The role of functional neuronavigation in the treatment of lesions in eloquent areas of the brain

Abstract

The aim of this paper is to evaluate reliability and the contribution of functional neuronavigation in the operative treatment of lesions located in functionally important areas. Functional neuronavigation consists of co-registration of preoperative functional data into the frameless neuronavigation system and their interactive employment during the neurosurgical procedure. Nineteen patients with neurosurgical targets located in or near the eloquent areas were operated on using functional magnetic resonance imaging (fMRI) and/or electrophysiological functional data intraoperatively. During surgery, all fMRI data were reliably displayed and in spatial correlation with electrophysiological data in patients where both modalities were used. After operation, the neurological deficit remained the same or improved in 17 patients, 1 patient suffered from temporary, and 1 from permanent, worsening of the neurodeficit. Functional neuronavigation is a safe and reliable method of intraoperative localization of the functional areas. This method is complementary to the electrophysiological methods and, in selected cases, could even substitute for them.