Neuropsychology in the neurosurgical management of primary brain tumors

In the modern era of brain tumor research and clinical management, neuroimaging techniques have supplanted neuropsychological methods for lesion localization. Nonetheless, neuropsychologists remain instrumental to the neurosurgical team in a variety of capacities. This chapter outlines the most common roles neuropsychologists serve in the care of patients with primary brain tumors, with particular focus paid to neurosurgical planning and monitoring of neurocognitive functioning at various stages of the disease course. In addition to issues surrounding neuropsychological assessment, broad coverage is given to the role of neuropsychologists in brain mapping procedures, including preoperative functional magnetic resonance imaging and intraoperative direct cortical stimulation. Following a brief introduction to functional neurosurgery for brain tumor management, the evidence base for integration of current neuropsychological practices within the neurosurgical care team is described. This is followed by discussion of issues related to practical application of neuropsychological services within the neurosurgical setting. Future directions for research and practice are also considered.