Neuroanatomical Landmarks to Approach Insular Tumors

The insular lobe is a complex and surgically challenging region of the brain due to its deep location and the cortical surrounding structures that obscure its surgical access. Insular tumors are relatively uncommon; however, their surgical removal can result in significant morbidity due to their location within the brain and their association with highly functional regions. The insula has extensive connections through hemispheric association and projection fibers, as well as adjacent eloquent structures, which are at risk during surgical intervention. Therefore, a thorough understanding of the neuroanatomical landmarks of the insula is essential to achieve a useful preoperative planning and subsequent surgical success.