Glioma surgery with intraoperative mapping—balancing the onco-functional choice

Abstract

A significant amount of the patients in this study experienced new or worsened neurological and or cognitive deficits during follow-up. We found a higher frequency of deficits than normally reported. This is due to the inclusion of mild deficits, the use of patient-reported data, and our focus on cognitive deficits. Our study indicates that the impact of awake craniotomy with mapping on patient outcome is larger than expected. This in no way negates the use of the technique.

Response to Cognitive outcome following glioma surgery

“…We thank Pietro Ivo D'Urso for his appreciation of our study [1] expressed in the above letter to the Editor [2]. We are in complete agreement with Pietro Ivo D'Urso, that the degrees of neurological and cognitive deficits in glioma patients are likely to be underestimated in most publications.…”

Brain Mapping-Aided SupraTotal Resection (SpTR) of Brain Tumors: The Role of Brain Connectivity

“…According to this concept, focal and slow growth tumors determine an upsetting of normal functional relations within the brain, leading to an anatomical reshaping and functional reconfiguration of both cortical and subcortical networks even far beyond the tumor borders ( 26 ). Thus, the functional sequelae of brain tumors should be considered also at a global level since these functional changes influence whole-brain functional complexity and network architecture ( 26 , 28 ). Moreover, the effects of tumor removal are related to the individual network robustness since the removal of the surrounding peritumoral brain might be functionally counterbalanced and might not result in significant additional functional impairment ( 26 ).…”

Introductory Chapter: Glioma - Merciless Medical Diagnosis

“…Introductory Chapter: Glioma -Merciless Medical Diagnosis http://dx.doi.org/10.5772/intechopen.82863 mapping (IEM) during awake craniotomy helps to maximize the extent of resection and to minimize the risk of permanent neurological morbidity, allowing a substantial increase in the survival and quality of life of patients [14,17,25].…”