Arcuate fasciculus cortico-cortical evoked potentials and direct cortico-subcortical stimulation during awake craniotomy for debulking of left dominant temporal oligodendroglioma

Electrophysiological mapping and monitoring techniques permit the objective measurement of eloquent cortical regions and accompanying white matter tracts to reduce the incidence of iatrogenic injury in glioma surgery. Recently, there has been increased interest in mapping and monitoring of the human arcuate fasciculus via cortico-cortical evoked potentials (CCEPs) during awake and asleep craniotomy. The authors present the case of a 27-year-old female who underwent a hypnosis-assisted awake craniotomy with cortico-subcortical language mapping and arcuate fasciculus CCEPs. There were no adverse effects associated with CCEP monitoring. Further investigation is required in order to substantiate the technique and validate clinical significance criteria, which may reliably permit asleep language mapping and monitoring.