Objective: To explore surgical treatment of gliomas involving the supplementary motor area (SMA) in the superior frontal gyrus.

Methods: Clinical data and follow-up outcome of 16 patients with low graded astrocytomas involving the supplementary motor area were analyzed.

Results: SMA syndrome was developed in 6 patients in whom the posterior tumor resection line was at a distance of more than 1 cm from the precentral sulcus and resolved after 12 months. Hemiplegia occurred however in 8 patients in whom the resection line was less than 1 cm to precentral sulcus and only resolved in 3 patients during follow period 12 months.

Conclusions: When the resection is performed at a distance of less than 1 cm from the precentral sulcus, surgery for gliomas of involving the supplementary motor area in the superior frontal gyrus may be result in permanent morbidity.

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