Ischemic complications associated with resection of opercular glioma

This study investigated the occurrence of infarction associated with radical resection of 11 consecutive opercular gliomas infero-lateral to the hand-digit sensorimotor area and the arterial supply to this region. Postoperative magnetic resonance imaging identified infarction beneath the resection cavity in all patients. Two patients developed permanent motor deficits associated with infarction involving the descending motor pathway. Cadaver angiography showed the distributing arteries to the corona radiata were the long insular arteries and/or medullary arteries from the opercular and cortical segments of the middle cerebral artery. Subcortical resection around the superior limiting sulcus of the posterior region of the insula and wide resection in the anteroposterior and cephalocaudal directions of the opercular region were considered to be risk factors of the critical infarction.