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THE USE OF INTRAOPERATIVE NEUROPHYSIOLOGICAL MONITORING TECHNIQUES IN SUPRATENTORIAL BRAIN SURGERIES

Authors :
Sameh M. Hefni
Hisham A. Simry
Salah Hamada
George H. Ibrahim
Ahmed M. Darwish
Source :
Ain Shams Medical Journal. 71:417-428
Publication Year :
2020
Publisher :
Egypts Presidential Specialized Council for Education and Scientific Research, 2020.

Abstract

Background: In patients with lesions located around or within eloquent motor or speech cortex, surgical resection is a challenge; because of high risk of development of postoperative deficits and incomplete resection. intraoperative neurophysiological monitoring (IONM) paves the way to complete resection in these patients along with functional preservation postoperative. Aim of the study: To assess the utility and effectiveness of IONM techniques in resection of lesions located in eloquent motor speech cortex (intrinsic brain tumors and epileptic zones), regarding the extent of resection and functional preservation postoperative. Patients and Methods: we conducted prospective observationalstudy on 30 patients with different types of lesions located within eloquent motor or speech cortex, by the use of low frequency direct cortical and subcortical stimulation technique,12 patients were operated under general anaesthesia and 18 patients were operated by awake craniotomy technique.All patients were assessed clinically and do MRI brain with contrast and FLAIR study postoperatively, those who developed new onset neurological deficits were assessed at 3months postoperative. Results: complete resection was achieved in 17 patients (56.6%). Immediate postoperative new onset or worsened neurological deficits were encountered in 18 patients (60%), however 3 months postoperative the deficits were persistent only in 4 patients (13.3%). Conclusion: direct cortical stimulation is an easy safe and reliablemethod for detection of cortical and subcortical functionally eloquent structures during resection of brain tumors and epileptic lesions

Details

ISSN :
27353540
Volume :
71
Database :
OpenAIRE
Journal :
Ain Shams Medical Journal
Accession number :
edsair.doi...........d8e26e38d2ff4b4e02231655504c5fa5