By Hugues Duffau
The reason of mind tumour surgical procedure is determined by antagonist ambitions: on one hand, to optimise the standard of resection, nonetheless, to minimise the chance of everlasting postoperative deficit. notwithstanding, end result of the physiological interindividual anatomo-functional variability, elevated in instances of cerebral tumours as a result of the plastic strength of the mind, a examine of the interactions among the lesion and the host turns out needed - which will comprehend the person dynamic company of the mind, then with the aim to prevent postsurgical sequelae. during this means, new tools of practical mind mapping will be beneficial for the neurosurgeon. First, prior to surgical procedure, non-invasive practical neuroimaging options (fMRI, puppy, MEG) and invasive extraoperative electric mapping (subdural grids) might enable to check the cortical service provider for every sufferer. additionally, Diffusion Tensor Imaging may also help to appreciate the mind connectivity.Thus, the relationships among the tumour and the eloquent parts might be expected, and those facts utilized to the surgical making plans. moment, in the course of surgical procedure, direct intraoperative electric stimulation allows to notice with accuracy and reliability, either the cortical websites and the white pathways crucial for a given functionality, at every one second and every position of the tumour removing. furthermore, repeated stimulations all alongside the surgical act additionally let to review the mechanisms of temporary plasticity, prompted by means of the resection itself. This online mapping is used to tailor the resection based on cortico-subcortical practical boundaries.Third, postoperative neurofunctional imaging, mixed to the ideal assessment of the medical path and the target overview of the positioning and volume of resection, offers the chance to review the mechanisms underlying the sensible reimbursement, i.e. the long term plasticity. This strength can be utilized to accomplish a moment surgical procedure with a greater caliber of resection than the 1st one, due to attainable mind remapping.Such a pre-, intra- and post-surgical longitudinal examine of dynamic interactions among mind and lesion, permits to higher recognize the exact styles of practical redistribution for every sufferer, therefore to use this data so as: to higher opt for the surgical indication in mind tumours; to higher tell the sufferer of the particular possibility of brief postoperative deficit; to higher plan the resection (surgical technique, cortico-subcortical boundaries); to optimise the standard of tumour removing whereas retaining the useful components and tracts; and to devise a particular rehabilitation. ultimately, on a primary viewpoint, the organization of equipment of sensible mapping in neurosurgical sufferers permits to higher comprehend the pathophysiology of mind parts, their connectivity, and the mechanisms of plastic capability of the glio-neurono-synaptic networks.