Cortical Mapping in the Resection of Gliomas

Prabhu, Vikram C.; Vargas, César Saúl Villamizar; Benedict, William J.; Owen, Kevin; Jellish, W. Scott

doi:10.1097/00029679-200701150-00001

Cited by 1 publication

(14 citation statements)

References 9 publications

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“…Patients with gliomas located in eloquent parts of the brain essential for language or motor function are candidates for intraoperative cortical mapping (3,(14)(15)(16). Commonly, these eloquent zones include the posterior frontal or anterior parietal lobe in either hemisphere; or the insula, inferior frontal; or superior temporal gyri in the dominant hemisphere.…”

Section: Surgical Considerationsmentioning

confidence: 99%

“…Occasionally, preoperative functional imaging may suggest eloquent areas beyond these confines, indicating the need for surgical mapping. Motor mapping may be done with the patient awake or asleep, while language mapping is always done awake, which requires a patient to be calm and cooperative (3,(14)(15)(16). Apprehensive or uncooperative patients, or those with airway or chronic pulmonary problems, may not tolerate being awake during surgery (2,17).…”

Section: Surgical Considerationsmentioning

confidence: 99%

“…Knowledge of scalp and cranial landmarks allows determination of the relationship of the lesion with the motor strip, language areas, ventricles, thalamus, basal ganglia, and their projecting fibers (1,3,(18)(19)(20)(21). Surface landmarks easily identified are the glabella, nasion, frontozygomatic (FZ) point, root of the zygoma, mastoid process, inion, and midline, indicating location of the sagittal suture.…”

Section: Surface Anatomical Landmarksmentioning

confidence: 99%

“…The lower rolandic point lies 2-3 cm behind the pterion, or about 5 cm above the EAM. The upper end of the precentral gyrus lies almost straight up from the EAM near the midline (1,3,19).…”

Section: Surface Anatomical Landmarksmentioning

confidence: 99%

“…Preoperative and intraoperative cortical mapping strategies are used to delineate the relationship of the tumor with adjacent eloquent and association cortical areas to provide a maximal functionally safe surgical resection. A protocol that encompasses anatomical, functional, and metabolic imaging provides a comprehensive view of the location and nature of the tumor and its relationship with the adjacent cortex (1)(2)(3). Preoperative and postoperative neuropsychological testing further identifies areas of subtle cognitive, motor, and language deficit.…”

Section: Introductionmentioning

confidence: 99%

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Cortical Mapping in the Resection of Malignant Cerebral Gliomas

Zakaria

Prabhu

2017

Glioblastoma

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Cerebral gliomas are diffuse intrinsic primary brain tumors that are most commonly encountered in the frontal, temporal, and parietal lobes, and that can present with an array of symptoms including alterations in mental status, speech and language difficulties, motor or sensory abnormalities, and seizures. Maximal safe surgical debulking of the tumor reduces mass effect, provides a precise histological diagnosis, and facilitates genetic analysis that may shed light on the response to therapies and prognosis, reduces the oncological burden of the tumor facilitating the effectiveness of adjuvant treatments such as radiation and chemotherapy, and may reduce seizures. Preoperative and intraoperative cortical mapping strategies are used to delineate the relationship of the tumor with adjacent eloquent and association cortical areas to provide a maximal functionally safe surgical resection. This chapter describes the protocols used at our institution for the surgical management of patients with malignant gliomas in proximity to or involving eloquent cortical areas.

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Section: Surgical Considerationsmentioning

confidence: 99%

Section: Surgical Considerationsmentioning

confidence: 99%

Section: Surface Anatomical Landmarksmentioning

confidence: 99%

“…The lower rolandic point lies 2-3 cm behind the pterion, or about 5 cm above the EAM. The upper end of the precentral gyrus lies almost straight up from the EAM near the midline (1,3,19).…”

Section: Surface Anatomical Landmarksmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations