Journal article
Precision surgery of rolandic glioma and insights from extended functional mapping
Clinical neurology and neurosurgery, Vol.163, pp.60-66
12/2017
DOI: 10.1016/j.clineuro.2017.10.008
PMID: 29073500
Abstract
Electrical cortical stimulation mapping (ECSM) is the current gold standard functional mapping technique; however, it is burdened by several limitations. Our objective in this study is to show that extended functional mapping modalities can (1) allow neurosurgeons to map and preserve eloquent regions that are inaccessible by the traditional ECSM technique and (2) factor into the operative decision-making process and surgical trajectory during resection of Rolandic brain tumors.
A 55year old patient having a right Rolandic glioblastoma underwent subdural grid implantation followed by surgical resection. Multimodal functional mapping including electrical stimulation, high gamma power mapping, functional magnetic resonance imaging, and diffusion tensor imaging were performed to define the location of the patient's eloquent cortex and white matter tracts in relation to the tumor and determine the optimal surgical trajectory prior to resection.
The patient tolerated a safe surgical resection without any new postoperative deficits. ECSM mapping successfully delineated safe areas for resection as well as eloquent areas related to motor control and speech production. High gamma power analysis successfully mapped areas involved in arm reach. Functional MRI showed the regions related to finger tapping. DTI demonstrated the corticospinal tract and its relation to the hand motor cortex and the tumor.
Adjunct mapping techniques used to supplement the data offered by ECSM can help advance the field of functional mapping and Rolandic surgery via broadening our accessibility to the human brain and providing a comprehensive map of eloquent grey and white matter structures and their relation to the tumor.
Details
- Title: Subtitle
- Precision surgery of rolandic glioma and insights from extended functional mapping
- Creators
- Oliver Flouty - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA. Electronic address: oliver-flouty@uiowa.eduChandan Reddy - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USAMarshall Holland - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USAChristopher Kovach - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USAHiroto Kawasaki - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USAHiroyuki Oya - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USAJeremy Greenlee - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USAPatrick Hitchon - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USAMatthew Howard - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Clinical neurology and neurosurgery, Vol.163, pp.60-66
- Publisher
- Netherlands
- DOI
- 10.1016/j.clineuro.2017.10.008
- PMID
- 29073500
- ISSN
- 0303-8467
- eISSN
- 1872-6968
- Grant note
- name: NIH, award: NIDCD R01 DC004290-16
- Language
- English
- Date published
- 12/2017
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984020649002771
Metrics
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