PMID: 9441254Jan 24, 1998Paper

Tumor surgery of the speech cortex in local anesthesia. Neuropsychological and neurophysiological monitoring during operations in the dominant hemisphere

Der Nervenarzt
H J ReulenK Bise

Abstract

We report on 30 cases where we have used cortical stimulation mapping to define the areas representing sensorimotor, language and speech functions under local anesthesia to facilitate resection of space-occupying lesions near these areas. Under the simplistic concept that Broca's area lies in the frontal operculum (inferior frontal gyrus) and that Wernicke's area is located in the posterior perisylvian area (superior temporal, angular and supramarginal gyri), we found language and speech function to be represented outside these areas in up to 4 stimulation sites of 15 patients. The results of cortical stimulation mapping were therefore essential to decide on the optimal access route to the lesions that were located subcortically and on the optimal resection plane in gliomas. After the limits of these areas and of the lesions had been established with stimulation mapping and with intrasurgical microscopic smear preparations, respectively, lesions were safely removed under continuous monitoring of sensorimotor, language and speech function. Immediately after surgery we encountered language and speech deficits in 9 patients (30%), which resolved completely in 5 and incompletely in 4 instances. Thus, language functions were normal ...Continue Reading

Citations

May 18, 2004·Anaesthesia·M KlimekJ Klein
Dec 24, 2005·Acta neurochirurgica·T PichtO Suess
Apr 13, 2002·Neurosurgery·Aurelia PeraudHans-Jürgen Reulen
Oct 2, 2008·Journal of Neurosurgery·Josef IlmbergerJoerg-Christian Tonn
Mar 6, 2012·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Brandon Kirsch, Mark Bernstein
Jul 14, 2016·Epilepsy & Behavior Case Reports·AmiLyn M TaplinGerwin Schalk

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