gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Resection of the primary face motor area in brain tumors

Meeting Abstract

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  • G. Neuloh - Neurochirurgische Klinik, Universität Bonn und Neurochirurgische Klinik, Universität Aachen
  • H. Clusmann - Neurochirurgische Klinik, Universität Bonn und Neurochirurgische Klinik, Universität Aachen

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 069

DOI: 10.3205/11dgnc290, URN: urn:nbn:de:0183-11dgnc2909

Published: April 28, 2011

© 2011 Neuloh et al.
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Outline

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Objective: In brain tumor surgery, considerable effort is devoted to the preservation of the primary face motor area, potentially at the expense of maximum cytoreduction. In epilepsy surgery it had been argued previously that this cortical area can be resected safely without significant sequelae. There are hardly any corresponding data in brain tumors. Here, we analyze a series of brain tumor cases where the lateral-most primary motor area was resected.

Methods: In 18 consecutive cases undergoing surgery for brain tumors, the infiltrated lateral (face) primary motor area was partially or totally resected up to four cm above the sylvian fissure. There were six glioblastomas, eight anaplastic gliomas WHO grade III, three low-grade gliomas, and one metastasis. In seven cases, tumor location was in the language-dominant hemisphere.

Results: In seven cases, there was a transient mild facial weakness postoperatively. In five cases, a moderate hemiparesis (upper and lower extremity) occurred, which resolved to a level of mild weakness in four out of five patients. Postoperative imaging yielded deep white matter ischemia in these cases. There was no new motor deficit in the remaining cases. Aphasia occurred in one case after resection within Broca’s area.

Conclusions: Resection of the primary face motor area is safely possible in brain tumors, even in the language-dominant hemisphere. In some cases, mild and transient facial weakness does occur. However, there is a significant risk of deep stroke and hemiparesis from affection of perisylvian vessels in these patients.