Skip to main content
SpringerLink
Log in

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

  • Chapter
  • First Online:
Principles of Neurophysiological Assessment, Mapping, and Monitoring

  • 2481 Accesses

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

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  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  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 Neurooncol. 1997;34:85–101.

    Article  PubMed  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  PubMed  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  PubMed  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  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  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  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  14. Kim S, McCutcheon I, Suki D, 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 Neurooncol. 2000;49:131–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

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

    Art Saus M.D., Charles Fox M.D. & Harish Bangalore Siddaiah M.D.

  2. Departments of Anesthesiology and Pharmacology, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA

    Alan David Kaye M.D., Ph.D.

  3. Interim Louisiana State University, Hospital and Ochsner Kenner Hospital, New Orleans, LA, USA

    Alan David Kaye M.D., Ph.D.

  4. Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Scott Francis Davis Ph.D., CNIM

  5. Department of Anesthesiology, Tulane University School of Medicine, New Orleans, LA, USA

    Scott Francis Davis Ph.D., CNIM

  6. Department of Anesthesiology, Louisiana State University Health, Shreveport, LA, USA

    Bharat Guthikonda M.D.

Authors
  1. Art Saus M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Charles Fox M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Harish Bangalore Siddaiah M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alan David Kaye M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Scott Francis Davis Ph.D., CNIM
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bharat Guthikonda M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charles Fox M.D. .

Editor information

Editors and Affiliations

  1. Departments of Anesthesiology and Pharmacology, LSU Health Sciences Center, New Orleans, Louisiana, USA

    Alan David Kaye

  2. Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, Louisiana, USA

    Scott Francis Davis

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Saus, A., Fox, C., Siddaiah, H.B., Kaye, A.D., Davis, S.F., Guthikonda, B. (2014). Intraoperative Cortical Mapping: Basic Concepts, Indications, and Anesthesia Considerations. In: Kaye, A., Davis, S. (eds) Principles of Neurophysiological Assessment, Mapping, and Monitoring. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8942-9_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-8942-9_18

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8941-2

  • Online ISBN: 978-1-4614-8942-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation