ANESTHETIC MANAGEMENT OF HIGH GRADE BUTTERFLY GLIOMA OF THE CORPUS CALLOSUM- A CASE REPORT

Glioblastoma (GBM), is an aggressive brain tumor associated with poor prognosis. The history of GBM remains unfavorable; however, recent evidence demonstrates prolonged survival with maximal safe surgical resection followed by adjuvant radiotherapy and chemotherapy.GBM typically spreads along white matter tracts. Growth and infiltration in certain tracts and eloquent areas of the brain, such as the corpus callosum, can render these tumors only partially resectable or unresectable. (1) GBM extending along the corpus callosum often shows a pattern of a butterfly on magnetic resonance imaging (MRI), hence the name butterfly glioma. This case report highlights the challenges faced by anesthesiologist in providing an optimal physiological condition during intra-operative period due to its critical location and its aggressive infiltrative nature. This report also focuses on how detailed pre operative neurological assessment and tailored anesthetic technique can allow early assessment of neurological status and a how, close communication with the surgical team can diligently improve patient’s outcome post operatively.