Reconciling Functional MRI Findings With Intraoperative Anatomy in Brain Tumor Surgery: Stereotactic-Guided Resection of Glioma in Broca’s Area

Stereotactic navigation and functional magnetic resonance imaging (fMRI) are increasingly used as important tools for intraoperative guidance and preoperative mapping for lesions in eloquent areas. We report a case in which a WHO grade II oligodendroglioma in Broca’s area with functional activation was successfully resected with the support of blood-oxygen-level-dependent imaging (BOLD)-fMRI mapping in a patient who refused an awake craniotomy. This case highlights key principles of tumor surgery navigation. Specifically, it calls into question the utility of awake craniotomy in this modern era. Ultimately, fMRI is an important tool for tumor resections and can limit the need for more expensive or invasive measures.