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Awake Surgery for Local Recurrence of Brain Metastasis in the Precentral Gyrus After Fractionated Stereotactic Radiotherapy: A Technical Case Report

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Background: To avoid permanent neurologic deficits and preserve brain function, intraoperative electrical stimulation mapping (IESM) is essential for surgical resection. Case Report: A 59-year-old right-handed woman with ovarian cancer who… Click to show full abstract

Background: To avoid permanent neurologic deficits and preserve brain function, intraoperative electrical stimulation mapping (IESM) is essential for surgical resection. Case Report: A 59-year-old right-handed woman with ovarian cancer who had undergone stereotactic radiotherapy for brain metastasis two years before, was introduced due to progressive left upper paresis. Magnetic resonance imaging showed a recurrence of the lesion. We performed awake surgery using IESM. Thus, the sensorimotor site was elicited on the precentral and postcentral gyrus. However, IESM elicited no disturbance of motor function on the surface of the posterior part of the precentral gyrus. We made a safe corticotomy on it, and performed the resection of recurrent BM. Preserving the motor and sensory function, we achieved the resection of BM. After surgery, she experienced a significant improvement in motor function. Conclusion: IESM is a useful tool to make a safe approach via the precentral gyrus avoiding permanent sensorimotor deficits.

Keywords: precentral gyrus; gyrus; case report; brain metastasis; stereotactic radiotherapy

Journal Title: AntiCancer Research
Year Published: 2022

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