Technical principles of direct bipolar electrostimulation for cortical and subcortical mapping in awake craniotomy

Neuro-Chirurgie
J PalludG Spena

Abstract

Intraoperative application of electrical current to the brain is a standard technique during brain surgery for inferring the function of the underlying brain. The purpose of intraoperative functional mapping is to reliably identify cortical areas and subcortical pathways involved in eloquent functions, especially motor, sensory, language and cognitive functions. The aim of this article is to review the rationale and the electrophysiological principles of the use of direct bipolar electrostimulation for cortical and subcortical mapping under awake conditions. Direct electrical stimulation is a window into the whole functional network that sustains a particular function. It is an accurate (spatial resolution of about 5mm) and a reproducible technique particularly adapted to clinical practice for brain resection in eloquent areas. If the procedure is rigorously applied, the sensitivity of direct electrical stimulation for the detection of cortical and subcortical eloquent areas is nearly 100%. The main disadvantage of this technique is its suboptimal specificity. Another limitation is the identification of eloquent areas during surgery, which, however, could have been functionally compensated postoperatively if removed surgically....Continue Reading

Citations

Jul 13, 2018·Cognitive Neuropsychology·Adrià RofesGabriele Miceli
Jul 15, 2018·Neurosurgical Review·Soumya SagarManish K Aghi
May 20, 2019·Neurosurgical Review·Anastasios GiamouriadisFrancesco Vergani
Aug 29, 2020·Acta neurochirurgica·Alexandre RouxJohan Pallud
Mar 9, 2021·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jason LabuschagneClaudia Casieri
May 26, 2021·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jason Labuschagne

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