Raising the Question of Personality Changes in Glioma Surgery

The history of neurology and neurosurgery shows that the risk of personality changes after brain damage should never be underestimated. Accumulating evidence suggests that major cognitive functions are generally well preserved in patients with diffuse low-grade glioma, even after extended tumors and resection. Efficient cognitive functioning in these patients could mask possible changes in certain aspects of their personality, explaining why to date this question has received little attention from researchers. However, it is necessary for the neurosurgeon to be informed by scientific research of the factors that could favor the appearance of unacceptable changes in personality and behavior. Investigating issues related to such changes is essential to protect and preserve patients’ quality of life and more generally reflect the most relevant and ethical management that patients have to receive. In this chapter, we address the general issue of personality assessment and its possible changes in patients with brain damage. We then review the few studies examining this question in the context of low-grade glioma surgery and consider the consequences for the patients’ management and clinical follow-up.