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Localization of precentral gyrus in image-guided surgery for motor cortex stimulation

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Operative Neuromodulation

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 97/2))

Abstract

According to recent clinical data, motor cortex stimulation (MCS) is an alternative treatment for central pain syndromes. We present our minimal invasive technique of image guidance for the placement of motor cortex stimulating electrode and assess the clinical usefulness of both neuronavigation and vacuum headrest. Neuronavigation was used for identification of precentral gyrus and accurate planning of the single burr-hole. The exact location was reconfirmed by intraoperative phase reversal of somatosensory evoked potential (SSEP) and clinical response after electrical stimulation test. Implementation of navigation technique facilitated localization of the precentral gyrus with a high degree of accuracy. Determination of stimulating electrode placement was possible in every case. Postoperative clinical and neuroradiological evaluations were performed in each patient. All patients experienced postoperative relief from pain. Our preliminary series may confirm image guidance as a useful tool for surgery of MCS. Additionally, minimal and safe exposure can be performed using a single burr-hole and vacuum head rest.

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Authors and Affiliations

  1. Department of Neurosurgery, Philipps University, Marburg, Germany

    W. Tirakotai, D. Hellwig, H. Bertalanffy & Thomas Riegel

Authors
  1. W. Tirakotai
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  2. D. Hellwig
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  3. H. Bertalanffy
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  4. Thomas Riegel
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Corresponding author

Correspondence to Thomas Riegel .

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Editors and Affiliations

  1. Department of Neurosurgery, University of Athens, Athens, Greece

    Damianos E. Sakas

  2. University Hospital of Wales, Cardiff, UK

    Brian A. Simpson

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© 2007 Springer-Verlag

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Tirakotai, W., Hellwig, D., Bertalanffy, H., Riegel, T. (2007). Localization of precentral gyrus in image-guided surgery for motor cortex stimulation. In: Sakas, D.E., Simpson, B.A. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/2. Springer, Vienna. https://doi.org/10.1007/978-3-211-33081-4_9

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  • DOI: https://doi.org/10.1007/978-3-211-33081-4_9

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-33080-7

  • Online ISBN: 978-3-211-33081-4

  • eBook Packages: MedicineMedicine (R0)

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