title: Navigated transcranial magnetic stimulation-guided resection of a left parietal tumor: case report.
abstract: BACKGROUND
  Operating on tumors with close margins to the primary motor cortex requires a precise preoperative planning. Transcranial magnetic stimulation (TMS) is the only preoperative technique for detecting eloquent cortical regions that is directly comparable to direct cortical stimulation (DCS). Combining this well established method in neurological diagnostics with a non-invasive navigation system using the patient's preoperative MRI scans in the NEXTSTIM system might be a promising tool in preoperative planning.
  
  
  METHODS
  We used preoperative navigated TMS to localize the motor strip in a 75-year-old female patient with a central lesion suspected to be a meningeoma. The elicited data were fused to the navigation MRI in the Brainlab IPLAN system. Following the preoperatively acquired MEP data, a posterior approach to the tumor was planned. After craniotomy, DCS and phase reversal were performed to verify the preoperative results. The motor strip could be located in the same cortical area where the motor response was elicited preoperatively.
  
  
  CONCLUSIONS
  Navigated transcranial cortical stimulation via the NEXTSTIM system is a helpful tool for preoperative planning.
authors.affiliation: Department of Neurosurgery, Klinikum Stuttgart, Stuttgart, Germany. J.Coburger@klinikum-stuttgart.de
authors.forename: J
authors.initials: J
authors.lastname: Coburger
authors.forename: C
authors.initials: C
authors.lastname: Musahl
authors.forename: C
authors.initials: C
authors.lastname: Weissbach
authors.forename: M
authors.initials: M
authors.lastname: Bittl
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D038361:Neuronavigation / Q000379:methods*; D010296:Parietal Lobe / Q000473:pathology / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*