Insular Glioma Esoteric Precinct

  • FAUZIA SAJJAD Department of Neurosurgery, Punjab Institute of Neuro Sciences (PINS), Lahore
  • MUHAMMAD ASIF SHABBIR Department of Neurosurgery, Punjab Institute of Neuro Sciences (PINS), Lahore
  • MUHAMMAD AKMAL Department of Neurosurgery, Lahore General Hospital Lahore
  • ZAIN SALEH Punjab Institute of Neurosciences, Lahore
  • ADEEB-UL- HASSAN Department of Neurosurgery, Punjab Institute of Neuro Sciences (PINS), Lahore – Pakistan
Keywords: Insular Glioma, Approaches to insular Glioma

Abstract

Background and Objective:  The complex insular anatomy and its proximity to eloquent areas make this area almost inaccessible for safe surgical resection of Glioma. Aim of our study is to determine outcome assessment after surgical resection.

Materials & Methods:  This was a retrospective analysis of 59 patients over a period of 5 years from July 2013 till June 2018. All patients of insular Glioma were included in our study irrespective of age and sex. Degree of surgical resection, Post-operative neurological deficits and complications were assessed. They were followed in the outpatient department at 3, 6 and 12 months.

Results:  Total 59 patients were included 38 (64.40%) male and 21 (35.59%) females. 36 (61%) patients had right sided insular Glioma and 23 (38.98%) have left sided. Seizures were main presentation in 46(77.96%) patients. Trans-sylvian route adopted in 34 (57.6%) patients followed by transcortical route. Near total Resection was Possible in 30 (50.84%) patients and partial in 29 (49.15%) patients. Focal neurological deficits the motor weakness & dysphasia were main post-operative complications in 18 (30.5%) patients. Three (5.08%) patients died. In all grade II and grade III Gliomas no increase in size was discovered on MRI Brain at 6 and 12 months.

Conclusion:  Maximum safe resection of insular Glioma with acceptable morbidity is possible with improved overall survival and disease free interval.

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Published
2020-07-13
Section
Original Article