Optimizing brain mapping: integrating real-time neuropsychological assessment in awake craniotomy.

Neslihan Nisa Gecici, Ahmed Habib, Ajay Niranjan, Jeffrey Balzer, Natalie Sherry, Pascal O Zinn
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Abstract

Intraoperative neuropsychological testing (IONT) is a sophisticated method of cognitive mapping during the resection of brain tumors in eloquent areas. Direct electrical stimulation during awake craniotomy is routinely utilized for mapping basic language and sensorimotor function, but the utilization of IONT offers an individualized approach that can yield real-time, comprehensive feedback on various cognitive functions, allowing for a tailored and more extensive tumor resection. In this video, the authors present the case of a 41-year-old male undergoing re-resection for a recurrent right temporal astrocytoma in which IONT played a crucial role. The video can be found here: https://stream.cadmore.media/r10.3171/2024.10.FOCVID24128.

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Arcuate fasciculus cortico-cortical evoked potentials and direct cortico-subcortical stimulation during awake craniotomy for debulking of left dominant temporal oligodendroglioma. Brain mapping during resection of high-grade brain arteriovenous malformation. Brain mapping for lower-grade glioma around Wernicke's area. Hexamodal awake brain mapping (language, sensorimotor, ictal, visual, auditory) for multilobar resection in a dominant hemisphere parieto-fronto-temporo-occipital cortical malformation with drug-resistant epilepsy. Motor mapping-guided resection of a brainstem recurrent pilocytic astrocytoma.
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