Surgical strategies for XXXX involving language areas.

@entity1 @entity75 @entity5 @entity11 @entity51 @entity86
BACKGROUND: Successful treatment of @entity11 in or adjacent to language areas constitutes a major challenge to neurosurgery. The present study was performed to evaluate the procedure of language mapping via intraoperative direct cortical electrical stimulation under awake anaesthesia when performed prior to resective @entity11 surgery. METHODS: Thirty @entity1 with @entity11 and left-hemisphere dominance and, who underwent language mapping via intraoperative direct cortical electrical stimulation under awake anaesthesia before resective @entity11 surgery, were analyzed retrospectively. All @entity1 had @entity5 in or adjacent to cortical language areas. The @entity75 were removed according to anatomic-functional boundaries with preservation of areas of language function. Both preoperative and postoperative functional findings were evaluated. RESULTS: Intraoperative language areas were detected in 20 @entity1 but not in four @entity1 . Language mapping failure for reasons attributable to the anaesthesia or to an intraoperative increase in intracranial pressure occurred in six cases. Seven @entity1 presented with moderate or severe @entity51 after six months of follow-up. Total resection was achieved in 14 cases, near-total resection in 12 cases and subtotal resection in four cases. CONCLUSIONS: Intraoperative cortical electrical stimulation is an accurate and safe approach to identification of the language cortex. Awake craniotomy intraoperative cortical electrical stimulation, in combination with presurgical neurological functional imaging to identify the anatomic-functional boundaries of @entity5 resection, permits extensive @entity5 excision while preserving normal language function and minimizing the risk of @entity86 .
