Intraoperative Neurophysiological Monitoring for Optimal Brain Mapping

  • Park, Sang-Nam (Department of Neurology Laboratory, Kang Nam Cha Medical Center) ;
  • Park, Sang-Ku (Department of Neurology Laboratory, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2013.11.02
  • Accepted : 2013.12.11
  • Published : 2013.12.30

Abstract

There is a correct way to avoid any sequale in the central motor area during neurosurgery procedures. A clear way to find the circumference of the central sulcus, central motor, and sensory areas by giving cortical electrical stimulation to the central motor area immediate after surgery is proposed. Looking at patients who underwent brain surgery September 2009 to July 2013, the central sulcus and speech areas around the central area of the brain was investigated, using the practices of either a localized brain map check or a direct cortical electrical stimulation test. Brain maps localized around the surgical site through functional movement or speech areas were identified. Accurate tests done during surgery without damage to motor neurons or after surgery were conducted smoothly. Although successful brain map test localization can be accomplished, there are some factors that can interfere. The following phenomena can reverse the phase: (1) the first sensory / motor in the case of patients severe nerve damage; (2) placement of the electrode on top of the vessel; (3) presence of a brain tumor near the brain cortex; (4) use of anesthesia if patient cooperation is difficult; and (5) location of the electrode position and stimulus is inappropriate.

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