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AANS: Cortical Map Maximizes Brain Tumor Resection

Awake brain surgery with cortical mapping may also minimize neurological deficits

MONDAY, April 16 (HealthDay News) -- In patients with malignant tumors near eloquent brain, cortical mapping during awake craniotomy can allow maximal tumor resection and minimize neurological deficits, according to research presented this week at the annual meeting of the American Association of Neurological Surgeons in Washington, D.C.

Stefan Kim, M.D., of the M.D. Anderson Cancer Center in Houston, and colleagues evaluated neurological outcomes in 309 patients with intracerebral tumors near and/or within eloquent cortices before, immediately after, and one month after surgery. Of these patients, 65 percent had greater than 95 percent tumor resection, and 78 percent had greater than 85 percent resection.

After one month, the researchers found that 84 percent of the patients showed improved or stable neurological status while 16 percent had new or worse deficits. They also observed worsened deficits in 21 percent of patients and in 10 percent of patients with negative mapping.

"Negative mapping of eloquent areas appeared to provide a safe margin for greater surgical resection with lower incidence of neurological deficits," the authors concluded. "However, identification of eloquent areas not only failed to eliminate but rather increased the risk of postoperative deficits, most likely indicating close proximity of functional cortex to tumor."

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