Mapping and anatomo-surgical techniques for SMA-cingulum-corpus callosum gliomas; how I do it

Area of Science:

• Neurosurgery
• Neuro-oncology
• Brain Mapping

Background:

• Current awake brain mapping paradigms for supplementary motor area (SMA) tumors lack personalization and can be variable.
• Standard subpial resections carry a risk of vascular injury due to potential violation of the pia mater.

Purpose of the Study:

• To develop and evaluate a personalized brain mapping strategy for SMA tumors.
• To assess the efficacy of a combined subpial/interhemispheric surgical approach in reducing vascular injury during tumor resection.

Main Methods:

• Development of tailored mapping paradigms by a multidisciplinary brain mapping team.
• Implementation of a combined subpial/interhemispheric surgical approach during tumor resection.
• Focus on early identification and arterial skeletonization, followed by precise anatomo-surgical dissection of the cingulum and corpus callosum.

Main Results:

• The combined approach facilitated early identification and arterial skeletonization, crucial for minimizing vascular damage.
• Precise anatomo-surgical dissection of the affected cingulum and corpus callosum was successfully achieved.
• The method demonstrated a reduced risk of vascular injury in supplementary motor area-cingulum-corpus callosum (SMA-CC) tumors.

Conclusions:

• A combined subpial/interhemispheric approach is effective in reducing vascular injury risk for SMA-cingulum-CC tumors.
• This technique enables precise anatomo-surgical dissections, crucial for complex tumor resections.
• Understanding the cognitive functions of the affected brain regions is vital for optimizing surgical outcomes.