The Use of Intraoperative Neurophysiological Monitoring Techniques in Supratentorial Brain Surgeries

Abstract

or greater than 50 years, electrical stimulation and recording of the cerebral cortex has been an important neurosurgical tool. Electrical stimulation of the cortex can be used to identify primary sensory, primary motor, and essential language cortices, as well as functional association areas and important subcortical tracts. (1) Stimulation mapping became the gold standard for localizing cortical function during surgery. Because of their reliability, intraoperative cortical and subcortical stimulation mapping techniques are used to guide resections in regions of brain near eloquent cortex. (2) In the surgical management of brain tumors, the current trend is toward greater extent of resection, which has been shown to provide a survival benefit. The potential benefits of greater extent of resection, though, must be balanced with the risk of loss of function, which has been shown to decrease overall survival. Cortical mapping is an intraoperative tool that can enable more extensive resections while reducing operative morbidity. (3)