====== Insular glioma surgery outcome ======
[[Insular glioma surgery]]s remains a neurosurgical [[challenge]] due to the close proximity of [[functional]]ly-important cortical, [[white matter tract]]s, and vasculature structures. More recently, the feasibility of resection has gained traction, however, there is a lack of consolidated [[neurological deficit]] metrics. 

The aim of a [[study]] of Lu et al., from the Mayo Clinic [[Jacksonville]], was to determine the [[incidence]]s of [[neurological deficit]]s following [[insular glioma]] [[resection]] to better guide selection [[algorithm]]s and [[resource allocation]]s. Searches of seven [[electronic database]]s from inception to August 2018 were conducted following [[Preferred Reporting Items for Systematic Reviews and MetaAnalyses]] ([[PRISMA]]) [[guideline]]s. [[Data]] were extracted and pooled using meta-analysis of proportions. [[Meta-regression]] was used to identify potential sources of heterogeneity. Nineteen observational studies reported the neurological outcomes of 890 insular glioma patients. The [[pooled]] [[incidence]]s of new temporary and permanent [[motor]] [[deficit]]s were 11% (95% CI, 6-17%) and 4% (95% CI, 2-7%) respectively, and new temporary and permanent [[language]] [[deficit]]s were 11% (95% CI, 6-17%) and 2% (95% CI, 0-4%) respectively. Single-surgeon series reported significantly lower incidences of both permanent motor (2% vs 7%; P < 0.001) and language (1% vs 3%; P = 0.03) deficits. The incidences of motor and language neurological deficits following insular glioma resection have been quantified, and will assist in determining the suitability and appropriateness of pursuing surgical resection for insular glioma. 

They note that permanent neurological deficits are lowest when reported by series describing outcomes of a single surgeon, indicating most optimal outcomes may be best achieved after intense [[training]] and/or greater [[experience]]
((Lu VM, Goyal A, Quinones-Hinojosa A, Chaichana KL. Updated incidence of
neurological deficits following insular glioma resection: A systematic review and
meta-analysis. Clin Neurol Neurosurg. 2018 Dec 17;177:20-26. doi:
10.1016/j.clineuro.2018.12.013. [Epub ahead of print] Review. PubMed PMID:
30580067.
)).