• H Duffau and L Capelle.
• Service de Neurochirurgie 1, Hôpital de la Salpêtrière, 47, boulevard de l'Hôpital, 75651 Paris. hugues.duffau@psl.ap-hop-paris.fr
• Neurochirurgie. 2001 Dec 1;47(6):534-41.

BackgroundWith the aim to achieve the most complete resection in cases of parietal low-grade glioma involving the primary somatosensory area (S I), the authors describe a series with resection of S I using an intraoperative brain mapping. The immediate and delayed postoperative functional results are analyzed.Patients And MethodsSix patients were operated on for a low-grade glioma involving S I, revealed by seizures with a normal clinical examination. All patients underwent awake surgery under local anesthesia, to allow realization of an intraoperative sensorimotor brain mapping using direct electrical stimulations.ResultsThe primary motor area (M I) and S I were detected in all procedures. A part of infiltrated S I was removed in spite of a sensitive response of this area during stimulations (sensory face in 2 cases, upper limb area in 5 cases, and lower limb area in 2 cases). All patients presented an immediate postoperative sensory deficit, with recovery in the 6 cases within 3 months. Five resections were total and one subtotal.ConclusionsIn our experience, the primary somatosensory area could be resected in case of tumoral infiltration, without inducing a permanent neurological deficit. This may be due to brain plasticity mechanisms, with recruitment of loco-regional and controlateral eloquent regions, and also the learning of new compensatory strategies. Such a phenomenon can lead to perform more extensive resections in cases of infiltrative gliomas in the somatosensory region.

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