뇌교종 수술에서 뇌지도화

Abstract

The aims of brain glioma surgery are to potentiate adjuvant therapies and to extend survival with maximizing the quality of resection, while minimizing the risk of postoperative neurologic deficits. However, it is often limited by the location and spatial extent of the tumor and its relationship to the eloquent tissue. Moreover, there is interindividual anatomofunctional variability and so, each patient should be evaluated for cortical functional organization, effective connectivity and potential for plasticity. Recently, “maximum safe resection” has been made possible by preoperative functional neuroimaging, intraoperative imaging and image-guided surgery, and intraoperative functional mapping. In each patient, preoperative evaluation of cortical functional organization and relationship between tumor and surrounding brain tissue, and intraoperative evaluation of anatomo-functional connectivity and short-term plasticity using repeated cortical and subcortical stimulation during resection made tailored resection of glioma in eloquent area possible. With continuous accumulation of neuroanatomical & neurophysiological knowledge and experience of preoperative and intraoperative mapping, we could understand more and better about dynamic functional anatomy of brain