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| Name | Motor strip Meningioma excision under Intraop monitoring and Neuronavigation |
| Video Uploader | Video From Amit Aiwale |
| Upload Date | This Video Uploaded At 07-10-2025 15:28:12 |
| Video Discription | meningioma is a typically benign, slow-growing tumor arising from the meninges—the protective membranes covering the brain and spinal cord. When a meningioma is located over or near the motor strip (also known as the precentral gyrus), which controls voluntary movement, it poses unique surgical challenges due to the high risk of neurological deficits. 2. Anatomy of the Motor Strip The motor strip is a region of the frontal lobe responsible for initiating motor function, especially of the opposite side of the body. It lies just anterior to the central sulcus. Surgical intervention in this area requires precise planning due to the critical nature of the brain tissue and its role in motor control. 3. Indications for Surgery Surgical removal is typically recommended for: Symptomatic tumors (e.g., seizures, weakness, or headaches) Tumors causing mass effect or edema Progressive neurological decline Radiographic growth on serial imaging 4. Preoperative Evaluation MRI with contrast is the imaging modality of choice to define tumor location, size, and relation to adjacent brain structures. Functional MRI (fMRI) and Diffusion Tensor Imaging (DTI) help map motor pathways. Neurophysiological testing and neurological exams assess baseline motor function. 5. Surgical Planning and Techniques Motor strip meningiomas demand a balance between maximal tumor resection and preservation of motor function. Key surgical considerations include: Awake Craniotomy (in selected patients): Allows intraoperative motor testing to preserve function. Intraoperative neurophysiological monitoring (IONM): Continuous monitoring of motor evoked potentials (MEPs) to avoid injury. Neuronavigation: Image-guided tools improve precision. Microsurgical techniques: Used to dissect the tumor carefully from the surrounding brain tissue. If the tumor is adherent to the motor cortex or invades it, subtotal resection may be chosen to prevent permanent deficits. 6. Postoperative Care Close neurological monitoring in the ICU or step-down unit Postoperative imaging (MRI within 24–72 hours) Rehabilitation (physical and occupational therapy) often required if deficits are present 7. Outcomes and Prognosis Tumor control: Gross total resection (GTR) can often be achieved, but may be limited by the proximity to critical cortex. Neurological outcomes: While many patients recover well, some may experience transient or permanent motor deficits. Recurrence: Lower with Simpson Grade I–II resections; higher with subtotal removal, necessitating follow-up imaging and possibly radiation. |
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