Multifaceted utilization of a cortical stimulator during tumor resection

Abstract

Abstract Background Neurosurgeons use Ojemann cortical stimulators to map and localize cortical and subcortical regions of the brain to map functional areas intraoperatively to avoid resecting or damaging functional tissue. Here we describe a technique where, rather than using a separate retracting tool, a handheld Ojemann cortical stimulator was used to retract cerebral parenchyma while simultaneously stimulating descending white matter tracts to prevent accidental damage to white matter tracts involved with motor function. Case description A 48-year-old patient developed intractable seizures and preoperative workup showed a left frontal brain mass close to her motor region. Subdural grid electrodes were implanted to localize the patient's ictal onset zone. The electrodes were then removed and the tumor was resected along with the ictal onset zone. During the resection, the neurosurgeon (S. Vadera) successfully utilized the Ojemann cortical stimulator to stimulate descending white matter tracts to prevent accidental injury to the patient and also retract cerebral parenchyma during resection. Four weeks post-operative, the patient had made a complete recovery and had no unforeseen deficits or weaknesses. Conclusion Here we show that the Ojemann cortical stimulator can be used as an effective retraction tool as well as a cerebral parenchyma stimulator, effectively preventing accidental injury to functional tissue while concurrently giving the neurosurgeon a free hand to perform other tasks.