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Insular Tumors

Last Updated: March 12, 2020

Dominant Insular Glioma: Strategies for Tumor Removal

The insula plays an important role in visceral sensorimotor processing, sympathetic control of cardiovascular tone and somatosensory input. It also participates in pain processing, motor planning, volitional swallowing, and gustatory, auditory, vestibular, emotional, and cognitive functions, including language. For further information regarding the complex functions of insula, please see Wikipedia.

Compared with other gliomas, insular gliomas are unique in their presentation and behavior. These tumors usually arise in areas of white matter adjacent to the allocortex or mesocortex. During their initial phases of growth, these tumors frequently respect the neocortices, central nuclei, and ventricles.

The insula is a challenging structure to reach surgically because of its complex anatomy and the overlying highly eloquent cortices and white matter tracts, as well as critical vascular structures. The development of microsurgical techniques and implementation of cortical and subcortical mapping strategies under conscious sedation (awake) and general anesthesia (sleep) have ad...