Indirect cognitive mapping in glioma surgery in patients not eligible for awake craniotomy – how I do it

1

The brain's white matter pathways are categorized into ventral and dorsal streams, crucial for cognitive connectivity and motor function.
2

Ineligible patients for awake craniotomy require alternative methods to protect subcortical tracts during glioma surgery.
3

Subcortical electrical stimulation can localize motor pathways, establishing a current-to-distance relationship for safe tumor resection.
4

In three case studies, careful mapping and stimulation parameters allowed for significant tumor removal without postoperative neurological deficits.
5

Awake craniotomy is the gold standard for preserving functional structures, but alternatives are necessary for patients unable to participate.

1