부산대학교 도서관

Resections of brain tumours in the left perisylvian area (LPA) carry a risk of language impairment. Thus, intraoperative language monitoring devices are used to explore the functional anatomy of the LPA and to detect beginning aphasia. Following recent approaches (Reulen et al. 1997, Herholz et al. 1997), the present study explored a combined monitoring procedure in 5 right-handed patients who were operated on brain tumours in and adjacent to the LPA. In addition, language and verbal memory was assessed pre- and postoperatively. Preoperatively, no patient was aphasic; however, most subjects showed minor impairments of language and memory. During the operation, which was performed in the wakeful patient, language functions were repeatedly tested using both, a clinical monitoring and an extended electrocortical mapping procedure. The extent of tumour resection (total or subtotal) was adapted to the patient's intraoperative language status. Following these safety procedures, the outcome of surgery was generally favourable. Only one patient suffered an aphasia intraoperatively from which she recovered completely; in the other subjects sporadical and minor impairments of language were observed which largely recovered over a period of several weeks. In subjects who had a preoperative deficit of immediate and long-term prose memory, an improvement of memory was evident on postoperative follow-up testing. Language functions can be effectively monitored using clinical tasks and electrocortical mapping during the removal of tumours in the LPA. [ABSTRACT FROM AUTHOR]