A super-selective wada test successfully detected an artery that supplied broca’s area in a case of left frontal lobe glioblastoma: Technical case report

Shota Yamashita, Ryuta Saito, Shin Ichiro Osawa, Kuniyasu Niizuma, Kazushi Ukishiro, Masayuki Kanamori, Kazuo Kakinuma, Kyoko Suzuki, Teiji Tominaga

Research output: Contribution to journalArticlepeer-review

Abstract

In cases of malignant gliomas located at language eloquent area, it is often difficult to preopera-tively detect those area with functional MRI. Awake surgery is often used to spare the language eloquent area during surgery for such tumors; it is not available for a patient whose intracranial pressure is elevated due to the malignant tumor. The Wada test involves infusing anesthetic agents into the internal carotid artery to determine language dominancy before surgery for epilepsy or brain tumor. The super-selective Wada test is a technique to detect more detailed functional localization by infusing anesthetics into far distal middle cerebral artery branches. We present a 37-year-old man suffering from a left frontal lobe glioblastoma, in whom detection of an artery supplying Broca’s area was attempted by a super-selective Wada test. The super-selective Wada test successfully detected the branch of middle cerebral artery supplying Broca’s area. Total resection of the contrast-enhancing area was achieved without damaging the artery supplying Broca’s area without any neurological sequelae. This is the first report describing the useful-ness of the super-selective Wada test in glioblastoma treatment. Our findings suggest that the super-selective Wada test is a powerful and useful means to distinguish the artery that supplies the language area from the tumor feeding artery in cases of tumors in the language eloquent area.

Original languageEnglish
Pages (from-to)661-666
Number of pages6
JournalNeurologia medico-chirurgica
Volume61
Issue number11
DOIs
Publication statusPublished - 2021

Keywords

  • Functional localization
  • Glioblastoma
  • Language area
  • Propofol test
  • Wada test

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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