[Neurophysiological assisted transsulcal approach to a high grade glioma without affect neither motor nor somatosensory function].

Rev Neurol

Servicio de Neurofisiología Clínica, Unidadde Cirugía de la Epilepsia, Hospital Universitario de la Princesa, Clínica Nuestra Señora del Rosario, 28006 Madrid, Spain.

Published: April 2013

Introduction: Intraoperative mapping and neuronavigation permitted a safe approach through the rolandic sulcus, minimizing the impact onto the motor or somatosensory functions. Fluorescence-guide resection defines a limit that allows a total resection without exceed the border of the tumor.

Case Report: A 39-year-old man who was operated by a tumor placed into the rolandic area. With the patient anesthetized (propofol+remyfentanil), we performed cortical mapping, neuronavigation and fluorescence-guide resection with 5-aminolevulinic acid. Post-resection neurophysiologic assessment showed a minor and highly localized effect onto the somato-sensory system.

Conclusion: Rolandic area surgery can be safely performed in anesthetized patients when extensive neurophysiological, anatomical and biological assessments are performed.

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