{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:09Z","timestamp":1787025729304,"version":"build-2736575974"},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2013,10]]},"abstract":"\n Object<\/jats:title>\n The aim of surgical glioma treatment is the complete resection of tumor tissue while preserving neurological function. Surgery-related neurological deficits arise from direct damage to the cortical or subcortical structures or from ischemia. The authors aimed to assess the incidence of resection-related ischemia of newly diagnosed or recurrent supratentorial gliomas and the sensitivity of intraoperative neuromonitoring (IOM) of motor evoked potentials (MEPs) for detecting such ischemic events and their influence on neurological motor function.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Between January 2009 and December 2010, 70 patients with tumors in motor-eloquent brain areas underwent intraoperative MEP monitoring during glioma resection and were examined by early postoperative MRI including diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping. Postoperative areas of restricted diffusion were assessed by investigators blinded to the course of intraoperative MEPs and the neurological course.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among the 70 enrolled patients, a MEP amplitude decline below 50% of the baseline level was observed in 21 patients (30%). Sixteen of these patients (76%) had ischemic lesions identified on postoperative MRI scans. Forty-nine patients (70%) showed no decline in MEP amplitude, and only 16 (33%) of these patients harbored ischemic lesions. Moreover, 9 (69%) of 13 patients with a permanent loss of MEP amplitude showed postoperative ischemic lesions. Factors that promoted the occurrence of postoperative infarction were previous radiotherapy and location of the tumor close to the central arteries.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Alterations in the MEP amplitude during tumor resection and postoperative ischemic lesions are associated with postoperative impairment of motor function. Rather than cortical or subcortical structural damage of eloquent brain tissue alone, peri- or postoperative ischemic lesions play a crucial role in the development of surgery-related motor deficits.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2013.5.jns121981","type":"journal-article","created":{"date-parts":[[2013,7,5]],"date-time":"2013-07-05T09:56:30Z","timestamp":1373018190000},"page":"829-836","source":"Crossref","is-referenced-by-count":57,"title":["Postoperative ischemic changes after glioma resection identified by diffusion-weighted magnetic resonance imaging and their association with intraoperative motor evoked potentials"],"prefix":"10.3171","volume":"119","author":[{"given":"Jens","family":"Gempt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro M.","family":"Krieg","sequence":"additional","affiliation":[{"name":"Neurochirurgische Klinik und Poliklinik; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"H\u00fcttinger","sequence":"additional","affiliation":[{"name":"Neurochirurgische Klinik und Poliklinik; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Buchmann","sequence":"additional","affiliation":[{"name":"Neurochirurgische Klinik und Poliklinik; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Mi","family":"Ryang","sequence":"additional","affiliation":[{"name":"Neurochirurgische Klinik und Poliklinik; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehab","family":"Shiban","sequence":"additional","affiliation":[{"name":"Neurochirurgische Klinik und Poliklinik; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Meyer","sequence":"additional","affiliation":[{"name":"Neurochirurgische Klinik und Poliklinik; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Zimmer","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Neuroradiologie, Klinikum rechts der Isar, Technische Universit\u00e4t, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"F\u00f6rschler","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Neuroradiologie, Klinikum rechts der Isar, Technische Universit\u00e4t, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Ringel","sequence":"additional","affiliation":[{"name":"Neurochirurgische Klinik und Poliklinik; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns121981","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1227\/00006123-198711000-00001","article-title":"Reoperation in the treatment of recurrent intracranial malignant gliomas","volume":"21","author":"Ammirati","year":"1987"},{"key":"b2-jns121981","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1097\/00006123-199804000-00013","article-title":"Survival and functional status after resection of recurrent glioblastoma multiforme","volume":"42","author":"Barker","year":"1998"},{"key":"b3-jns121981","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1227\/01.NEU.0000249206.58601.DE","article-title":"Intraoperative subcortical language tract mapping guides surgical removal of gliomas involving speech areas","volume":"60","author":"Bello","year":"2007"},{"key":"b4-jns121981","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.3171\/jns.2003.98.6.1175","article-title":"Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the Glioma Outcome Project","volume":"98","author":"Chang","year":"2003"},{"key":"b5-jns121981","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.1002\/cncr.20867","article-title":"Survival rates in patients with low-grade glioma after intraoperative magnetic resonance image guidance","volume":"103","author":"Claus","year":"2005"},{"key":"b6-jns121981","series-title":"J Neurooncol","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1007\/s11060-011-0784-1","article-title":"Risk of ischemia in glioma surgery: comparison of first and repeat procedures","volume":"107","author":"D\u00fctzmann","year":"2012"},{"key":"b7-jns121981","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"801","DOI":"10.3171\/2012.12.JNS12125","article-title":"Postoperative ischemic changes following resection of newly diagnosed and recurrent gliomas and their clinical relevance. 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