Indirect cognitive mapping in glioma surgery in patients not eligible for awake craniotomy – how I do it

This paper illustrates a method to map cognitive subcortical white matter pathways in brain tumour surgery, in patients not eligible for awake intraoperative mapping. The latter being the gold standard, it is not feasible in all patients. Illustrated by three cases, the presented method includes a preoperative mapping of both motor and subcortical eloquent structures - such as arcuate fasciculus and basal ganglia - subsequentially using subcortical motor mapping as a landmark to indirectly identify the cognitive structures.