Journal
NEURO-ONCOLOGY PRACTICE
Volume 9, Issue 5, Pages 364-379Publisher
OXFORD UNIV PRESS
DOI: 10.1093/nop/npac019
Keywords
glioblastoma; intraoperative mapping; imaging; preoperative mapping; review
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This article discusses the major challenges during glioblastoma surgery and provides updates on the state-of-the-art management of both primary and recurrent glioblastomas. The authors review the latest surgical advances, techniques for identifying eloquent areas, and visualization methods. They also provide an overview of current prospective scientific efforts.
One of the major challenges during glioblastoma surgery is balancing between maximizing extent of resection and preventing neurological deficits. Several surgical techniques and adjuncts have been developed to help identify eloquent areas both preoperatively (fMRI, nTMS, MEG, DTI) and intraoperatively (imaging (ultrasound, iMRI), electrostimulation (mapping), cerebral perfusion measurements (fUS)), and visualization (5-ALA, fluoresceine)). In this review, we give an update of the state-of-the-art management of both primary and recurrent glioblastomas. We will review the latest surgical advances, challenges, and approaches that define the onco-neurosurgical practice in a contemporary setting and give an overview of the current prospective scientific efforts.
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