This patient is a
sixty-year-old man who presented with a two-month history of right hand paresis
and mild aphasia. The MR images show a ring-like enhanced tumor in the left
frontal lobe. The tumor is well demarcated and accompanied with edema. The
tumor is located adjacent to the primary motor area. High-grade glioma was most
suspected based on the preoperative examinations.
The operation was
performed under a general anesthesia. The patient was laid in a supine
position. His head was rotated fifteen degrees to the right and fixed with a
three-point fixator.
We made an arc-shaped
skin incision as shown in Figure 1. Then we made a craniotomy in due form. The
brain surface was normal and slightly expanded. We identified the central
sulcus using the monitoring and the neuro-navigation system. A 2 cm corticotomy
was made on the middle frontal gyrus shown in Figure 2. The tumor was well
recognized and resected en bloc. The monitoring system did not show any abnormal
findings during the surgery.
The tumor was sent to
the pathology section. The rapid diagnosis was glioblastoma.
We confirmed that
there was no residual tumor and no blood oozing from the resected cavity wall.
Then we sutured the dura mater and fixed the bone flap with fixators. The skin
was sutured with two layers. There
were no problems during the operation.
He didn't receive a blood transfusion.
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