Complication avoidance: resection of the insular glioma complicated by iatrogenic injury to the lenticulostriate artery

Neurosurgical resection of insular gliomas is complicated by the risk of iatrogenic injury to lenticulostriate arteries (LSAs). We provide a description, figures, and a video to illustrate the clinical case in which the LSA was damaged during the resection of insular glioma. Cadaveric dissection from our anatomical laboratory and our 3D anatomical model provided relevant surgical anatomy of the insula. Proximal dissection of the Sylvian fissure up to the most lateral LSA, the emergence of the beige putamen, and the lenticulostriate veins are anatomic landmarks that allow reducing the risk of damaging the intraparenchymatous segment of the LSAs.