Visual and sensorimotor cortices mapping during awake resection of lesion on the right periatrium: a case report on brainwaves and their peculiar patterns
-
Zamzuri Idris
,
Ch’ng Chee How
Abstract
Background: Advances in neurosurgery have allowed for more sophisticated mapping of various eloquent neural structures including the visual cortex. Applications of various modalities of new technologies allow accurate brain mapping for neurosurgical planning and preservation of functions in patients with lesions involving the eloquent cortex. The authors demonstrate the use of various new technologies for accurate presurgical planning, preservation of brain functions, and depiction of patterns of cortical brainwaves, which relate to motor networks and continuous visual stimuli.
Methods: A patient with a right periatrial lesion involving the optic radiation with no visual field deficits was operated under an awake state and under continuous contralateral electrocorticography and visual monitoring. Presurgically, extra-operative brain mapping for visual-, sensory-, and motor-evoked magnetic fields were completed using magnetoencephalography (MEG). The dipole areas were identified, and the images were fused with a 116-region cortical brain atlas. The ideal trajectory was planned based on these images and diffusion tensor imaging (tractography). The trans-sulcal approach via the inferior parietal lobule was elected. Prior to resection, intra-operative stimulation and mappings were done and continuous visual-evoked potentials were monitored during the actual resection.
Results: A good agreement for eloquent areas was identified based on extra-operative MEG and intra-operative neurostimulation mappings. The patient had no new neurological or visual-field deficits after the surgery. Certain patterns of brainwaves for motor cortex and visual stimulation were obtained: (a) spikes at the contralateral sensorimotor area when the motor strip was stimulated and (b) up-down and dense-loose continuous visual-evoked brainwaves at the occipital pole toward flashing checkerboard visual stimulation.
Conclusions: A combination of extra- and intra-operative brain mappings should ideally be done in patients harboring lesions near eloquent areas. The continuous visual-evoked potential monitoring, using a grid electrode and flashing checkerboard and contralateral sensorimotor responses, observed in our case is interesting and needs further studies.
References
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2014 by De Gruyter
Articles in the same Issue
- Frontmatter
- Research Articles
- New strategy for firm ventricular wall tap
- Endoscopic anatomy of the intracisternal oculomotor nerve: a new segmentation based on the topography of the arachnoid membranes
- Revisiting intradural spinal cord stimulation: an introduction to a novel intradural spinal cord stimulation device
- Case Reports
- SOMI brace immobilization as a treatment option for inveterate hangman’s fracture in pediatric patients
- Complete resolution of large intracranial aneurysm and cranial nerve deficits after endovascular treatment in an infant with tuberous sclerosis
- Visual and sensorimotor cortices mapping during awake resection of lesion on the right periatrium: a case report on brainwaves and their peculiar patterns
- Calendar of Events
- Calendar of Events
- Acknowledgement to our Reviewers
- Acknowledgement to our Reviewers
Articles in the same Issue
- Frontmatter
- Research Articles
- New strategy for firm ventricular wall tap
- Endoscopic anatomy of the intracisternal oculomotor nerve: a new segmentation based on the topography of the arachnoid membranes
- Revisiting intradural spinal cord stimulation: an introduction to a novel intradural spinal cord stimulation device
- Case Reports
- SOMI brace immobilization as a treatment option for inveterate hangman’s fracture in pediatric patients
- Complete resolution of large intracranial aneurysm and cranial nerve deficits after endovascular treatment in an infant with tuberous sclerosis
- Visual and sensorimotor cortices mapping during awake resection of lesion on the right periatrium: a case report on brainwaves and their peculiar patterns
- Calendar of Events
- Calendar of Events
- Acknowledgement to our Reviewers
- Acknowledgement to our Reviewers
