Clinical Features And Treatment Of Tumors Located In The Splenium Of Corpus Callosum

Background:The corpus callosum is an important white matter structure in the human brain.It is responsible for coordinating the tasks of the bilateral cerebral hemispheres when humans perform tasks.It is the most important joint fiber between the hemispheres.The tumors of the corpus callosum mainly include gliomas,lymphomas,and lipomas,among which gliomas are the most common.The tumors of corpus callosum are mainly located in the genu and body of corpus callosum,and tumors located in the splenium are relatively rare.Generally,tumors of corpus callosum are considered to be a disease with more risks than benefits of surgical resection.However,with the development of imaging and microsurgery techniques,surgical resection of corpus callosum tumors has become possible.At present,there are limited data on the treatment and prognosis of tumors of the corpus callosum,especially the splenium,and there are also controversies about surgical methods.Objective:To explore the clinical features,surgical treatment and prognosis of tumors located in the splenium of corpus callosum,and summarize the treatment experience located in the splenium of corpus callosum to guide clinical application.Method:Collected patients with space-occupying lesions of the corpus callosum treated by microsurgery who were admitted to the Department of Neuro-Tumor Surgery of the First Hospital of Jilin University from January 2010 to December2020,and the postoperative pathological reports were gliomas,lymphomas,and lymphomas.For the above tumorous lesions,we retrospectively analyze them,and check the existing literature for demonstration and summary.Result:There are 19 cases in this paper,the male to female ratio is 0.9:1,and the age range is from 27 to 68 years old,with an average of 55.2±12.34 years old.The first symptoms are headache,dizziness,limb dysfunction,and memory loss.In this set of data,there were 11 patients whose tumors occurred in the splenium of corpus callosum and affected both cerebral hemispheres,and there were 8patients whose tumors only affected one cerebral hemisphere.Two of the patients with tumors invading both cerebral hemispheres and with large tumors received bilateral craniotomy through the longitudinal fissure-corpus callosum approach for surgery.The rest of the patients received unilateral approach to remove the tumors,and the total tumor resection rate was 73.6%.According to postoperative pathological diagnosis,glioblastoma,non-Hodgkin’s lymphoma,and anaplastic oligoastrocytoma are the three most common pathological types.On the first day after the operation,there were 9 patients whose clinical symptoms improved compared with the preoperative ones,and 8 patients whose clinical symptoms did not change significantly from those before the operation.Two patients had partial limb dyskinesias before the operation,but after the operation The corresponding limbs have decreased muscle strength and even hemiplegia.In general,the situation of intracranial hypertension is better alleviated,while the degree of relief of limb movement disorders is limited,and the symptoms may even worsen,and the remaining symptoms have not changed significantly in the short term.Conclusion:Glioblastoma is the most common tumor that occurs in the splenium of corpus callosum.When glioma or lymphoma is found in the corpus callosum,surgical treatment should be actively performed.For tumors that occurs in the splenium of corpus callosum,the total resection rate and prognosis of bilateral craniotomy are better than those of unilateral craniotomy.In the preoperative neurological symptoms,intracranial hypertension was better improved,but the clinical manifestations such as slow response and memory decline did not improve significantly in a short time.Skilled microsurgery techniques and the application of assistive technologies such as intraoperative electrophysiology and intraoperative MRI can enable patients to obtain a better prognosis.