Optimizing brain mapping: integrating real-time neuropsychological assessment in awake craniotomy

Area of Science:

• Neurosurgery
• Neuropsychology
• Cognitive Neuroscience

Background:

• Eloquent brain areas require precise surgical navigation.
• Current methods like direct electrical stimulation map basic functions.
• A need exists for comprehensive, real-time cognitive assessment during surgery.

Purpose of the Study:

• To demonstrate the utility of intraoperative neuropsychological testing (IONT) in a complex neurosurgical case.
• To highlight IONT's role in maximizing tumor resection while preserving cognitive function.

Main Methods:

• Presentation of a case study involving a 41-year-old male with a recurrent right temporal astrocytoma.
• Utilizing awake craniotomy with intraoperative neuropsychological testing (IONT).
• Real-time cognitive mapping to guide surgical resection.

Main Results:

• IONT provided comprehensive, real-time feedback on cognitive functions.
• The individualized approach allowed for a tailored and potentially more extensive tumor resection.
• IONT played a crucial role in the management of the recurrent tumor.

Conclusions:

• Intraoperative neuropsychological testing (IONT) is a valuable tool for cognitive mapping during brain tumor resection.
• IONT facilitates personalized surgical strategies in eloquent brain regions.
• This method supports maximizing safe tumor removal and preserving cognitive function.