title: [Neurophysiological assisted transsulcal approach to a high grade glioma without affect neither motor nor somatosensory function].
abstract: BACKGROUND
  Intraoperative mapping and neuronavigation permitted a safe approach through the rolandic sulcus, minimizing the impact onto the motor or somatosensory functions. Fluorescence-guide resection defines a limit that allows a total resection without exceed the border of the tumor.
  
  
  METHODS
  A 39-year-old man who was operated by a tumor placed into the rolandic area. With the patient anesthetized (propofol+remyfentanil), we performed cortical mapping, neuronavigation and fluorescence-guide resection with 5-aminolevulinic acid. Post-resection neurophysiologic assessment showed a minor and highly localized effect onto the somato-sensory system.
  
  
  CONCLUSIONS
  Rolandic area surgery can be safely performed in anesthetized patients when extensive neurophysiological, anatomical and biological assessments are performed.
authors.affiliation: Servicio de Neurofisiología Clínica, Unidadde Cirugía de la Epilepsia, Hospital Universitario de la Princesa, Clínica Nuestra Señora del Rosario, 28006 Madrid, Spain. jpastor.hlpr@salud.madrid.org
authors.forename: Jesús
authors.initials: J
authors.lastname: Pastor
authors.forename: Paloma
authors.initials: P
authors.lastname: Pulido-Rivas
authors.forename: Rafael G
authors.initials: RG
authors.lastname: Sola
mesh_terms: D000328:Adult; D000622:Aminolevulinic Acid; D000771:Anesthesia, Intravenous; D001931:Brain Mapping; D003399:Craniotomy / Q000379:methods*; D005073:Evoked Potentials, Somatosensory; D005456:Fluorescent Dyes; D005625:Frontal Lobe / Q000601:surgery*; D005909:Glioblastoma / Q000601:surgery*; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative; D038361:Neuronavigation; D011183:Postoperative Complications / Q000517:prevention & control; D015173:Supratentorial Neoplasms / Q000601:surgery*
chemical_list: D005456:Fluorescent Dyes; D000622:Aminolevulinic Acid