Safe surgery for glioblastoma: Recent advances and modern challenges
Jasper K W Gerritsen, Marike L. D. Broekman, Steven De Vleeschouwer, Philippe Schucht, Brian V. Nahed, Mitchel S. Berger, Arnaud Jean Pierre Edouard Vincent
Abstract
One of the major challenges during glioblastoma surgery is balancing between maximizing extent of resection and preventing neurological deficits. Several surgical techniques and adjuncts have been developed to help identify eloquent areas both preoperatively (fMRI, nTMS, MEG, DTI) and intraoperatively (imaging (ultrasound, iMRI), electrostimulation (mapping), cerebral perfusion measurements (fUS)), and visualization (5-ALA, fluoresceine)). In this review, we give an update of the state-of-the-art management of both primary and recurrent glioblastomas. We will review the latest surgical advances, challenges, and approaches that define the onco-neurosurgical practice in a contemporary setting and give an overview of the current prospective scientific efforts.