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Brain Arteriovenous Malformations Located in Language Area: Surgical Outcomes and Risk Factors for Postoperative Language Deficits

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机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China; [2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [3]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [4]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China; [5]Fujian Med Univ, Affiliated Hosp 1, Dept Neurosurg, Fuzhou, Fujian, Peoples R China
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关键词: Diffusion tensor imaging Functional magnetic resonance imaging Geschwind's area Language area BAVMs Risk factor Surgical outcome

摘要:
OBJECTIVE: Case selection for surgical treatment of language-area brain arteriovenous malformations (L-BAVMs) remains difficult. This study aimed to determine the surgical outcomes and risk factors for postoperative language deficits (LDs) in patients with L-BAVMs. METHODS: Patients with L-BAVMs who underwent microsurgical resection between September 2012 and June 2016 were reviewed. All patients had undergone preoperative functional magnetic resonance imaging and diffusion tensor imaging. Both functional and angioarchitectural factors were analyzed regarding the postoperative LD. Functional factors included the eloquence involved, the side of blood-oxygenation level-dependent signal activation and the white-matter fibers (anterior segment, long segment [LS], and posterior segment of arcuate fasciculus, and the inferior fronto-occipital fasciculus) involved. RESULTS: Sixty-nine patients with L-BAVMs were reviewed. Postoperative short-and long-term LD was found in 32 (46.4%) and 14 (20.3%) patients, respectively. Twelve of the 14 patients with Geschwind's territory L-BAVMs (85.7%) had short-term LD, compared with 10 (34.5%) in Wernicke's and 10 (38.5%) in Broca's area. LS involvement (P = 0.001) and larger nidus size (P = 0.017) were independent risk factors for the short-term LD. Meanwhile, nidus size (P = 0.007), preoperative LD (P = 0.008), and LS involvement (P = 0.028) were independent risk factors for long-term LD. CONCLUSIONS: L-BAVMs located in Geschwind's territory can cause a high incidence of LD. LS involvement and larger nidus size are risk factors for postoperative shortand long-term LD, and preoperative LD is a risk factor for postoperative, long-term LD.

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出版当年[2016]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 外科
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
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出版当年[2015]版:
Q1 SURGERY Q2 CLINICAL NEUROLOGY
最新[2023]版:
Q2 SURGERY Q3 CLINICAL NEUROLOGY

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第一作者机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China; [2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [3]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [4]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China;
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China; [2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [3]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [4]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China;
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