[Methods of intraoperative control in resection of intraparenchymal brain tumors]

Primary CNS tumors represent 1.4% of all malignant neoplasias and 2.4% of total oncological mortality. The principal goal of tumor resection is maximally possible radical removal with minimal injury of normal brain tissue. This is due to correlation between intraoperative trauma of the brain and postoperative neurological deficit and quality of life. Recently intraoperative ultrasonic and fluorescent methods of guidance have been widely introduced in neurosurgical practice. In conditions of altered anatomy ultrasonographic guidance is intended to optimize approach to intracerebral tumors considering eloquent areas and main vessels. This allows decrease of neurological deficit in the postoperative period. Fluorescent guidance provides possibility of visual differentiation of tumor and normal tissue thus defining the borderline. Combination of these two techniques may lead to more radical resection of tumors and minimize injury of normal brain. We operated 70 patients with primary and metastatic intraparenchymal brain tumors. Intraoperative ultrasonographic guidance was applied in 58 cases, fluorescent guidance--in 21, both methods--in 9.