Awake Craniotomy and Excision of a Diffuse Low-Grade Glioma in a Multilingual Patient: Neuropsychology and Language.

Abstract

Diffuse low-grade gliomas are a group of brain tumors that require an individualized and targeted therapeutic approach, such as awake craniotomy for surgical resection and intraoperative monitoring of speech and language functions. This case report presents a young, right-handed, Tamil-English-Malay multilingual man who underwent awake brain surgery for the excision of a diffuse low-grade glioma in the left frontal pars triangularis and opercularis region (i.e., Broca's area). Preoperative and postoperative neuropsychological assessments were conducted. Intraoperative language mapping was performed with electrostimulation. Awake craniotomy with speech and language monitoring allows a customized approach to the treatment and management of diffuse low-grade gliomas. Neuropsychological assessment and intraoperative findings are discussed in the context of functional reorganization and cortical representations of language.