UNASSIGNED: Few studies have examined the clinical characteristics of @entity1 with lesions in the deep parietal operculum facing the sylvian fissure, the region recognized as the secondary somatosensory area (SII). Moreover, surgical approaches in this region are challenging. In this paper the authors report on a @entity1 presenting with @entity302 with a @entity5 in the left deep parietal operculum. The @entity1 was a 24-year-old @entity1 who suffered daily partial @entity410 with extremely uncomfortable @entity809 and/or occasional @entity158 on his right side. MRI revealed a @entity5 in the medial aspect of the anterior transverse parietal gyrus, surrounding the posterior insular point. Long-term video electroencephalography monitoring with scalp electrodes failed to show relevant changes to @entity410 . Resection with cortical and subcortical mapping under awake conditions was performed. A negative response to stimulation was observed at the subcentral gyrus during language and somatosensory tasks; thus, the transcortical approach (specifically, a transsubcentral gyral approach) was used through this region. Subcortical stimulation at the medial aspect of the anterior parietal gyrus and the posterior insula around the posterior insular point elicited strong @entity809 and @entity158 in his right side, similar to manifestation of his @entity410 . The @entity5 was completely removed and pathologically diagnosed as @entity1893 . His @entity302 disappeared without @entity16 postoperatively. In this case study, 3 points are clinically significant. First, the clinical manifestation of this case was quite rare, although still representative of @entity302 . Second, the location of the lesion made surgical removal challenging, and the transsubcentral gyral approach was useful when intraoperative mapping was performed during awake surgery. Third, intraoperative mapping demonstrated that the @entity1 experienced @entity158 with electrical stimulation around the posterior insular point. Thus, this report demonstrated the safe and effective use of the transsubcentral gyral approach during awake surgery to resect deep parietal @entity75 , clarified electrophysiological characteristics in the SII area, and achieved successful @entity5 resection with good control of @entity302 .

A case of secondary XXXX with a left deep parietal opercular lesion: successful @entity5 resection using a transsubcentral gyral approach during awake surgery.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'man'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizure', 'seizures'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity75 :: ('MESH:D001927', 'Disease') :: ['opercular lesions'] @entity809 :: ('MESH:D010292', 'Disease') :: ['dysesthesia'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurological deterioration'] @entity302 :: ('MESH:D004827', 'Disease') :: ['epilepsy', 'SII epilepsy'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity1893 :: ('MESH:D008228', 'Disease') :: ['pleomorphic xanthoastrocytoma']
@entity302 :: (MESH:D004827,Disease) :: ['somatosensory epilepsy']
