Subcortical mapping and monitoring during insular tumor surgery.

Full Abstract

OBJECT: The treatment of insular tumors is controversial. Surgical treatment is associated with a higher morbidity rate than other therapies. The present work presents a new method in which the descending motor pathways are monitored during surgery for insular tumors. METHODS: Intraoperative monitoring was performed in a combination of 2 techniques. The motor cortex was stimulated with a transcranial electrical stimulus. In addition, direct subcortical stimulation was performed with an electrical anodal monopolar stimulus. Compound motor action potentials (CMAPs) were recorded from target muscles. RESULTS: Fifteen patients were included in this preliminary study. Following transcranial stimulation, CMAPs were recorded in all cases. Subcortical stimulation was successful in 12 cases. Significant CMAP alterations were recorded in 5 patients. There were no false-negative results in the series. CONCLUSIONS: The technique presented here is a safe method. It allows a quantitative monitoring of motor function and functional mapping of the pyramidal tract during insular surgery.

Author information

Author/s: Kombos, Theodoros (T); Süss, Olaf (O); Vajkoczy, Peter (P);

Affiliation: Neurosurgical Clinic, Charité-Universitätsmedizin, 12200 Berlin, Germany. theodoros.kombos(-atsign-)charite.de

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Neurosurgical focus (Neurosurg Focus), published in United States. (Language: eng)

Reference: 2009-Oct; vol 27 (issue 4) : pp E5

Dates: Created 2009/10/02; Completed 2009/10/20;

PMID: 19795954, status: MEDLINE (last retrieval date: 10/20/2009, IMS Date: )

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