Eloquent brain tumor12/17/2023 ![]() Eloquent areas were identified in 65% of cases, and in that group, worsened neurological deficits were observed in 21% of patients, whereas only 9% with negative mapping sustained such deficits (P < 0.01). RESULTS: A gross total resection (≥95%) was obtained in 64%, and a resection of 85% or more was obtained in 77% of the procedures. Intraoperative cortical stimulation for language, motor, and/or sensory function was performed in all patients to safely maximize surgical resection. Craniotomy was tailored to encompass tumor plus adjacent areas presumed to contain eloquent cortex. METHODS: Patients with intracerebral tumors near and/or within eloquent cortices (n = 309) were clinically evaluated before surgery, immediately after, and 1 month and 3 months after surgery. We report herein the results of a retrospective study of cortical mapping and subsequent clinical outcomes in a large series of patients. However, identification of eloquent areas not only failed to eliminate but rather increased the risk of postoperative deficits, likely indicating close proximity of functional cortex to tumor.Ībstract = "OBJECTIVE: Intraoperative localization of cortical areas for motor and language function has been advocated to minimize postoperative neurological deficits. CONCLUSION: Negative mapping of eloquent areas provides a safe margin for surgical resection with a low incidence of neurological deficits. Extent of resection less than 95% also predicted worsening of neurological status (P < 0.025). ![]() At 1 month, 83% overall showed improved or stable neurological status, whereas 17% had new or worse deficits however, at 3 months, 7% of patients had a persistent neurological deficit. Intraoperative neurological deficits occurred in 64 patients (21%) of these, 25 (39%) experienced worsened neurological outcome at 1 month, whereas only 27 of 245 patients (11%) without intraoperative changes had such outcomes (P < 0.001). ![]() OBJECTIVE: Intraoperative localization of cortical areas for motor and language function has been advocated to minimize postoperative neurological deficits. ![]()
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