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How I do it? Anatomical multifocal high-grade glioma resection
Zixiao Yang1, Jianping Song2, Wei Zhu1
1Department of Neurosurgery, Huashan Hospital, Shanghai Medical Collage, Fudan University, No.12 Wulumuqi Zhong Road, Shanghai, 200040, China.
Acta Neurochirurgica
|November 12, 2020
Summary
For gliomas near the language area, anatomical resection guided by diffusion tensor imaging (DTI) is crucial when awake surgery is not feasible. This strategy ensures safe and effective tumor removal, preserving neurological function.
Area of Science:
- Neurosurgery
- Neuro-oncology
- Neuroradiology
Background:
- Awake surgery is often preferred for gliomas near eloquent brain areas like the language cortex.
- However, patient intolerance or technical limitations can preclude awake procedures.
Purpose of the Study:
- To present a case of multifocal high-grade gliomas in the language area where awake surgery was not an option.
- To highlight the utility of diffusion tensor imaging (DTI) and anatomical resection strategies in such challenging cases.
Main Methods:
- A patient with deep-seated, multifocal high-grade gliomas in the left temporal lobe (including Wernicke's area) was treated.
- Due to inability to undergo awake surgery and obtain functional MRI, an anatomical resection strategy guided by DTI was employed.
Main Results:
- The surgical strategy successfully guided the resection of gliomas located in critical language areas.
- Diffusion tensor imaging provided essential anatomical information for safe navigation.
Conclusions:
- This case underscores the importance of DTI in neurosurgical planning for gliomas.
- Anatomical resection strategies are vital for achieving safe and effective tumor removal when functional mapping is limited.
