The masses of four cases were deeply located on eloquent brain
Awake craniotomy for aggressive resection of gliomas located in eloquent brain
. Mayo Clinic Proc 2001;76(7):67787.
3 The study also recommended the use of preoperative factors like location of recurrence in eloquent brain
regions, Karnofsky Performance Status (KPS) and tumour volume; to be considered when evaluating a patient for reoperation.
A certain indication of the presence of the 'steal'phenomenon is the length of the arterial supply greater than 8 cm, measured from the circle of Willis (12), localization in the eloquent brain
zone or in the posterior cranial fossa, arterial supply of the VB siphon (p<0.01), feeder length greater than 60 mm, drainage of the blood vessel dilation, and blood flow angle of inclination relative to the AVM which is bleeding of [greater than or equal to]130[degrees] (13).
Special sequencing, such as diffusion tractography imaging and functional MRI, can be used to determine the association between eloquent brain
areas and the epileptogenic area, thereby allowing preservation of function in patients who undergo resection of the epileptiform area.
Kaminska, "Reoperations of patients with low-grade gliomas in eloquent or near eloquent brain
areas," Neurologia i Neurochirurgia Polska, vol.
However, when an epileptogenic zone cannot be located or is localized in the eloquent brain
, epilepsy surgery is not acceptable.