Cited by 312Glioma Diagnosis and TreatmentAdvanced Neuroimaging Techniques and ApplicationsIntraoperative Neuromonitoring and Anesthetic Effects

INTRAOPERATIVE SUBCORTICAL LANGUAGETRACT MAPPING GUIDES SURGICAL REMOVALOF GLIOMAS INVOLVING SPEECH AREAS

Bello, Lorenzo, Gallucci, Marcello, Fava, Marica, Carrabba, Giorgio, Giussani, Carlo, Acerbi, Francesco, Baratta, Pietro, Songa, Valeria +5 more·2007·Neurosurgery

Abstract

OBJECTIVE: Subcortical stimulation can be used to identify functional language tracts during resection of gliomas located close to or within language areas or pathways. The objective of the present study was to investigate the feasibility of the routine use of subcortical stimulation for identification of language tracts in a large series of patients with gliomas and to determine the influence that subcortical language tract identification exerted on the extent of surgery and on the appearance of immediate and definitive postoperative deficits. METHODS: Subcortical stimulation for language tract identification was systematically used during surgical removal of 88 gliomas (44 high-grade and 44 low-grade gliomas) involving language pathways. Procedures were performed during asleep/awake craniotomy. Subcortical stimulation was continuously alternated with surgical resection in a back-and-forth fashion. Language performances were tested by neuropsychological language evaluation preoperatively and at 3, 30, and 90 days after surgery. RESULTS: Language tracts were identified in 59% of patients, with differences according to tumor location but not according to histological grade. Language tract identification influenced the ability to reach a complete tumor removal in low-grade gliomas, in which tracts were documented inside the peripheral mass of the tumor. Identification of language tracts was associated with a higher occurrence of transient postoperative deficits (67.3% of cases), but a low occurrence of definitive morbidity (2.3% of cases). A pattern of typical language disturbances related to the phonological and semantic system can be identified according to tumor location, with preservation being important for the maintenance of language integrity. CONCLUSION: Our study supports the routine use of subcortical stimulation for language tract identification as a reliable tool for guiding surgical removal of gliomas in or in close proximity to language areas or pathways.

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Crossref · 10.1227/01.neu.0000249206.58601.de

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  • Current surgical methods in neurooncology have led to significant advancements in patient outcome and the emergence of supramarginal resections.

    “Current surgical methods in neurooncology, including awake surgery, 80 cortical mapping, 28 and neurophysiological techniques, 13 have led to significant advancements in patient outcome and the emergence of supramarginal resections whereby tumor resections are extended to functional boundaries.54”

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Authors
Bello, L., Gallucci, M., Fava, M., Carrabba, G., Giussani, C., Acerbi, F., Baratta, P., Songa, V., Conte, V., Branca, V., Stocchetti, N., Papagno, C., & Gaini, S. M.
Affiliations
University of Milan (IT)
Venue
Neurosurgery
Published
2007-01
Volume
60
Issue
1
Pages
67-82
ISSN
0148-396X (ISSN-L)
OpenAlex
W1158397885
Cited by
312
References
32
Citations by year
2026: 9 · 2025: 14 · 2024: 13 · 2023: 21 · 2022: 25 · 2021: 23 · 2020: 16 · 2019: 13 · 2018: 13 · 2017: 17 · 2016: 17 · 2015: 15 · 2014: 14 · 2013: 24 · 2012: 21
FWCI
6.38
Type
journal article
Language
en
Open access
closed
Locations
  • Neurosurgery (publishedVersion)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
  • BOA (University of Milano-Bicocca) (submittedVersion)
  • Institutional Research Information System (Università degli Studi di Trento) (submittedVersion)
  • Neuro-Oncology
Topics
  • Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
  • Health Sciences › Medicine › Surgery › Intraoperative Neuromonitoring and Anesthetic Effects
Keywords
glioma resection, awake craniotomy, language pathways, postoperative language deficits, extent of resection, tumor location
MeSH terms
Adult, Aged, Brain Mapping, Brain Neoplasms, Cerebral Cortex, Electric Stimulation, Female, Glioma, Humans, Language Tests, Male, Middle Aged, Speech, Monitoring, Intraoperative

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