**Author details**

more than 95% of patients recovering to the normal neurological status in 3 months after the surgery, while some patients had improvement in comparison with their preoperative status. In respect of epilepsy, 80% of the patients with preoperative epilepsy did not report it after the surgery [28]. Electrostimulation is a safe, easy, accurate, and reliable technique of individual-

"Oncofunctional balance" is the term used by Duffau to illustrate the approach to glioma resection through interaction with the patient to determine the best therapeutic sequence according to the patient's needs [31]. Intraoperative electrostimulation is used during the awake glioma surgery, which allows studying interactions between the natural history of tumor and the brain reorganization. With this approach, we are able to preserve the eloquent functions of the brain. Each patient who will undergo supratotal resection should be informed about possible deterioration of the eloquent functions, which of them are most important to him/her to achieve maximal oncofunctional balance. With this approach, glioma surgery

Glioma surgery is one of the most impacting surgical interventions to human health, life, and quality of it. As the molecular knowledge of the life circle of gliomas and techniques improves, it increases our dream that potential curing glioma will come true. Today, the most important treatment option for preserving the quality of life and overall survival is surgical resection. If possible, maximal surgical resection with preservation of neurological functions should be first option in treatment of low and high grade glioma. The resection should be performed with the balance of maximal resection and maximal preservation or improvement of the quality of life. The new promising approach in glioma surgery is supratotal resection with the use of electrostimulation mapping, which makes glioma surgery an individual treatment option for each single patient. But there is a need of more clinical evidence to make supratotal resection widely used. Supratotal resection today is still reserved for individual cases. However, if it is impossible to perform GTR, then STR should be performed. Glioma biopsy is only the last option to confirm the diagnosis for gliomas without possible surgical resection as treatment option.

All images in this chapter are from the prime author's personal series, extracted from the archive of *Impax* system of the Clinical Center, University of Sarajevo, with permission.

Publishing is allowed also by the patients and/or their relatives.

The authors do not declare any conflict of interest.

ization of resection for each patient aiming to achieve the "oncofunctional balance."

becomes an individual surgery, especially designed for each patient.

160 Glioma - Contemporary Diagnostic and Therapeutic Approaches

**4. Conclusion**

**Acknowledgements**

**Conflict of interest**

Ibrahim Omerhodžić<sup>1</sup> \*, Almir Džurlić<sup>1</sup> , Adi Ahmetspahić<sup>1</sup> , Bekir Rovčanin2 , Mirela Kalamujić<sup>3</sup> , Nurija Bilalović<sup>4</sup> , Bilal Imširović<sup>5</sup> and Enra Suljić<sup>6</sup>

\*Address all correspondence to: ibrahimomerhodzic74@gmail.com

1 Department of Neurosurgery, Sarajevo University Clinical Center, Sarajevo, Bosnia and Herzegovina

2 Department of General Practice, Health Centers of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina

3 Department of Oncology, Sarajevo University Clinical Center, Sarajevo, Bosnia and Herzegovina

4 Department of Pathology, Sarajevo University Clinical Center, Sarajevo, Bosnia and Herzegovina

5 Department of Radiology, General Hospital of Sarajevo, Sarajevo, Bosnia and Herzegovina

6 Department of Neurology, Sarajevo University Clinical Center, Sarajevo, Bosnia and Herzegovina
