title: Resection extent of the supplementary motor area and post-operative neurological deficits in glioma surgery.
abstract: Objective The supplementary motor area (SMA) is important for the prediction of post-operative symptoms after surgical resection of gliomas. We investigated the relationships between clinical factors and the resection range of SMA gliomas, and the post-operative neurological symptoms. Methods We retrospectively studied 18 consecutive surgeries for gliomas involving the SMA proper performed in 13 patients. Seven cases were recurrence of the tumour. Clinical factors and details of specific resection of the SMA proper (resection of posterior part, medial wall) and cingulate motor area (CMA) were examined. Results Eight cases suffered new post-operative neurological deficits. Six of these eight cases had transient deficits. Permanent deficits persisted in two cases with partial weakness or paresis, after rapid improvement of post-operative global weakness or hemiplegia, respectively. The risk of post-operative neurological deficits was not associated with the resection of the posterior part of the SMA proper or the CMA, but was associated with resection of the medial wall of the SMA proper. Surgery for recurrent tumour was associated with post-operative neurological deficits. The medial wall was frequently resected in recurrent cases. Discussion The frequency of post-operative neurological symptoms, including SMA syndrome, may be higher after resection of the medial wall of the SMA proper compared with the resection of only the lateral surface of the SMA proper.
authors.affiliation: a Department of Neurosurgery , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ibe
authors.affiliation: a Department of Neurosurgery , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tosaka
authors.affiliation: a Department of Neurosurgery , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Horiguchi
authors.affiliation: a Department of Neurosurgery , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugawara
authors.affiliation: a Department of Neurosurgery , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Miyagishima
authors.affiliation: a Department of Neurosurgery , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Hirato
authors.affiliation: a Department of Neurosurgery , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Yoshimoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005910:Glioma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods; D010291:Paresis / Q000473:pathology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D055815:Young Adult
keywords: Gliomas; recurrence; resection; supplementary motor area