Technique of Localizing the Central Sulcus under Awake Anesthesia for Treatment of Gliomas in or near Motor Areas.

AIM: To study the protective effect on motor function of intraoperative awakening and localizing the central sulcus during surgery in patients with gliomas located in motor areas.

MATERIAL AND METHODS: A total of 68 patients with gliomas in motor areas were intubated with a laryngeal mask and rapidly underwent craniotomy without scalp clips and with surgical awakening, followed by localization of the central sulcus by somatosensory evoked potential. To protect brain function, we resected the greatest degree of tumor possible, and then finished by closing the skull with the patient in an awake state or under general anesthesia.

RESULTS: All the patients underwent surgery successfully. Except for the emergence of new neurological dysfunction in six patients, most patients' neurological function did not deteriorate, or even showed improvement. In addition, there were no complications or postoperative painful memories for the patients. The resection of gliomas in motor areas with intraoperative awakening and localization of the central sulcus can ensure the largest possible resection of the tumor while protecting brain function.

CONCLUSION: Here, we describe a simple and effective surgical procedure for patients with glioma. The technique involves localizing the central sulcus under awake anesthesia, which can improve the prognosis for patients with gliomas in motor areas.