[Planning of surgical approach to intracerebral tumors of the hemispheres using fMRI, neuronavigation, and electrophysiological monitoring]

The paper discusses pre- and intraoperative application of different guiding techniques (frameless neuronavigation, fMRI, electrophysiological monitoring). We performed comparative analysis of different combinations of these methods. 74 patients with intracerebral tumors involving eloquent areas (sensorimotor cortex in 56 and speech zones in 18) were operated. In 9 cases 'awake surgery' was applied. We found that frameless navigation combined with brain mapping allows to optimize planning of surgical approach and to decrease postoperative neurological deficit. Also in certain cases 'awake craniotomy' can be replaced by fMRI and neuronavigation.