Intraoperative ultrasonography and cortical mapping for removal of deep cerebral tumors.

Stereotactic biopsies of brain tumors have recently become frequent, but prognosis may be improved by more aggressive surgery for primary and metastatic tumors. This report describes techniques for debulking and removal of deep cerebral tumors that are commonly subjected only to biopsy. With the use of intraoperative cranial ultrasonography and cortical mapping, five gliomas were debulked and three metastatic lesions were grossly totally removed. No complications occurred, and the patients with metastatic disease had striking neurologic improvement. Deep cerebral tumors may be treated aggressively with appropriate surgical techniques in selected patients.