Awake surgery and cortico-subcortical mapping: Neurosurgery of Udine esperience based on consecutive 316 cases

Neurological functional preservation coupling with a maximal oncological resection in surgical resection of mass effect cerebral lesions is mandatory. We present a consecutive series of 316 cases of cerebral lesions in which preoperative functional study, intraoperative cortical mapping and awake surgery has been performed. Histological specimen has been different and the lesions have been treated along 8 years. During surgery we were use to perform cortico-subcortical mapping by means direct cortical stimulation (DCS) and motor evoked potential (MEP). To the aim of applying these techniques, low grade tumour is the more suitable case, because gross total resection brings to a better prognosis. Overall results must be distinguished among different histology. The group of low grade tumour showed an immediate transient morbidity of 15%, although definitive morbidity was 4%. All of the lesions were placed inside or near eloquent cerebral areas.