Abstract
The resection of eloquent located infiltrating brain tumors still presents one of the most formidable challenges in neurosurgery. The need to perform complete (and hence aggressive) resections of high-grade gliomas has been strongly supported by level II evidence of the impact of a complete resection on survival [1–3] and stands in contrast to the need to preserve the patients’ integrity and the general principle of medicine to “ first do no harm.” Fortunately, recent developments in neuro-oncologic neurosurgery provide technologies that can allow for a safe and still aggressive resection even in the central motor area. Among these developments are:
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Improved preoperative imaging (metabolic and functional/anatomic) that allows for improved planning,
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Intraoperative visualization of the tumor (5-aminolevulinic acid [ALA], ultrasound, and intraoperative magnet resonance tomography [iMRI])
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The identification of functional and nonfunctional areas (i.e., resectable areas) by intraoperative monitoring.
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Sabel, M., Rapp, M., Smuga, M., Kamp, M.A. (2019). Surgical Resection Techniques of Central Area Gliomas. In: Fountas, K., Kapsalaki, E. (eds) Epilepsy Surgery and Intrinsic Brain Tumor Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-95918-4_21
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