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Intraoperative Cortical Mapping: Basic Concepts, Indications, and Anesthesia Considerations

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Abstract

The eloquent area of the brain is responsible for written and verbal communication. Functional neuroimaging indicates that interindividual variation exists with the anatomical location of the eloquent area of the brain. Some patients have shown significant contribution from areas located near, but outside of, the traditionally recognized eloquent area. Classically, these areas adjacent to or near the eloquent area were thought to have little impact on written or oral language skills, and many neurosurgeons, in the past, underestimated the impact of operating in these areas. Now, each patient is known to have a unique eloquent area. This necessitates intraoperative cortical mapping to more accurately identify functioning before removing brain tissues in patients undergoing epilepsy or brain tumor surgery in areas near this region of the brain. The goal of intraoperative cortical mapping is to maximize surgical resection in the eloquent area while minimizing the incidence of permanent disabilities. This chapter is intended to provide you with the concepts, indications, and anesthetic considerations important to intraoperative cortical mapping and to prepare you for further reading of more advanced texts and primary literature on this topic.

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References

  1. Lederer S. Subjected to science: human experimentation in America before the Second World War. Baltimore: John Hopkins University Press; 1995. p. 7–9.

    Google Scholar 

  2. Kruggel F, Brückner MK, Arendt T, Wiggins CJ, von Cramon DY. Analyzing the neocortical fine-structure. Med Image Anal. 2003;7(3):251–64.

    Article  CAS  Google Scholar 

  3. Johansson C, Lansner A. Towards cortex sized artificial neural systems. Neural Netw. 2007;20:48–61.

    Article  Google Scholar 

  4. Mountcastle V. The columnar organization of the neocortex. Brain. 1997;120(4):701–22.

    Article  Google Scholar 

  5. Buxhoeveden DP, Casanova MF. The minicolumn hypothesis in neuroscience. Brain. 2002;125:935–51.

    Article  Google Scholar 

  6. Reis J, Rosenow F. Eloquent cortex and tract: overview and noninvasive evaluation methods. In: Luders H, editor. Textbook of epilepsy surgery. London: Informa; 2008. p. 869–80.

    Google Scholar 

  7. Berger MS, Rostomily RC. Low grade gliomas: functional mapping resection strategies, extent of resection, and outcome. J Neuro-Oncol. 1997;34:85–101.

    Article  CAS  Google Scholar 

  8. Berger MS, Deliganis AV, Dobbins J, Keles GE. The effect of extent of resection on recurrence in patients with low grade cerebral hemisphere gliomas. Cancer. 1994;74:1784–91.

    Article  CAS  Google Scholar 

  9. Keles GE, Anderson B, Berger MS. The effect of extent of resection on time to tumor progression and survival in patients with glioblastoma multiforme of the cerebral hemisphere. Surg Neurol. 1999;52:371–9.

    Article  CAS  Google Scholar 

  10. Keles GE, Lamborn KR, Berger MS. Low-grade hemispheric gliomas in adults: a critical review of extent of resection as a factor influencing outcome. J Neurosurg. 2001;95:735–45.

    Article  CAS  Google Scholar 

  11. Berger MS. Functional mapping-guided resection of low-grade gliomas. Clin Neurosurg. 1995;42:437–45.

    CAS  PubMed  Google Scholar 

  12. Berger MS, Kincaid J, Ojemann GA, Lettich E. Brain mapping techniques to maximize resection, safety, and seizure control in children with brain tumors. Neurosurgery. 1989;25:786–92.

    Article  CAS  Google Scholar 

  13. Black PM, Ronner SF. Cortical mapping for defining the limits of tumor resection. Neurosurgery. 1987;20:914–9.

    Article  CAS  Google Scholar 

  14. Kim S, McCutcheon I, Suki D, Weinberg JS, Sawaya R, Lang FF, et al. Awake craniotomy for brain tumors near eloquent cortex: correlation of intraoperative mapping with neurological outcomes in 309 consecutive patients. Neurosurgery. 2000;64:836–46.

    Article  Google Scholar 

  15. Ranks RA, Aglio LS, Gugino LD, Black PM. Craniotomy under local anesthesia and monitored conscious sedation for the resection of tumors involving eloquent cortex. J Neuro-Oncol. 2000;49:131–9.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Ochsner LSU Health, Department of Anesthesiology, Shreveport, LA, USA

    J. Arthur Saus & Harish Siddaiah

  2. Department of Anesthesiology, Louisiana State, University Health Sciences Center Shreveport, Shreveport, LA, USA

    Charles Fox

  3. Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, LSU School of Medicine, Shreveport, LA, USA

    Alan David Kaye

  4. LSU School of Medicine, Department of Anesthesiology, New Orleans, LA, USA

    Alan David Kaye

  5. Tulane School of Medicine, New Orleans, LA, USA

    Alan David Kaye

  6. Department of Anesthesiology, Louisiana State University School of Medicine, Tulane University School of Medicine, New Orleans, LA, USA

    Scott Francis Davis

  7. LSU Health Sciences Center, Department of Neurosurgery, Shreveport, LA, USA

    Bharat Guthikonda

Authors
  1. J. Arthur Saus
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  2. Charles Fox
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  3. Harish Siddaiah
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  4. Alan David Kaye
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  5. Scott Francis Davis
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  6. Bharat Guthikonda
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Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Louisiana State University School of Medicine, Tulane University School of Medicine, New Orleans, LA, USA

    Scott Francis Davis

  2. Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, LSU School of Medicine, Shreveport, LA, USA

    Alan David Kaye

Review Questions

Review Questions

  1. 1.

    What are the two most common techniques for cortical stimulation when mapping? How do they differ?

  2. 2.

    How is the central sulcus identified intraoperatively?

  3. 3.

    What is ECoG and when is it used?

  4. 4.

    What are the contraindications for awake craniotomy?

  5. 5.

    What is the difference between positive and negative mapping, and which produces a more favorable surgical outcome?

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Saus, J.A., Fox, C., Siddaiah, H., Kaye, A.D., Davis, S.F., Guthikonda, B. (2020). Intraoperative Cortical Mapping: Basic Concepts, Indications, and Anesthesia Considerations. In: Davis, S., Kaye, A. (eds) Principles of Neurophysiological Assessment, Mapping, and Monitoring. Springer, Cham. https://doi.org/10.1007/978-3-030-22400-4_18

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  • DOI: https://doi.org/10.1007/978-3-030-22400-4_18

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-22399-1

  • Online ISBN: 978-3-030-22400-4

  • eBook Packages: MedicineMedicine (R0)

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