischemic symptoms, such as motor dysfunction, aphasia, dysarthria, and dysgraphia, developed at an average of 24 hours (14-48 hours) after resection by awake craniotomy. All 4 patients showed symptom improvement within a week after surgery and completely recovered within a month. CONCLUSION: DWM ischemia is caused by sacrifice of the medullary artery, which feeds the tumor and adjacent brain tissue during tumor resection, and should be considered when delayed aphasia or paralysis occurs postoperatively. These symptoms are often transient and recovery usually occurs. Tumors located in the frontal or parietal lobes, particularly in the watershed area, should be carefully monitored for postoperative ischemia.
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Metadata
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- article
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- en
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- References
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- OpenAlex ID
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https://openalex.org/W4404349185Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1227/neuprac.0000000000000105Digital Object Identifier
- Title
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Delayed Deep White Matter Ischemia After Resection of Gliomas by Awake SurgeryWork title
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-08-28Full publication date if available
- Authors
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Takahiro Tsuchiya, Masamichi Takahashi, Makoto Ohno, Shunsuke Yanagisawa, Sho Osawa, Shohei Fujita, Yoshitaka NaritaList of authors in order
- Landing page
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https://doi.org/10.1227/neuprac.0000000000000105Publisher landing page
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YesWhether a free full text is available
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diamondOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1227/neuprac.0000000000000105Direct OA link when available
- Concepts
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Medicine, Ischemia, Craniotomy, Surgery, Anesthesia, Astrocytoma, White matter, Glioma, Magnetic resonance imaging, Radiology, Internal medicine, Cancer researchTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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| abstract_inverted_index.or | 228, 246 |
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| abstract_inverted_index.4). | 156 |
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| abstract_inverted_index.DWM | 43, 82, 157, 200 |
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| abstract_inverted_index.47.5 | 120 |
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| abstract_inverted_index.awake | 46, 75, 180 |
| abstract_inverted_index.brain | 66, 112, 216 |
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| abstract_inverted_index.feeds | 211 |
| abstract_inverted_index.hours | 174 |
| abstract_inverted_index.motor | 162 |
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| abstract_inverted_index.tumor | 72, 213, 219 |
| abstract_inverted_index.which | 150, 210 |
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| abstract_inverted_index.(14-48 | 175 |
| abstract_inverted_index.(41-73 | 122 |
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| abstract_inverted_index.caused | 203 |
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| abstract_inverted_index.glioma | 21 |
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| abstract_inverted_index.lobes, | 248 |
| abstract_inverted_index.mainly | 68 |
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| abstract_inverted_index.aphasia | 227 |
| abstract_inverted_index.artery, | 209 |
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| abstract_inverted_index.delayed | 42, 57, 226 |
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| abstract_inverted_index.frontal | 134, 245 |
| abstract_inverted_index.located | 127, 242 |
| abstract_inverted_index.occurs. | 240 |
| abstract_inverted_index.surgery | 118, 192 |
| abstract_inverted_index.symptom | 186 |
| abstract_inverted_index.tumors, | 67 |
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| abstract_inverted_index.years). | 123 |
| abstract_inverted_index.However, | 23 |
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| abstract_inverted_index.RESULTS: | 98 |
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| abstract_inverted_index.aphasia, | 164 |
| abstract_inverted_index.arteries | 12 |
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| abstract_inverted_index.hospital | 79 |
| abstract_inverted_index.ischemia | 17, 31, 44, 201 |
| abstract_inverted_index.ischemic | 83, 158 |
| abstract_inverted_index.parietal | 142, 247 |
| abstract_inverted_index.patients | 100, 184 |
| abstract_inverted_index.perfused | 8 |
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| abstract_inverted_index.studied. | 36 |
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| abstract_inverted_index.surgery. | 97 |
| abstract_inverted_index.symptoms | 84, 92, 233 |
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| abstract_inverted_index.developed | 81, 168 |
| abstract_inverted_index.elucidate | 49 |
| abstract_inverted_index.ischemia. | 58, 260 |
| abstract_inverted_index.medullary | 11, 29, 208 |
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| abstract_inverted_index.paralysis | 229 |
| abstract_inverted_index.presented | 106 |
| abstract_inverted_index.recovered | 195 |
| abstract_inverted_index.resection | 73, 178 |
| abstract_inverted_index.sacrifice | 205 |
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| abstract_inverted_index.symptoms, | 159 |
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| abstract_inverted_index.watershed | 130, 252 |
| abstract_inverted_index.worsening | 89 |
| abstract_inverted_index.BACKGROUND | 0 |
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| abstract_inverted_index.considered | 224 |
| abstract_inverted_index.craniotomy | 47, 76 |
| abstract_inverted_index.identified | 61 |
| abstract_inverted_index.left-sided | 152 |
| abstract_inverted_index.management | 55 |
| abstract_inverted_index.resection, | 220 |
| abstract_inverted_index.resection. | 22 |
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| abstract_inverted_index.OBJECTIVES: | 2 |
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| abstract_inverted_index.dysgraphia, | 167 |
| abstract_inverted_index.improvement | 187 |
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| abstract_inverted_index.astrocytoma, | 110 |
| abstract_inverted_index.dysfunction, | 163 |
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| abstract_inverted_index.significance | 26 |
| abstract_inverted_index.glioblastoma, | 108 |
| abstract_inverted_index.postoperative | 28, 259 |
| abstract_inverted_index.retrospectively | 38 |
| abstract_inverted_index.artery–related | 30 |
| abstract_inverted_index.characteristics, | 52 |
| abstract_inverted_index.postoperatively. | 231 |
| abstract_inverted_index.oligodendroglioma, | 109 |
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| institutions_distinct_count | 7 |
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| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |