The combination of neuronavigation with transcranial magnetic stimulation for treatment of opercular gliomas of the dominant brain hemisphere.
OBJECTIVE
The objective of this study is to investigate the application of transcranial magnetic stimulation combined with neuronavigation for preoperative mapping of the language area in neurosurgical interventions on the opercular area of the dominant hemisphere.


METHODS
Five patients were operated upon gliomas in the opercular area. For localization of the speech area a transcranial magnetic stimulator MEDTRONIC-MagPro was used. BrainLAB-VectorVision Neuronavigation system was utilized for precise planning of the operative approach.


RESULTS
Gross total resection was achieved in all patients. Three-month postoperative follow-up was done. Three of the patients had a transient postoperative motor aphasia which resolved within 1 month.


CONCLUSIONS
This method is useful for preoperative localization of the speech area, as well as preoperative planning of the operative approach and intra-operative planning of the direction of brain retraction and operative corridor.
Shamov
T
T
Department of Neurosurgery, Medical Military Academy Sofia, Bulgaria. shamov@abv.bg
Spiriev
T
T
Tzvetanov
P
P
Petkov
A
A
D000328:Adult; D001037:Aphasia / Q000517:prevention & control; D001931:Brain Mapping / Q000295:instrumentation / Q000379:methods*; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D007839:Functional Laterality; D005910:Glioma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D013702:Temporal Lobe / Q000473:pathology / Q000601:surgery; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D055815:Young Adult