Mapping glioma electromagnetic waves and temperature as a surgical strategy to resect a diffusely infiltrative glioma.

Background: Brain waves are regarded as brain energy and their visualization as images requires neurophysiological recordings using electrocorticographic electrodes which are commonly utilized during surgery to study brain functions. On the other hand, brain temperature refers to heat within the brain. Intracranial brain heat is regulated by heat production and dissipation. Herein, we present two neurosurgical cases of using glioma electromagnetic waves and temperature as a surgical strategy to resect the diffusely infiltrative gliomas. Case Description: We report two glioma cases: the first was a low-grade glioma case who presented with focal seizures and was diagnosed with a left prefrontal glioma. He underwent awake cranial surgery with additional glioma waves and temperature mappings. The intraoperative glioma wave findings were increased delta waves and low wave amplitudes with a lack of oscillations. Referring to temperature, it was noted that there was a glioma temperature gradient with the highest recorded temperature at the center of the tumor. For the second case, a high-grade glioma was also removed under awake technique in the left prefrontal lobe. This case further validated the aforementioned findings for glioma temperature gradient with similar findings of having the highest temperature recorded at the core of the tumor. Conclusion: We found that gliomas had low energy states with high temperatures when compared to adjacent cortices. This inverse relationship between energy and temperature should be further explored because a novel neurosurgical strategy in glioma mapping and resection might arise from this principle.