Language and Visual Deficits after Parietal Lobe Glioma Microsurgery
Keywords:parietal lobe glioma, Visual deficits, Language deficits, Supramarginal gyrus, Angular gyrus, Parietal lobe syndromes
Objective: To see language and visual field outcome after high grade glioma excision of parietal lobe area.
Study Design: It was observational experimental study.
Setting: Department of neurosurgery unit 1, Lahore General Hospital, Lahore.
Duration: Three years from March 2015 to April 2018.
Inclusion Criteria: Both male and female of 13 to 56 yrs of age having intrinsic tumours in left or right parietal lobe area with midline shift, seizure and headache.
Exclusion Criteria: Butterfly glioma, gliomatosis cerebri, lymphoma suspected on MRI brain, patient unfit for anaesthesia and surgery. The patients on anticoagulants and with bleeding disorder were also excluded from the surgery. The patients with chronic systemil ailment like renal failure, liver failure and ischemic heart disease were also excluded from the study.
Material and Methods: Two hundred and forty one (241) patients were included in the study. All patients were prepared for the surgery and informed consent obtained from all patients. All patients under went microsurgical excision of the tumours and followed for 3 months. But forty patients lost to follow-up in three months.
Results: Maximum tumor resection was attempted up to 99 percent. Median age was 47 years (13 – 56 years) and kernofsky performance scale was 75 percent at presentation. Most common presentation was seizure 76 percent, only 3.5 percent presented with parietal lobe syndromes. The most common deficit was language disturbance, which was also noticed in patients with right parietal lobe gliomas. Parietal lobe gliomas produce language and visual deficits in addition to other neurological dysfunction.
Recommendations: Result can be improved by preoperative better localization with diffusion tensor tractography and peroperative cortical mapping.
Conclusions: Microsurgical resection would increase language and visual deficits in tumors located on supramarginal and angular gyri which are reduced in postoperative period and become fixed in three months.
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