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**15** 

*Italy* 

**Surgical Treatment of Supratentorial** 

Andrea Talacchi1, Giovanna Maddalena Squintani2, Barbara Santini1, Francesca Casagrande3, Francesco Procaccio3, Franco Alessandrini4,

*3Neurosurgical Intensive Care Unit, Department of Emergency and Intensive Care;* 

Awake surgery (AS) and cortical mapping have gained wider acceptance for a variety of reasons: new anesthetic agents, improved surgical techniques, increasing use of functional magnetic resonance (fMRI), and growing interest in brain mapping as shown by refinements and upgrading of imaging techniques, such as magnetoencephalography, evoked responses potentials, high density electroencephalography, positron emission tomography (PET), and optical imaging among others (Bookheimer et al., 1997; Nariai et al., 2005; Papanicolau et al., 1999; Pouratian et al., 2002; Ruge et al., 1999; Rutten et al., 1999; Simos et al., 1999). Information technology and image-guided surgery have prompted researchers to compare non-invasive versus invasive mapping while the patient is awake (Hill et al., 2000; Kamada et al., 2007; Rutten et al., 2002). Cortical mapping has rapidly evolved, but the technical characteristics of electrocortical stimulation (ECS) have remained essentially the same since Penfield's time and it is still considered the gold standard for mapping language (Fitzgerald et al., 1997; Pouratian et al., 2004; Weidemayer et al., 2004). During cortical stimulation, task disruption is taken to indicate that the underlying cortex is essential for task performance. What has changed is the increasing feasibility of mapping the brain in vivo in a way that is safe and acceptable for the patient, and the opportunity to use a broad variety of selective tasks in standardized conditions (Bulsara et al., 2005; Serletis & Bernstein, 2007; Sielbergeld et al., 1992). This has stimulated translational research and cooperation between

neuroscientists and neurosurgeons from the basic sciences to clinical applications.

Direct ECS has been used in Neurosurgery since 1930, first by Foerster, and then later by Penfield and colleagues (Foerster, 1931; Penfield & Boldrey, 1937; Penfield & Erickson, 1942;

**1. Introduction** 

**1.1 Historical background** 

**Glioma in Eloquent Areas** 

Giada Zoccatelli4, Vincenzo Tramontano1, Aurel Hasanbelliu1 and Massimo Gerosa1

*2Neurological Unit, Department of Neuroscience;* 

*4Neuroradiological Unit, Department of Radiology;* 

*1Institute of Neurosurgery,* 

*University Hospital, Verona,* 

