How I do it: trans-cortical approach for insular diffuse glioma

Area of Science:

• Neurosurgery
• Neuro-oncology
• Brain Mapping

Background:

• The trans-cortical approach is utilized for function-based resection of insular diffuse glioma.
• This method demonstrates a favorable benefit-to-risk ratio with minimal permanent morbidity.

Purpose of the Study:

• To evaluate the safety and efficacy of the trans-cortical approach for insular glioma resection.
• To highlight the role of intraoperative functional brain mapping in preserving neurocognitive function.

Main Methods:

• The technique involves a trans-cortical resection of insular diffuse glioma.
• Intraoperative functional brain mapping is performed under awake conditions.
• Direct electrical stimulation at cortical and subcortical levels identifies critical brain connectivity.

Main Results:

• The trans-cortical approach is a safe and efficient method for removing insular diffuse glioma.
• Awake functional brain mapping enables the preservation of brain connectivity and tailored resection.
• Careful attention to preventing vascular damage, especially to lenticulostriate arteries, is crucial.

Conclusions:

• The trans-cortical approach offers a safe and effective strategy for insular glioma resection.
• Intraoperative functional brain mapping is essential for preserving neurocognitive function and optimizing surgical outcomes.
• Meticulous surgical technique is required to minimize vascular complications.