BACKGROUND Preservation of language and cognition is crucial in glioma surgery, as they are crucial aspects of daily life functioning. Several studies claimed that awake surgery in eloquent areas is demanded in low and high-grade gliomas. Cognitive and language outcome has been less investigated in high-grade gliomas compared to low-grade. METHOD We analyzed the neuropsychological and neuro-oncological outcome of nineteen patients (from a cohort of forty patients) who underwent fully awake surgery for resection of malignant tumors located in eloquent areas. RESULTS Post-surgery, linguistic functions were unchanged in 80 % of patients. Slight impairments in memory and executive functions were observed in about 50 % of patients. Survival rate at one year follow-up was 89 %. Results showed that awake procedure is safe, well tolerated and related with good linguistic outcome similar to low-grade gliomas. The majority of patients reported a good outcome in term of quality of life. CONCLUSIONS Our results confirm that awake surgery is associated to good cognitive and linguistic clinical outcome also in malignant tumors.

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高级别胶质瘤患者清醒开颅手术后的认知和语言结果

背景语言和认知的保存在神经胶质瘤手术中是至关重要的，因为它们是日常生活功能的关键方面。几项研究声称，低级别和高级别胶质瘤需要在雄辩区进行清醒手术。与低级别胶质瘤相比，对高级别胶质瘤的认知和语言结果的研究较少。方法 我们分析了 19 名患者（来自 40 名患者的队列）的神经心理学和神经肿瘤学结果，这些患者接受了完全清醒手术以切除位于雄辩区的恶性肿瘤。结果 手术后，80% 的患者的语言功能没有变化。在大约 50% 的患者中观察到记忆和执行功能的轻微损伤。一年随访的存活率为 89%。结果表明，清醒手术是安全的，耐受性良好，并与类似于低级别胶质瘤的良好语言结果相关。大多数患者在生活质量方面报告了良好的结果。结论 我们的结果证实，清醒手术与恶性肿瘤的良好认知和语言临床结果相关。