Background: If an awake surgery is somehow not available for gliomas at the language area, understanding the anatomy and well-designed surgical strategy are important.
Method: We present a case with left hemispheric multifocal high-grade gliomas located deeply at the left temporal pole, the Wernicke's area, and mesial temporal region. Because the patient could not endure the awake surgery and obtain practicable functional magnetic resonance imaging (MRI) for eloquent cortex evaluation, we removed the lesions following the anatomical resection strategy guided by diffusion tensor imaging (DTI).
Conclusion: This case demonstrates the value of DTI and the importance of anatomical resection strategies in glioma surgeries.
Keywords: Anatomy; Glioma; High-grade glioma; Resection.