Abstract
INTRODUCTIONGlioblastomas often grow in a butterfly shape in the bifrontal lobes. The aggressive removal of these contrast-enhanced lesions may cause serious cognitive dysfunction. In this study, we have analyzed changes of cognitive function, effects on ADL, as well as rehabilitation methods for patients with bifrontal glioblastoma before and after tumor removal.SUBJECTSIn this study, 6 patients including 2 males and 4 females with a mean age of 39.8 were reviewed. All patients exhibited bifrontal glioblastoma that was surgically removed. The primary tumor location was lower-left frontal gyrus for four of the patients, the right preSMA-SMA region for one patient, and the lower-right frontal gyrus for the remaining patient.METHODPatients’cognitive function and ADL evaluated after the tumor removal and at the end of postoperative chemoradiotherapy, were retrospectively analyzed. We compared and verified the features and EOR. An evaluation was performed using MMSE-J, FAB, TMT, RCPM, RBMT, BADS, and FIM.RESULTAfter completion of chemoradiotherapy, 3 patients returned home, 2 were transferred to the hospital, and 1 returned to work. MMSE score was worsen in two patients, and their tumor were located in the lower-right frontal gyrus and the lower-left frontal gyrus. Two cases in the right frontal lobe and two cases in the lower left frontal gyrus scored lower average on the TMT. In our final evaluation, ADL was not worsening after surgery.DISCUSSIONMany patients with bifrontal glioblastoma exhibited disturbance of consciousness due to strong edema before surgery, but they recovered in about two months after the tumor removal and many of them considered back to work. Involvement of prefrontal cortex may be related to severe cognitive dysfunction. Active rehabilitation should be started as soon as possible after surgery to acquire a compensation functions for the cognitive disorders and simulation for social life and work.
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