• Neurosurg Focus · Oct 2018

    Case Reports

    nTMS guidance of awake surgery for highly eloquent gliomas.

    • Sebastian Ille, Jens Gempt, Bernhard Meyer, and Sandro M Krieg.
    • Neurosurg Focus. 2018 Oct 1; 45 (VideoSuppl2): V9.

    AbstractNavigated transcranial magnetic stimulation (nTMS) allows for preoperative mapping for eloquent gliomas. Besides surgical planning, it also guides intraoperative stimulation mapping. The authors' routine includes preoperative nTMS plus nTMS-based tractography for motor and language to consult patients, plan surgery, craniotomy, and guide cortical and subcortical stimulation. Here, the authors present this routine in a 48-year-old woman with a glioma of the left middle and superior frontal gyrus reaching the precentral gyrus and superior longitudinal fascicle. Gross-total resection via awake surgery was achieved without deficit. The nTMS data and nTMS-based tractography augment eloquent glioma management far beyond its current application. The video can be found here: https://youtu.be/h4ldgMXL1ys .

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