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Tetsuya Goto, Chika Ndubuisi, Tatsuya Kobayashi, Takafumi Kiuchi, Kunihiko Kodama, Keiichi Sakai and Kazuhiro Hongo

. In the present case, the NIRS was only used after the fifth surgery. However, it is possible that if the NIRS was used earlier around the third or fourth perioperative period, with a reliable confirmation of migration of the right motor function to opposite side, the option of a more aggressive tumor removal may have been attempted at that time. Further clinical studies are required for better understanding of the clinical relevance of NIRS investigation in the pre-operative monitoring for areas of eloquence and the concept of brain plasticity. 4 Conclusion