A left temporal mass and symptoms of speech hesitation

Left temporal mass T2 sequenceSymptoms:  Difficulty in word choice

Brain MRILeft temporal mass post gadolinium T1 sequence   shows a left temporal mass without enhancement.  Preoperative MEG reveals expressive speech area just superior to tumor. 

Procedure: Awake craniotomy with intraoperative speech mapping.

Findings: Intraoperative speech mapping revealed complete speech arrest just outside margin of tumor. 

Pathology: oligoastrocytoma

Outcome: Patient with preserved speech function via awake craniotomy technique.