Twenty-one patients (77.7%) suffered transient postoperative worsening, but at 6 months follow-up only three (11.1%) patients had persistent neurological impairment.
Results Total plus subtotal resection reached 88.8%. We topographically correlated intraoperatively identified sites (cortical and subcortical) with areas of fMRI activation and DTI tractography. Intraand postoperative complications, stimulation effects, extent of resection, and neurological outcome were determined. All subjects underwent preoperative sensorimotor and language fMRI and DTI tractography of major white matter bundles. Patients and methods We prospectively studied 27 patients with eloquent-area tumors who were selected to undergo awake surgery and direct brain mapping. The objective of this study was to assess surgical and functional neurological outputs of awake surgery and intraoperative cortical and subcortical electrical stimulation (CSES) and to use CSES to examine the reliability of preoperative functional magnetic resonance (fMRI) and diffusion tensor imaging fiber tracking (DTI-FT) for surgical planning. The role and integration of these techniques is still a matter of debate.
Direct cortical and subcortical stimulation is widely used in routine practice, however, because of its ability to reveal tissue function in eloquent regions. Preoperative functional neuroimaging and diffusion tensor imaging can display cortical functional organization and subcortical anatomy of major white matter bundles. Background Localization of brain function is a fundamental requisite for the resection of eloquent-area brain tumors.
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