• Nobuyuki Izutsu, Manabu Kinoshita, Takufumi Yanagisawa, Katsuhiko Nakanishi, Mio Sakai, and Haruhiko Kishima.
• Department of Neurosurgery, Osaka International Cancer Institute, Osaka, Japan.
• World Neurosurg. 2017 Nov 1; 107: 1045.e5-1045.e8.

BackgroundIntra-axial brain tumors located at anatomically eloquent areas are challenging conditions. On one hand, it is often difficult to pursue maximum extent of resection of tumor in these locations. On the other hand, neuroplasticity occurs in some patients with low-grade glioma, and the primary neural functions are known to sometimes shift from conventional "eloquent cortices."Case DescriptionIn a patient with a lower-grade glioma located at the precentral gyrus, shift of primary motor function from the precentral gyrus to the postcentral gyrus was detected on magnetoencephalography and functional magnetic resonance imaging. Aggressive removal of the pathologic precentral gyrus was accomplished via awake craniotomy without causing obvious motor function deficit.ConclusionsThis case highlights the importance of preoperative multimodal neurophysiologic imaging in patients with low-grade gliomas in eloquent areas.Copyright © 2017 Elsevier Inc. All rights reserved.

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