Minim Invasive Neurosurg 2003; 46(2): 65-71
DOI: 10.1055/s-2003-39334
Original Article
© Georg Thieme Verlag Stuttgart · New York

Neuronavigation Combined with Electrophysiological Monitoring for Surgery of Lesions in Eloquent Brain Areas in 42 Cases: A Retrospective Comparison of the Neurological Outcome and the Quality of Resection with a Control Group with Similar Lesions

T.  Reithmeier1 , M.  Krammer1 , H.  Gumprecht1 , W.  Gerstner1 , C.  B.  Lumenta1
  • 1Department of Neurosurgery, Academic Hospital Munich-Bogenhausen, Technical University of Munich, Munich, Germany
Further Information

Publication History

Publication Date:
22 May 2003 (online)

Abstract

The purpose of this study was to achieve a more radical resection of tumors in the area of the motor cortex via minimal craniotomy using a combination of neuronavigation and neurophysiological monitoring with direct electrical cortical stimulation and to compare retrospectively the clinical outcome and postoperative magnetic resonance imaging with a control group that was operated on in our service when the combination of these monitoring techniques was not available. A total of 42 patients with tumors in or near the central region underwent surgery with neuronavigation guidance and neurophysiological monitoring. The primary motor cortex was identified intraoperatively by the somatosensory evoked phase reversal method and direct cortical stimulation. The functional areas were transferred into the neuronavigation system. By stimulating the identified primary motor cortex and displaying the motor area in the operating microscope a permanent control of the motor function was possible during the whole operation. Using these techniques a more radical tumor resection - evaluated by postoperative MRI - was achieved in the study group (p = 0.04) and also a trend toward a better neurological outcome.

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T. Reithmeier,M. D. 

Neurochirurgische Klinik · Universität zu Köln

Joseph-Stelzmann-Str. 9

50924 Köln · Germany

Phone: +49-221-4784591

Fax: +49-221-4785891

Email: Thomas.Reithmeier@web.de