Preservation of motor function after resection of lower-grade glioma at the precentral gyrus and prediction by pre-surgical fMRI and MEG: a case report.

World Neurosurg. 2017 Aug 04;:

Authors: Izutsu N, Kinoshita M, Yanagisawa T, Nakanishi K, Sakai M, Kishima H

Abstract
Intra-axial brain tumors located at anatomically eloquent areas are challenging conditions. It is often difficult to pursue maximum extent of resection of the tumor in these locations. On the other hand, neuroplasticity takes place in some patients with low-grade glioma and the primary neural functions are known to sometimes shift from conventional "eloquent cortices". In the presented case, the authors detected shift of primary motor function from the precentral gyrus to the postcentral gyrus on magnetoencephalography and functional magnetic resonance imaging in a patient suffering from a lower-grade glioma located at the precentral gyrus. Aggressive removal of the pathological precentral gyrus was accomplished via awake craniotomy without causing obvious motor function deficit. This case highlights the importance of preoperative multimodal neurophysiological imaging in eloquent area seated low-grade glioma patients.

PMID: 28826712 [PubMed - as supplied by publisher]