Cortical Mapping in the Resection of Malignant Cerebral Gliomas

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Jehad Zakaria
Vikram C. Prabhu

ABSTRACT


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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Article Details

Section
Chapter 13