Document Detail


Electrocorticographic frequency alteration mapping of speech cortex during an awake craniotomy: case report.
MedLine Citation:
PMID:  19940544     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Traditional electrocortical stimulation (ECS) mapping is limited by the lengthy serial investigation (one location at a time) and the risk of afterdischarges in localizing eloquent cortex. Electrocorticographic frequency alteration mapping (EFAM) allows the parallel investigation of many cortical sites in much less time and with no risk of afterdischarges because of its passive nature. We examined its use with ECS in the context of language mapping during an awake craniotomy for a tumor resection.
CLINICAL PRESENTATION: The patient was a 61-year-old right-handed Caucasian male who presented with headache and mild aphasia. Imaging demonstrated a 3-cm cystic mass in the posterior temporal-parietal lobe. The patient underwent an awake craniotomy for the mapping of his speech cortex and resection of the mass.
INTERVENTION: Using a 32-contact electrode array, electrocorticographic signals were recorded from the exposed cortex as the patient participated in a 3-min screening task involving active (patient naming visually presented words) and rest (patient silent) conditions. A spectral comparison of the 2 conditions revealed specific cortical locations associated with activation during speech. The patient was then widely mapped using ECS. Three of 4 sites identified by ECS were also identified passively and in parallel by EFAM, 2 with statistical significance and the third by qualitative inspection.
CONCLUSION: EFAM was technically achieved in an awake craniotomy patient and had good concordance with ECS mapping. Because it poses no risk of afterdischarges and offers substantial time savings, EFAM holds promise for future development as an adjunct intraoperative mapping tool. Additionally, the cortical signals obtained by this modality can be utilized for localization in the presence of a tumor adjacent to the eloquent regions.
Authors:
J Breshears; M Sharma; N R Anderson; S Rashid; E C Leuthardt
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-11-20
Journal Detail:
Title:  Stereotactic and functional neurosurgery     Volume:  88     ISSN:  1423-0372     ISO Abbreviation:  Stereotact Funct Neurosurg     Publication Date:  2010  
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-03-25     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  8902881     Medline TA:  Stereotact Funct Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  11-5     Citation Subset:  IM    
Copyright Information:
2009 S. Karger AG, Basel.
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MeSH Terms
Descriptor/Qualifier:
Brain Mapping / methods*
Brain Neoplasms / surgery*
Craniotomy / methods*
Electric Stimulation
Glioblastoma / surgery*
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Monitoring, Intraoperative / methods
Speech / physiology
Temporal Lobe / physiopathology,  surgery*
Comments/Corrections

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