Awake Craniotomy and Excision of a Diffuse Low-Grade Glioma in a Multilingual Patient: Neuropsychology and Language.

Background: Diffuse low-grade gliomas are a group of brain tumors that require an individualized and targeted therapeutic approach, such as awake craniotomy for surgical resection and intraoperative monitoring of speech and language functions.

Case Description: This case report presents a young, right-handed, Tamil-English-Malay multilingual man who underwent awake brain surgery for the excision of a diffuse low-grade glioma in the left frontal pars triangularis and opercularis region (i.e., Broca's area). Preoperative and postoperative neuropsychological assessments were conducted. Intraoperative language mapping was performed with electrostimulation.

Conclusion: Awake craniotomy with speech and language monitoring allows a customized approach to the treatment and management of diffuse low-grade gliomas. Neuropsychological assessment and intraoperative findings are discussed in the context of functional reorganization and cortical representations of language.