Summary
A practical method of intraoperative identification of the central sulcus using cortical evoked potentials (EP) was reported. The method herein proposed is unique with stimulation to the trigeminal and tibial nerve in addition to median nerve stimulation, depending on the location of the lesion. Thus, a wide coverage of the rolandic fissure was possible. Eighteen adult patients with peri-rolandic lesions were investigated. Fourteen cases had a malignant tumour but all except 3 showed only a minor neurological deficit preoperatively.
In 13 cases, the central sulcus could be identified through the phenomenon of the phase-reversal of cortical EP across the central fissure. Of the remaining 5 cases, cortical EP were not detected in 3 (all showed hemiplegia and/or aphasia) and EP without phasereversal were obtained in 2. As a result, in most cases showing only a trivial neurological deficit before surgery, aggressive removal of the tumour was successfully carried out without producing severe motor dysfunction.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Gregorie EM, Goldring S (1984) Localization of function in the excision of lesions from the sensorimotor region. J Neurosurg 61: 1047–1054.
Lueders H, Lesser RP, Hahn J, Dinner DS, Klem G (1983) Cortical somatosensory evoked potentials in response to hand stimulation. J Neurosurg 58: 885–894.
Morris HH, Lueders H, Hahn JF, Lesser RP, Dinner DS, Estes ML (1986) Neurophysiological techniques as an aid to surgical treatment of primary brain tumours. Ann Neurol 19: 559–567.
Penfield W, Rasmussen T (1955) Sensorimotor representation of the body. In: The cerebral cortex of man. Macmillan, New York, pp 11–65.
Ring BA, Waddington MM (1967) Ascending frontal branch of middle cerebral artery. Acta Radiol [Diagn] 6: 209–220.
Seki Y, Aiba T, Shirai Y, Ishiyama Y (1987) Trigeminal somatosensory evoked potentials: Recording technique and normal responses. No To Shinkei 39: 105–112 (Engl Abst) (Jpn).
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1988 Springer-Verlag/Wien
About this paper
Cite this paper
Aiba, T., Seki, Y. (1988). Intraoperative Identification of the Central Sulcus: a Practical Method. In: Isamat, F., Jefferson, A., Loew, F., Symon, L. (eds) Proceedings of the 8th European Congress of Neurosurgery Barcelona, September 6–11, 1987. Acta Neurochirurgica Supplementum 42, vol 42. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8975-7_5
Download citation
DOI: https://doi.org/10.1007/978-3-7091-8975-7_5
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-8977-1
Online ISBN: 978-3-7091-8975-7
eBook Packages: Springer Book Archive