====== Basal ganglia glioma ======

[[Basal ganglia glioblastoma]]

The [[basal ganglia]] and [[thalamus]] are uncommon locations for infiltrating [[glioma]]s. [[Tumor]]s here are usually treated with [[biopsy]] and [[adjuvant therapy]] with relatively poor results. Rarely do patients undergo extensive surgical [[intervention]]. It seems reasonable to suggest that successful [[cytoreduction]] may help these patients. However, this [[hypothesis]] has not been studied due to the general view that it is not possible to remove deep-seated brain tumors with acceptable outcomes.

Through retrospective data collection, Briggs et al.,  described a small case series undergoing awake contralateral, [[transcallosal approach]] surgery for deep-seated brain tumors affecting the basal ganglia. They described the patient [[cohort]], report on patient [[outcome]]s, and describe our surgical technique.

Four patients underwent [[awake]] contralateral, transcallosal surgery for [[glioblastoma]] invading the basal ganglia. All four patients demonstrated hemibody [[weakness]] contralateral to the side of their tumor, with three patients confined to wheelchairs at presentation. Ages ranged from 25-64 years. Tumor volumes ranged from 14-93 cm3. Greater than 50% resection of each tumor was achieved during surgery. In two cases, approximately 90% resection was achieved. Motor strength improved in one patient who presented with hemiplegia. Two patients required [[ventriculoperitoneal shunt]]ing for complications related to [[hydrocephalus]]. When writing this manuscript, two of our patients were still alive, functional, and free of tumor progression.

They presented results attempting to resect large [[glioma]]s infiltrating the basal ganglia in four patients. This technique combined a contralateral, transcallosal approach with awake [[neuromonitoring]]. The results suggest it is possible to remove these tumors with reasonable outcomes
((Briggs RG, Nix CE, Conner AK, Palejwala AH, Smitherman AD, Teo C, Sughrue ME. 
An Awake, Contralateral, Transcallosal Approach for Deep-Seated Gliomas of the
Basal Ganglia. World Neurosurg. 2019 Jul 10. pii: S1878-8750(19)31937-0. doi:
10.1016/j.wneu.2019.07.031. [Epub ahead of print] PubMed PMID: 31301441.
)).