Surgery of Insular Gliomas

For a long time, surgery within the insular lobe, especially in cases of intrinsic tumors, was considered as too dangerous. Even though such interventions are still challenging, resection of insular glioma became more popular during the past decade. First of all, this has happened due to better understanding of the functional anatomy of this complex brain region, combined with an improved knowledge of its connectivity. Furthermore, development of advanced intraoperative techniques, especially functional brain mapping with direct electrical stimulation, resulted in increased safety of procedures. Finally, recent evidence-based data from multiple clinical studies strongly support early maximal safe resection of both low- and high-grade gliomas. These conceptual and methodological advances led neurosurgeons to envision surgical strategy for insular gliomas in a more systematic manner.