Subtypes And Micro-neurosurgery Of Cerebral Insular Gliomas

Objective To discuss the types of insular glioma and it’s treatment inmicroneurosurgery.Method To analyze retrospectively pre-and post-operative outcomes of imaging andclinical data of38cases. The tumor can be separated for4types. The tumor arisedfrom insular lobe in5cases as type1, frontoinsular lobe in10cases as type2,temporoinsular lobe in14cases as type3and frontotemporoinsular lobe in9cases.All cases were operated through pterion approach or amplification pterioncraniotomy.Results Total resection of the tumor was achieved in21cases, subtotal in7cases,and most in10cases. The pathological examination showed that astrocytoma wasfound in34patients (Grade I in5cases, Grade II in22cases, Grade III in4cases and Grade IV in3cases), and oligodendroglioma was found in4cases. There were nodeath case.26patients gradually recovered,4patients got neurological deficits.Neurological deficits in6cases did not get better and in2cases got worse. Follow-updata is about22cases in6to15monthes.8patients relaped and underwent secondsurgery.2Grade IV patients was dead after2years.2patients got hemiplegia and2aphasia.Conclusion Pre-operation MRI scan is helpful to type the insular glioma, figure outthe area of the mass and choose approach. Application of Micro-neurosurgicaltechnology in operation of insular glioma is safe and efficient. Mastering the anatomicknowledge and operative skills will help to get maximum tumor resection, prolong thelifetime and reduce the rate of neurological deficits.