Awake surgery has become a standard practice for managing diffuse low-grade gliomas (LGGs), particularly in eloquent brain areas, and is established as a gold standard technique for left-dominant-hemisphere tumors. However, the intraoperative monitoring of functions in the right non-dominant hemisphere (RndH) is often neglected, highlighting the need for a better understanding of neurocognitive testing for complex functions in the right hemisphere. This article aims to comprehensively review the current literature on the benefits of awake craniotomy in gliomas of the non-dominant right hemisphere. A systematic review was conducted using the PubMed and ScienceDirect databases with keywords such as “right hemisphere”, “awake surgery”, “direct electrical brain stimulation and mapping”, and “glioma”. The search focused on anatomical and surgical aspects, including indications, tools, and techniques of awake surgery in right cerebral hemisphere gliomas. The literature search identified 74 sources, including original articles, books, monographs, and review articles. Two papers reported large series of language assessment cases in 246 patients undergoing awake surgery with detailed neurological semiology and mapping techniques, while the remaining studies were predominantly neuroradiological and neuroimaging in nature. Awake craniotomy for non-dominant-hemisphere gliomas is an essential tool. The term “non-dominant” should be revised, as this hemisphere contributes significantly to essential cognitive functions in the human brain.
清醒手术已成为处理弥漫性低级别胶质瘤（LGGs）的标准实践，尤其是在功能关键脑区，并已确立为左半球优势侧肿瘤的金标准技术。然而，右半球非优势侧（RndH）功能的术中监测常被忽视，这凸显了需更深入理解右半球复杂功能的神经认知测试。本文旨在全面综述当前关于清醒开颅手术在非优势右半球胶质瘤中益处的文献。通过使用PubMed和ScienceDirect数据库，以“右半球”、“清醒手术”、“直接脑电刺激与映射”和“胶质瘤”等关键词进行系统综述。搜索重点包括解剖和手术方面，如右半球胶质瘤清醒手术的适应症、工具和技术。文献检索共识别74项来源，包括原始文章、书籍、专著和综述文章。其中两篇论文报告了246例接受清醒手术患者的语言评估大系列案例，详细描述了神经学症状学和映射技术，其余研究主要为神经放射学和神经影像学性质。对于非优势半球胶质瘤，清醒开颅手术是一种重要工具。“非优势”这一术语应予以修正，因为该半球在人脑关键认知功能中发挥着重要作用。
Awake Craniotomy for Gliomas in the Non-Dominant Right Hemisphere: A Comprehensive Review
肿瘤(癌症)患者之家