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Optic Radiations Monitoring in Awake Glioma Surgery: Intraoperative Campimetry

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Functional Anatomy of the Brain: A View from the Surgeon’s Eye

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Abstract

The state of the art in contemporary glioma surgery is the irremediable fight between anatomic, supramarginal and functional tumor resections. All our efforts are focused on increasing the ‘progression-free survival’ but not at any cost, as the neurological function preservation is nowadays considered as a must. Low grade glioma patients are now considered as long survivors, who should be able to continue with their normal lives after surgical treatments for a long time. Therefore, achieving supramarginal resections, by predicting, detecting and respecting the eloquent areas of the human brain represents the gold-standard on glioma surgery. In this sense, preserving the visual function is of extreme importance, especially in those patients whose daily routine requires a normal visual field. Visual pathways represent a complex anatomy not easily recognizable into the surgical field due to its depth and different directions followed into the periventricular areas. We present our protocol and results after implementing a novel method to detect the optic radiations based on preoperative MRI images and an original intraoperative campimetry implemented to the subcortical stimulation device. The use of this method has allowed us to maximize our resections, as well as to decide the safest surgical trajectory in certain cases.

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Authors and Affiliations

  1. Department of Neurosurgery, Alicante General University Hospital, Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain

    Pablo Gonzalez-Lopez & Carlos Martorell-Llobregat

  2. Department of Clinical Neurophysiology, Alicante General University Hospital, Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain

    Maria Dolores Coves Piqueres

  3. Biomedical Neuro Engineering Department, University Miguel Hernández and CIBER-BBN, University Miguel Hernández, Elche, Spain

    Eduardo Fernández

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  1. Pablo Gonzalez-Lopez
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  2. Carlos Martorell-Llobregat
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  3. Maria Dolores Coves Piqueres
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  4. Eduardo Fernández
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Corresponding author

Correspondence to Pablo Gonzalez-Lopez .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, King Edward Memorial Hospital and Seth G. S. Medical College, Mumbai, Maharashtra, India

    Abhidha Shah

  2. Department of Neurosurgery, Lilavati Hospital and Research Center, Mumbai, Maharashtra, India

    Atul Goel

  3. Department of Neurosurgery, Fujita Health University Hospital, Aichi, Japan

    Yoko Kato

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Gonzalez-Lopez, P., Martorell-Llobregat, C., Piqueres, M.D.C., Fernández, E. (2023). Optic Radiations Monitoring in Awake Glioma Surgery: Intraoperative Campimetry. In: Shah, A., Goel, A., Kato, Y. (eds) Functional Anatomy of the Brain: A View from the Surgeon’s Eye. Springer, Singapore. https://doi.org/10.1007/978-981-99-3412-6_7

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  • DOI: https://doi.org/10.1007/978-981-99-3412-6_7

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