Abstract
Under local anesthesia, gliomas of the premotor and primary motor cortex can be surgically
removed with minimal morbidity. However, since these neoplasms exhibit an infiltrative
growth pattern towards the pyramidal tract and are frequently not well delineated
from functional motor cortex, the long-term outcome is unfavorable. In this series,
5 of 11 patients presented with a recurrent tumor within two years of operation. Two
of these patients with recurrent tumors initially had a low grade glioma and three
an anaplastic glioma. Due to the longer progression-free interval after surgery and
the unpredictable course of patients with low grade gliomas, all efforts should be
undertaken to achieve safe and radical resection with the use of intraoperative mapping
and monitoring techniques as wall as cryo-cut examinations at all tumor border zones
to prove radicality. Since malignant tumors are known to recur in most instances,
radical resection is justified only in functionally safe areas.
Key words
Astrocytoma - Mapping - Motor and premotor cortex - Local anesthesia
