Neurosurgical anatomy of the insula and Sylvian fissure in gliomas: literature data and own experience. The first report. Arteries
Insular gliomas account for 25 % of all low-grade and 10 % of all high-grade gliomas. This complex neural and vascular anatomy of the insula and subinsular areas and the attendant risk of postoperative neurological deficit render resection of insular gliomas challenging. Postoperative mor...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Romodanov Neurosurgery Institute
2020-09-01
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| Series: | Ukrainian Neurosurgical Journal |
| Online Access: | https://theunj.org/article/view/203857 |
| _version_ | 1797350794730668032 |
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| author | Valentyn M. Kliuchka Volodymyr D. Rozumenko Tetyana A. Malysheva Artem V. Rozumenko Andrii V. Dashchakovskyi |
| author_facet | Valentyn M. Kliuchka Volodymyr D. Rozumenko Tetyana A. Malysheva Artem V. Rozumenko Andrii V. Dashchakovskyi |
| author_sort | Valentyn M. Kliuchka |
| collection | DOAJ |
| description |
Insular gliomas account for 25 % of all low-grade and 10 % of all high-grade gliomas. This complex neural and vascular anatomy of the insula and subinsular areas and the attendant risk of postoperative neurological deficit render resection of insular gliomas challenging. Postoperative morbidity can result from injury to these arteries. The cortex and adjacent subcortical structures of the insula are supplied with blood from the cortical insular perforating arteries and lenticulostriate arteries. The source of both types of arteries is the middle cerebral artery. To preserve these vessels, it is necessary to take into account their location while performing approach and tumor debulking.The presurgical planning is extremely important for insular glioma surgery, which allows predicting the extent of removal and to assess the risk of postoperative morbidity. The digital subtractive angiography, CT angiography, MRI angiography make a full picture of the tumor relationship with the lenticulostriate arteries while it is almost impossible to identify the tumor involvement of the insular arteries.The aim of insular glioma surgery is to achieve total removal while preserving critical arteries. This goal is complicated both by a small diameter of lenticulostriate and insular arteries, which intraoperatively complicates their identification and their involvement in tumor tissue. The intraoperative neuroimaging, neuronavigation, intraoperative neuromonitoring can help guide the extent of resection and prevent or minimize postoperative morbidity. However, these advanced technologies are often insufficient without a comprehensive understanding of the insular functional and vascular anatomy. |
| first_indexed | 2024-03-08T12:50:13Z |
| format | Article |
| id | doaj.art-40a9600d1dc64d90b54a970e33ddf60e |
| institution | Directory Open Access Journal |
| issn | 2663-9084 2663-9092 |
| language | English |
| last_indexed | 2024-03-08T12:50:13Z |
| publishDate | 2020-09-01 |
| publisher | Romodanov Neurosurgery Institute |
| record_format | Article |
| series | Ukrainian Neurosurgical Journal |
| spelling | doaj.art-40a9600d1dc64d90b54a970e33ddf60e2024-01-20T09:13:03ZengRomodanov Neurosurgery InstituteUkrainian Neurosurgical Journal2663-90842663-90922020-09-01263132110.25305/unj.203857Neurosurgical anatomy of the insula and Sylvian fissure in gliomas: literature data and own experience. The first report. ArteriesValentyn M. Kliuchka0https://orcid.org/0000-0001-6025-7199Volodymyr D. Rozumenko1https://orcid.org/0000-0002-8774-6942Tetyana A. Malysheva2https://orcid.org/0000-0003-4071-8327Artem V. Rozumenko3https://orcid.org/0000-0003-0668-6659Andrii V. Dashchakovskyi4https://orcid.org/0000-0001-6675-9368Romodanov Neurosurgery Institute, Kyiv, UkraineRomodanov Neurosurgery Institute, Kyiv, UkraineRomodanov Neurosurgery Institute, Kyiv, UkraineRomodanov Neurosurgery Institute, Kyiv, UkraineRomodanov Neurosurgery Institute, Kyiv, Ukraine Insular gliomas account for 25 % of all low-grade and 10 % of all high-grade gliomas. This complex neural and vascular anatomy of the insula and subinsular areas and the attendant risk of postoperative neurological deficit render resection of insular gliomas challenging. Postoperative morbidity can result from injury to these arteries. The cortex and adjacent subcortical structures of the insula are supplied with blood from the cortical insular perforating arteries and lenticulostriate arteries. The source of both types of arteries is the middle cerebral artery. To preserve these vessels, it is necessary to take into account their location while performing approach and tumor debulking.The presurgical planning is extremely important for insular glioma surgery, which allows predicting the extent of removal and to assess the risk of postoperative morbidity. The digital subtractive angiography, CT angiography, MRI angiography make a full picture of the tumor relationship with the lenticulostriate arteries while it is almost impossible to identify the tumor involvement of the insular arteries.The aim of insular glioma surgery is to achieve total removal while preserving critical arteries. This goal is complicated both by a small diameter of lenticulostriate and insular arteries, which intraoperatively complicates their identification and their involvement in tumor tissue. The intraoperative neuroimaging, neuronavigation, intraoperative neuromonitoring can help guide the extent of resection and prevent or minimize postoperative morbidity. However, these advanced technologies are often insufficient without a comprehensive understanding of the insular functional and vascular anatomy.https://theunj.org/article/view/203857 |
| spellingShingle | Valentyn M. Kliuchka Volodymyr D. Rozumenko Tetyana A. Malysheva Artem V. Rozumenko Andrii V. Dashchakovskyi Neurosurgical anatomy of the insula and Sylvian fissure in gliomas: literature data and own experience. The first report. Arteries Ukrainian Neurosurgical Journal |
| title | Neurosurgical anatomy of the insula and Sylvian fissure in gliomas: literature data and own experience. The first report. Arteries |
| title_full | Neurosurgical anatomy of the insula and Sylvian fissure in gliomas: literature data and own experience. The first report. Arteries |
| title_fullStr | Neurosurgical anatomy of the insula and Sylvian fissure in gliomas: literature data and own experience. The first report. Arteries |
| title_full_unstemmed | Neurosurgical anatomy of the insula and Sylvian fissure in gliomas: literature data and own experience. The first report. Arteries |
| title_short | Neurosurgical anatomy of the insula and Sylvian fissure in gliomas: literature data and own experience. The first report. Arteries |
| title_sort | neurosurgical anatomy of the insula and sylvian fissure in gliomas literature data and own experience the first report arteries |
| url | https://theunj.org/article/view/203857 |
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