Intraoperative awake brain mapping and multimodal image-guided resection of dominant side insular glioma

Neurosurg Focus. 2018 Oct;45(VideoSuppl2):V2. doi: 10.3171/2018.10.FocusVid.18259.

Abstract

Resection of insular tumors in the dominant hemisphere poses a significant risk of postoperative motor and language deficits. The authors present a case in which intraoperative awake mapping and multi-modal imaging was used to help preserve function while resecting a dominant insular glioma. The patient, a 55-year-old man, came to the clinic after experiencing sudden onset of numbness in the right limbs for 4 months. Preoperative MRI revealed a nonenhancing lesion in the left insular lobe. Gross-total tumor resection was achieved through the transcortical approach, and the patient recovered without language or motor deficits. Informed patient consent was obtained. The video can be found here: https://youtu.be/gFky09ekmzw .

Keywords: glioma; insula; transcortical resection; video.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Brain Mapping / methods*
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / surgery
  • Cerebral Cortex / diagnostic imaging*
  • Cerebral Cortex / surgery
  • Glioma / diagnostic imaging*
  • Glioma / surgery
  • Humans
  • Intraoperative Neurophysiological Monitoring / methods*
  • Male
  • Middle Aged
  • Multimodal Imaging / methods*
  • Wakefulness*