Fig. 4.

A case of high-grade glioma located in left parietal lobe. A: Preoperative contrast enhanced-T₁ axial MRI showing an enhanced lesion in the left postcentral gyrus. B: Three-dimensional cortical image in operative view. C: Tractography showing the tumor (beige) near the pyramidal tract (yellow), somato-sensory tract (blue), the superior longitudinal fascicle III (green), and the arcuate fascicle (red). D: Postoperative FLAIR axial MRI. E and F show an intraoperative photo and preoperative tractography within the white square in B. E: An intraoperative photo taken after surgical resection of tumor with preservation of positive mapping areas elicited by cortical and subcortical electrical stimulations. Cortical mappings: Dysarthria was elicited in the precentral gyrus (tag 1), and dysesthesia in the postcentral gyrus (tags 2 and 3). Subcortical mappings: Involuntary movements of right arm (tag 4) and leg (tag 6) were reproduced on the pyramidal tract, and dysesthesias of right hand (tag 5) and fingers (tag 7) on the somatosensory tract. F: Subcortical positive mapping areas are overlapped on the preoperative tractography. A and P indicate the anterior and the posterior side, respectively.