SURGERY OF ASTROCYTOMAS IN THE MOTOR AND PREMOTOR CORTEX UNDER LOCAL-ANESTHESIA - REPORT OF 11 CASES

Under local anesthesia, gliomas of the premotor and primary motor cort ex can be surgically removed with minimal morbidity, However, since th ese neoplasms exhibit an infiltrative growth pattern towards the pyram idal tract and are frequently not well delineated from functional moto r cortex, the long-term outcome is unfavorable. In this series, 5 of 1 1 patients presented with a recurrent tumor within two years of operat ion, Two of these patients with recurrent tumors initially had a low g rade glioma and three an anaplastic glioma. Due to the longer progress ion-free interval after surgery and the unpredictable course of patien ts with low grade gliomas, all efforts should be undertaken to achieve safe and radical resection with the use of intraoperative mapping and monitoring techniques as well as cryo-cut examinations at all tumor b order zones to prove radicality. Since malignant tumors are known to r ecur in most instances, radical resection is justified only in functio nally safe areas.