Transient inhibition of motor function induced by the Cavitron ultrasonic surgical aspirator during brain mapping

Neurosurgery
Giorgio CarrabbaLorenzo Bello

Abstract

We report, for the first time, the occurrence of interference between a Cavitron ultrasonic surgical aspirator (CUSA) and intraoperative brain mapping performed by direct electrical stimulation (DES). Intraoperative polygraphic recordings (electrocorticogram and electromyogram) were gathered from a 44-year-old patient harboring a recurrent Grade II oligoastrocytoma operated on with the aid of a CUSA and DES. Simultaneous use of CUSA and DES at the subcortical level in proximity to the corticospinal tract brought about the abolition of previously evident motor responses. This abolition was fully reversible after the CUSA was turned off. An analogous pattern of motor response inhibition was evident when the DES was applied cortically and the CUSA was used subcortically close to motor pathways. Interestingly, the authors had already observed a similar phenomenon in many patients when the CUSA was used for resection of lesions located within or in proximity to subcortical language pathways. In this setting, the CUSA induced transient speech disturbances that were confirmed afterwards by the DES. This interference with language and motor mapping might be interpreted as a transitory inhibition of axonal conduction. The clinical signi...Continue Reading

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Citations

Feb 4, 2010·Neurosurgical Focus·Andrea SzelényiUNKNOWN Workgroup for Intraoperative Management in Low-Grade Glioma Surgery within the European Low-Grade Glioma Network
Dec 20, 2012·Expert Review of Medical Devices·Piotr Zieliński, Jacek Furtak
Dec 5, 2009·Neuroimaging Clinics of North America·Lorenzo BelloSergio M Gaini
Feb 7, 2015·Brain and Language·Joanna SierpowskaAntoni Rodríguez-Fornells
May 14, 2016·Journal of Neurosurgery·Joanna SierpowskaAntoni Rodríguez-Fornells
Nov 22, 2014·Expert Review of Neurotherapeutics·Tomasz Dziedzic, Mark Bernstein
Nov 3, 2016·Journal of Neuro-oncology·Karine Michaud, Hugues Duffau
Jan 22, 2021·Neurosurgery·Marco RossiLorenzo Bello

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