Awake Mapping of the Auditory Cortex during Tumor Resection in an Aspiring Musical Performer: A Case Report

Area of Science:

• Neurosurgery
• Neuroimaging
• Music Neuroscience

Background:

• Established methods for language mapping in neurosurgery include preoperative functional MRI (fMRI) and intraoperative awake cortical mapping.
• There is an increasing need to identify and preserve brain regions critical for music production.

Observation:

• A musician with musicogenic seizures underwent surgery for a right posterior temporal tumor.
• Preoperative fMRI identified brain activation near the tumor during musical tasks.
• Intraoperative stimulation did not reveal critical music-related areas at the surgical site.

Findings:

• A gross total tumor resection was performed.
• The patient maintained her singing ability post-surgery.
• At 9-month follow-up, musical ability was preserved, seizures resolved, and no tumor recurrence was observed.

Implications:

• A novel awake craniotomy strategy combining fMRI for music processing and intraoperative stimulation, guided by a musician expert, enabled safe tumor resection.
• This approach successfully preserved the patient's musical function, demonstrating a potential method for similar cases.