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Anatomical landmarks during high-magnification microsurgery for a safe and effective resection of high-grade gliomas: how I do it

  • How I Do it
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Abstract

Background

Gross total resection, when possible, is the first crucial treatment for high-grade gliomas, as it has been demonstrated to be associated with longer survival. Different intraoperative tools, such as neuronavigation, fluorescent agents, and intra-operative ultrasound, have been developed to help neurosurgeons to extend the resection.

Methods

We describe the high-magnification microsurgery technique used during the first surgical removal for high-grade gliomas. We illustrate the key anatomical “markers” of normal brain parenchyma, which guide the surgery.

Conclusion

High-magnification microsurgery is an anatomically based approach that allows the identification of key anatomical “markers” of normal brain parenchyma in order to resect high-grade gliomas safely and effectively.

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Abbreviations

HGG:

High-grade glioma

3D:

3-Dimensional

MRI:

Magnetic resonance imaging

DTI:

Diffusion tensor imaging

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, IRCCS Neuromed, Pozzilli, IS, Italy

    Arianna Fava, Paolo di Russo, Roberta Morace & Vincenzo Esposito

  2. Department of Human Neurosciences, University of Rome “La Sapienza”, Rome, Italy

    Arianna Fava & Vincenzo Esposito

Authors
  1. Arianna Fava
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  2. Paolo di Russo
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  3. Roberta Morace
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  4. Vincenzo Esposito
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Corresponding author

Correspondence to Arianna Fava.

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Fava, A., di Russo, P., Morace, R. et al. Anatomical landmarks during high-magnification microsurgery for a safe and effective resection of high-grade gliomas: how I do it. Acta Neurochir 165, 4235–4240 (2023). https://doi.org/10.1007/s00701-023-05723-2

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  • DOI: https://doi.org/10.1007/s00701-023-05723-2

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