Objective To investigate the clinical characteristics,operative methods,and diffusion tensor imaging(DTI) in the resection of intrinsic insular gliomas via transsylvian approach. Methods From June 2008 to June 2010,12 patients with intrinsic insular gliomas were treated via transsylvian microsurgical approach,with preoperative magnetic resonance imaging diffusion tensor imaging(MR DTI) evaluation.The data of these patients were retrospectively analyzed. Results All patients had astrocytoma,including 8 patients of Grades I to II,2 patients of Grades III to IV,and 2 patients of mixed glial tumors.The insular rumors were completely removed in 9 patients,whereas they were only partially removed from 3 patients. No death was related to the operations.Two patients had transient aphasia,2 experienced worsened hemiplegia on opposite sides of their bodies,and 2 had mild hemiplegia and language function disturbance. Conclusions Most of the insular gliomas are of low grade.By evaluating the damage of the corticospinal tract through DTI and using ultrasonography to locate the tumors during operation,microsurgery treatment removes the lesions as much as possible, protects the surrounding areas,reduces the mobility rate,and improves the postoperative quality of life. Objective To investigate the clinical characteristics, operative methods, and diffusion tensor imaging (DTI) in the resection of intrinsic insular gliomas via transsylvian approach. Methods From June 2008 to June 2010, 12 patients with intrinsically insular gliomas were treated via transsylvian microsurgical approach, with Results All patients had astrocytoma, including 8 patients of Grades I to II, 2 patients of Grades III to IV, and 2 patients of mixed glial tumors.The insular rumors were completely removed in 9 patients, as they were only partially removed from 3 patients. 2 died worsening hemiplegia on opposite sides of their bodies, and 2 had mild hemiplegia and language function disturbance. Conclusions Most of the insular gliomas are of low grade.By evaluating the damag e of the corticospinal tract through DTI and using ultrasonography to locate the tumors during operation, microsurgery treatment removes the lesions as much as possible, protects the surrounding areas, reduces the mobility rate, and improves the postoperative quality of life.