Thalamic gliomas: Advances in the surgical management

Thalamic glioma is a rare type of brain tumor with a high rate of morbidity and mortality. Secondary to its deep-seated location and proximity to numerous eloquent structures, it has historically been considered an "inoperable" tumor. However, with recent technological advances in imaging and operative techniques, surgical resection has gradually become a more safe and valuable option in the management of these tumors. Preoperative DTT allows the visualization of white fiber tracts neighboring the thalamus, allowing surgeons to plan safer surgical approaches. Intraoperative magnetic resonance imaging (MRI) and ultrasound (US) provide further guidance, as minimally invasive approaches, including surgical retraction devices and laser therapy, and can be used to increase precision and reduce iatrogenic disruption of healthy brain tissues. While many challenges still exist, tremendous progress has been made in the surgical management of thalamic gliomas.