Surgical treatment of gangliogliomas in functional areas of the brain in child: a literature review and clinical cases

Abstract

Surgical treatment of tumors located near functional areas involves the use of technologies such as awake craniotomy, cortical and subcortical stimulation. The introduction of these and other technologies makes it possible to achieve maximum resection of the tumor without compromising the functional status of the patient. The use of this technologies has been well studied in adults, but this not about pediatric patients.Aim of the work is to present two clinical cases of successful treatment of low‑grade gliomas of functional areas of the brain in children and literature review.In clinical cases, damage of functionally significant areas were noted: the sensory speech cortex and the corticospinal tract. The involving speech cortex in the first case was also confirmed by functional magnetic resonance imaging. In the first case, an operation was performed with awake craniotomy, using cortical and subcortical mapping, in the second, using subcortical mapping and metabolic navigation. Total tumor resection was achieved in both clinical cases with a good functional outcome.Achieving an optimal balance of functional outcome and the degree of radical removal of low‑grade tumors of functional areas is possible using an integrated approach based on the analysis of multimodal data.