Berger sinar classification
- For insula gliomas
- Grading
- A: The insula is covered by the frontoparietal and temporal opercula.
- B: Zones I to IV are divided along the sylvian fissure and a perpendicular plane crossing the foramen of Monro.
- C: Insular tumor location is determined by the position of the majority of the tumor mass.
- D: Axial illustration of Zones I and II located anterior to the foramen of Monro and Zones II and III located behind the foramen of Monro.
- Help predict the extent of resection and likely deficit and surgical positioning for zone.
- For zone 2/3 tumours the head can be rotated 15° upward, allowing tumor resection beneath functional cortical structures positioned over the posterior insula.
- Zone classification was predictive of EOR
- Highest EOR seen in Zone I and Zone IV tumour
- Predictive of short term post operative morbidity
- Higher early complication rate seen in Giant and Zone I tumour
- Lowest complication rates seen in Zone II and Zone IV tumour
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