neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.63769/1683-3295-2015-0-2-62-67neurosurgery-166Research ArticleНАБЛЮДЕНИЕ ИЗ ПРАКТИКИFROM PRACTICEУДАЛЕНИЕ АСТРОЦИТОМЫ ЛЕВЫХ ВИСОЧНОЙ И ОСТРОВКОВОЙ ДОЛЕЙ ГОЛОВНОГО МОЗГА У ПАЦИЕНТА С ИСПОЛЬЗОВАНИЕМ ИНТРАОПЕРАЦИОННОГО КАРТИРОВАНИЯ РЕЧЕВЫХ ЗОН В УСЛОВИЯХ ИНТРАОПЕРАЦИОННОГО ПРОБУЖДЕНИЯThe removal of left temporal and insular astrocytoma using intraoperative mapping of language zones under conditions of intraoperative awakeningЗуевАндрей АлександровичZuevA. A.noemail@neicon.ruПедяшНикита ВитальевичPedyashN. V.noemail@neicon.ruИвановаДарья СергеевнаIvanovaD. S.noemail@neicon.ruКуликоваИрина СергеевнаKulikovaI. S.noemail@neicon.ruКузнецовАлексей НиколаевичKuznetsovA. N.noemail@neicon.ruНациональный медико-хирургический центр им. Н.И. ПироговаRussian Federation201505102017026267Copyright © Зуев А.А., Педяш Н.В., Иванова Д.С., Куликова И.С., Кузнецов А.Н., 20172017Зуев А.А., Педяш Н.В., Иванова Д.С., Куликова И.С., Кузнецов А.Н.Zuev A.A., Pedyash N.V., Ivanova D.S., Kulikova I.S., Kuznetsov A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/166

Применение современных медицинских технологий, таких как функциональная МРТ, трактография, интраоперационная сонография, нейронавигация, нейрофизиологическое картирование коры и белого вещества головного мозга у пациента в сознании, значительно уменьшает риск развития послеоперационного неврологического дефицита при удалении опухолей из функционально значимых зон головного мозга. Использование интраоперационного нейрофизиологического картирования коры головного мозга у пациентов в сознании по протоколу asleep-awake-asleep позволяет увеличить радикальность удаления внутримозговых опухолей функционально-значимых речевых зон, при этом значительно снизить риск развития стойкого послеоперационного неврологического дефицита. Однако проведение операций на головном мозге у пациентов в условиях интраоперационного пробуждения требует слаженной работы большой бригады специалистов (нейрохирурга, нейрофизиолога, анестезиолога, нейропсихолога и радиологов). В статье приведен пример успешного лечения пациента с астроцитомой II степени злокачественности левых височной и островковой долей, распространяющейся на речевые зоны.

The usage of such current medical technologies as functional MRI, tractography, intraoperative sonography, neuronavigation, neurophysiological mapping of cortex and white matter of brain at patient in conscious lead to significant decrease of risk of postoperative neurological deficit development during removal of brain tumors located in the functionally significant brain areas. The usage of intraoperative neurophysiological mapping of cerebral cortex at patients in conscious using protocol “asleep-awake-asleep” allows increasing the radicality of removal of parenchymal tumors located in language significant areas with significant decrease risk of refractory postoperative neurological deficit development. However the performing of neurosurgical manipulations on brain under condition of “asleep-awake-asleep” protocol requires слаженной работы of a team including neurosurgeon, neurophysiologist, anesthesiologist, neuropsychologist and radiologist. This article presents the clinical case of successful surgical treatment of patient with left temporal and insular astrocytoma (grade II) with infiltration of language zones.

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The authors declare that there are no conflicts of interest present.