Intracranial neurosurgery guided by functional imaging.
Neurosurgery on eloquent cortex entails important risks of functional deficits complicating aggressive lesion resection. In this study, advanced biomagnetic functional imaging of somatosensory and motor cortex combined with surface rendered magnetic resonance imaging displays including vascular anatomy were used in conjunction with a new nonintrusive intraoperative guided instrumentation system to resect a tumor in eloquent cortex. Intraoperative verification of the accuracy of pre-operative motor localization demonstrated highly accurate results comparing direct stimulation and noninvasive presurgical mapping. The applicability of surface rendered combined functional and anatomic maps of cortex is directly evident on comparison of preoperative computer images and intraoperative pictures. This combination of new technologies has a significant potential for reduced risk and improved outcome in neurosurgery of eloquent cortex.
Gallen
C C
CC
Department of Neuropharmacology, Scripps Research Institute, La Jolla, California 92037.
Bucholz
R
R
Sobel
D F
DF
D001931:Brain Mapping / Q000295:instrumentation / Q000379:methods*; D001932:Brain Neoplasms / Q000503:physiopathology / Q000556:secondary / Q000601:surgery*; D002540:Cerebral Cortex / Q000503:physiopathology / Q000601:surgery*; D003196:Computer Graphics; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography / Q000379:methods; D008875:Middle Aged; D009493:Neurosurgery / Q000379:methods; D011237:Predictive Value of Tests; D013003:Somatosensory Cortex / Q000502:physiology / Q000601:surgery