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Since the cortico-cortical evoked potential (CCEP) was first introduced in 2004, CCEP monitoring has been utilized in various types of brain surgery to achieve maximal safe resection (MSR). MSR is the primary goal in improving the prognosis of glioma; however, this is particularly challenging when the tumor is located around eloquent areas. Since the complexity of the language network system makes it more difficult to achieve MSR, language area mapping is essential when tumors are located around these areas. Awake surgery has been the gold standard for intraoperative language area mapping. However, awake craniotomy is not always feasible due to various clinical and patient-related factors. CCEP monitoring has emerged as a promising alternative for intraoperative language function assessment under general anesthesia to overcome the limitations of awake surgery. This review aims to summarize the current evidence on CCEP-guided surgery, focusing on its effectiveness in preserving language function.
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http://dx.doi.org/10.14791/btrt.2025.0008 | DOI Listing |
Pediatr Surg Int
September 2025
Department of Women's and Children's Health, University of Padova, Padua, Italy.
Artificial intelligence (AI) and machine learning (ML) are rapidly transforming healthcare, with growing interest in their application to rare pediatric surgical conditions. In these settings, limited data availability often brakes traditional research. Although pediatric surgery has historically been slower than other specialties in adopting ML, recent years have seen an increase in AI-driven tools designed for surgical care.
View Article and Find Full Text PDFJ Clin Neurosci
September 2025
Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Neurosurgery, National Regional Medical Center, Huashan Hospital Fujian Campus, Fudan University, Fuzhou, Fujian 350209, China; Neurosurgical Institute of
The brain arteriovenous malformation (BAVM) within language-eloquent area poses a significant surgical challenge, demanding meticulous planning to ensure both preservation of language function and curative resection. This report details the successful microsurgical resection of a Spetzler-Martin grade II BAVM located in Wernicke's area in a 51-year-old male, ruptured three weeks ago and characterized by mild anomia. Following thorough discussion, the patient elected for microsurgery, providing informed consent, and the procedure was approved by the ethics committee.
View Article and Find Full Text PDFClin Neurophysiol
August 2025
Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, UK.
Objective: Cortical speech mapping using navigated Transcranial Magnetic Stimulation (nTMS) has a variable positive predictive value (PPV) when compared with intraoperative direct electrical stimulation.
Methods: This is a single centre prospective study of all patients undergoing pre-operative nTMS and tractography (frontal aslant tract (FAT) and arcuate fasciculus (AF)) for awake surgery between October 2018 and November 2023. We reviewed operative notes for speech arrest, collected data on demographics, histopathology and pre-/post-operative language assessment.
Brain Spine
August 2025
Division of Neurosurgery, Department of Clinical Neuroscience, University Hospitals of Geneva (HUG), Switzerland.
Introduction: The preservation of the human self-a fundamental yet underexplored aspect of neurosurgical practice-has gained increasing attention in recent years.
Research Question: How can neural correlates of self-consciousness be identified, monitored, and protected during brain tumor surgery, and how might this reshape the concept of "onco-functional balance"?
Material And Methods: This review synthesizes emerging evidence from neuroimaging, neuropsychology, and intraoperative neurophysiology to build a framework for integrating the concept of self into modern neurosurgical practice.
Results: We describe the anatomical and functional basis of bodily and cognitive self-awareness, highlighting the roles of interoception, multisensory integration, and higher-order cortical networks such as the medial prefrontal cortex, insula and temporoparietal junction.
Neurosurg Rev
September 2025
Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Awake craniotomy (AC) can aid in preserving neurological function through intraoperative mapping of sensorimotor and language functions. It has been associated with increased extent of resection (EOR) and reduced neurological deficits in glioma patients. Most studies focused on low grade tumours and there remains limited evidence assessing utility of AC for glioblastoma (GB).
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