Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Aug 1998
Case ReportsTwo-staged resection of a left frontal astrocytoma involving the operculum and insula using intraoperative neurophysiological monitoring--case report.
A 29-year-old right-handed male with a 12-year education presented with a 2-month history of generalized epileptic activity. Neuroradiological imaging demonstrated a large lesion in the left frontal lobe involving the insulooperculum and in the temporal tip. Neurological and neuropsychological examination revealed no abnormality. ⋯ The medially extended insular tumor was then resected stepwise with frequent neurological monitoring with the patient awake. Surgery for intraaxial insuloopercular lesions in the dominant hemisphere carries a high risk of speech and motor deficit. This staged operation enables maximum tumor resection of dominant-side large frontal gliomas involving the insuloopercular region, with preservation of both motor and speech functions.