Surgery Decision in Brainstem Mass Resection by Diffusion Tensor Based Fiber Tracking Assistance: A Report of Four Cases

Brainstem is surrounded by noteworthy dense packed white matter fibers which must be preserved during surgery. Brain stem surgery carries serious risks. It is very important to know about the localization of the tumor and the eloquent white matter tracts for surgery decision and for preoperative neurosurgical planning. In this report, four cases with brain stem mass were discussed. The three of them were operated and the one of the four cases was referred to Oncology department for radiotherapy in which major fibers could not be preserved based on White matter tractography (WMT) and Diffusion tensor imaging (DTI) findings.