Model of growth and surgical treatment glioblastoma multiforme tumors localized in the motor zone of the brain-use of the direct electrocorticostimulation in the prevention of motor deficit

Abstract

Gioblastoma multiforme lo cal ized in the mo tor area is the sur gi cal chal lenge be cause of the need for more rad i cal re sec tion in or der to ex tend the life of the pa tient, and the other due to the risk that rad i cal ism could lead to ad di tional-crip pling neu ro log i cal def i cit. Method. We pres ent a se ries of 26 pa tients with Glioblastoma multiforme local ized in and around the mo tor area in front of the cen tral sulcus who were hos pi tal ized from Oc tober 2004 to Feb ru ary 2009. Dur ing all op er a tions we con ducted cor ti cal electrostimulation on dis played area of the brain, to the an a tom i cal lo ca tion of M1 seg ment of the mo tor cor tex. Re sults. Dis tance of the cen tral sulcus in re la tion to the cor o nary su ture, measured by mag netic res o nance im ag ing (MRI) was 18.38 mm±9.564 mm. The vol ume of elec tric ity required for a mo tor re sponse was 9.26±1.286 mA(min. 7mA, max. 11mA), with in creas ing dis tance from the cor o nary su ture the am per age re quired to ex plicit mo tor re sponses de creased (p<0.01). Con clu sion: The method of di rect ce re bral cor tex elec tro-stim u la tion is sim ple and safe method and a bind ing pro to col to the pa tient safe op er a tion glioblastoma multiforme local ized in the mo tor area of the brain. Key words : glioblastoma multiforme, ce re bral mo tor cor tex, electrocorticostimulation IN TRO DUC TION M a lig nant gliomas cause a to tal of 2.5% of can cer deaths per year and the third cause of death from cancer at the age of 15 to 34 years of age 1,2. Ac tual po si tion on low grade glioma brain tu mors is that they are clas si fied as ma lig nant, with an av er age survival of 4 to 9 years 3. Re sults of group of au thors in di cate that rad i cal sur gi cal re sec tion may post pone ma lig nant trans for ma tion and pro long sur vival time 4 .