{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T17:25:34Z","timestamp":1776446734953,"version":"3.51.2"},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nSeveral studies have reported that gross total resection contributes to improved prognosis in patients with butterfly glioblastoma (bGBM). However, it sometimes damages the corpus callosum and cingulate gyrus, leading to severe neurological complications.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nWe report two cases of bGBM that was safely and maximally resected using brief and exact awake mapping after general anesthesia. Two patients had butterfly tumors in both the frontal lobes and the genu of the corpus callosum. Tumor resection was first performed on the nondominant side under general anesthesia to shorten the resection time and maintain patient concentration during awake surgery. After that, awake surgery was performed for the lesions in the dominant frontal lobe and genu of the corpus callosum. Tumor resection was performed through minimal cortical incisions in both frontal lobes. Postoperative magnetic resonance imaging showed gross total resection, and the patients had no chronic neurological sequelae, such as akinetic mutism and abulia.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nbGBM could be safely and maximally resected by a combination of asleep and brief awake resection, which enabled patients to maintain their attention to the task without fatigue, somnolence, or decreased attention. The bilateral approach from a small corticotomy can avoid extensive damage to the cingulate gyrus.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_543_2022","type":"journal-article","created":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T08:41:51Z","timestamp":1666946511000},"page":"492","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Combination of asleep and awake craniotomy as a novel strategy for resection in patients with butterfly glioblastoma: Two case reports"],"prefix":"10.25259","volume":"13","author":[{"given":"Tomohiro","family":"Hosoya","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Yonezawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kagoshima University Hospital, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aiko","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Ohno","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuji","family":"Miyakita","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masamichi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Yanagisawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukie","family":"Tamura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miyu","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Nakano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuri","family":"Oishi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sei","family":"Manabe","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsufumi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshitaka","family":"Narita","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2022,10,28]]},"reference":[{"key":"10.25259\/SNI_543_2022\/ref-1","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1007\/s00701-021-04844-w","article-title":"Improved outcomes associated with maximal extent of resection for butterfly glioblastoma: Insights from institutional and national data","volume":"163","author":"Boaro","year":"2021","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_543_2022\/ref-2","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.3171\/2016.5.JNS153006","article-title":"A method for safely resecting anterior butterfly gliomas: The surgical anatomy of the default mode network and the relevance of its preservation","volume":"126","author":"Burks","year":"2017","journal-title":"J 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