3 - Preoperative Brain Mapping

Abstract

This chapter focuses on the brain mapping evaluations. An important use of current brain mapping methods is the pre-surgical evaluation of patients in terms of both their structural and functional anatomy. The goal of such evaluations is to reduce the risk of injury to normal brain. There are three basic types of preoperative brain mapping evaluations. First, brain mapping methods can be used to characterize and localize lesions in the central nervous system. Almost every brain mapping technique can be used for the structural and functional characterization of lesions. A single brain mapping method, typically a structural imaging technique, often provides the first confirmatory evidence that such a lesion exists. The second approach to the use of brain mapping methods in the preoperative evaluation of patients with cerebral lesions lies in lesion targeting. An ever-increasing number of disorders of the brain are being treated with stereotactic strategies that target selective brain lesions or normal brain centers for ablation or stimulation. The final strategy for using preoperative brain mapping is in the evaluation of the normal brain, either adjacent to or remote from the lesion in question. The goal is to preserve normal tissue while, at the same time, removing the pathologic lesion in its entirety.