Insular gliomas and tractographic visualization of the connectome

In this video, the authors present a connectome-guided surgical resection of an insular glioma in a 39-year-old woman. Preoperative study with constrained spherical deconvolution (CSD)-based tractography revealed the surrounding brain connectome architecture around the tumor relevant for safe surgical resection. Connectomic information provided detailed maps of the surrounding language and salience networks, including eloquent white matter fibers and cortical regions, which were visualized intraoperatively with image guidance and artificial intelligence (AI)-based brain mapping software. Microsurgical dissection is presented with detailed discussion of the safe boundaries and angles of resection when entering the insular operculum defined by connectomic information. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21194.