Abstract
The resection of brain tumors located within or near the eloquent tissue has a higher risk of postoperative neurological deficits. The primary concerns include loss of sensory and motor functions in the contralateral face, upper and lower extremities, as well as speech deficits. Intraoperative neurophysiological monitoring (IONM) techniques are performed routinely for the identification and preservation of the functional integrity of the eloquent brain areas during neurosurgical procedures. The IONM modalities involve sensory, motor, and language mapping, which helps in the identification of the boundaries of these areas during surgical resection. Cortical motor Mapping (CmM) technique is considered as a gold-standard technique for mapping of the brain. We present the intraoperative CmM technique, including anesthesia recommendations, types of electrodes, as well as stimulation and recording parameters for successful monitoring.
Highlights
The first documented cortical tumor resection was performed by two neurologists A
We present the intraoperative Cortical motor Mapping (CmM) technique, including anesthesia recommendations, types of electrodes, as well as stimulation and recording parameters for successful monitoring
Mapping of the motor cortex should be done after identifying the central sulcus with sensory mapping
Summary
The first documented cortical tumor resection was performed by two neurologists A. Taniguchi et al proposed short multipulse stimulation using high frequencies during surgeries performed under general anesthesia [5] In this technical report, we will discuss Penfield and Taniguchi's methods of motor mapping with other consideration such as required tools, anesthetic recommendations, and modalities with their parametric values. Penfield and Taniguchi, have evolved for intraoperative cortical and subcortical mapping of the corticospinal tracts Either of these two methods can be utilized based on tumor location, patient history, surgical procedure, and other factors. Electromyography (EMG) is used to record myogenic responses from the contralateral target muscles This method provides the ability to monitor the functional integrity of corticospinal tracts throughout the procedure and alert the surgeon for any potential damage to the functional brain areas. We recommend that postoperative evaluations should be performed after 24 hours, 48 hours, two weeks, three months, and six months after the procedure
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