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

  • J. Arthur Saus
  • Charles Fox
  • Harish Siddaiah
  • Alan David Kaye
  • Scott Francis Davis
  • Bharat Guthikonda


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.


Depression Attenuation Titration Respiration Epinephrine Cortical mapping Stimulation Eloquent cortex Brain tumor Epilepsy ECoG 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • J. Arthur Saus
    • 1
  • Charles Fox
    • 2
  • Harish Siddaiah
    • 1
  • Alan David Kaye
    • 3
    • 4
    • 5
  • Scott Francis Davis
    • 6
  • Bharat Guthikonda
    • 7
  1. 1.Ochsner LSU Health, Department of AnesthesiologyShreveportUSA
  2. 2.Department of Anesthesiology, Louisiana StateUniversity Health Sciences Center ShreveportShreveportUSA
  3. 3.Departments of Anesthesiology and Pharmacology, Toxicology, and NeurosciencesLSU School of MedicineShreveportUSA
  4. 4.LSU School of MedicineDepartment of AnesthesiologyNew OrleansUSA
  5. 5.Tulane School of MedicineNew OrleansUSA
  6. 6.Department of AnesthesiologyLouisiana State University School of Medicine, Tulane University School of MedicineNew OrleansUSA
  7. 7.LSU Health Sciences Center, Department of NeurosurgeryShreveportUSA

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