Published in

American Association of Neurological Surgeons, Neurosurgical Focus, 2(34), p. E4, 2013

DOI: 10.3171/2012.12.focus12358

Links

Tools

Export citation

Search in Google Scholar

Intraoperative cortical mapping of visuospatial functions in parietal low-grade tumors: Changing perspectives of neurophysiological mapping

This paper is available in a repository.
This paper is available in a repository.

Full text: Download

Red circle
Preprint: archiving forbidden
Red circle
Postprint: archiving forbidden
Question mark in circle
Published version: policy unknown
Data provided by SHERPA/RoMEO

Abstract

Object The aim of this study was to explore the feasibility of intraoperative visuospatial mapping with the same criteria currently used to define essential language areas. Methods The authors compared surgical procedures in 2 patients with similar tumors (Grade II oligodendroglioma in the right parietal lobe) undergoing awake, image-assisted surgery for lesion removal with intraoperative neurophysiological monitoring. The line bisection task was used in both patients but with different criteria. Results In the first case, the authors respected any area, even within the tumor, where significant interference was found (a stimulation-induced error in 2 of 3 applications defined an essential area). In the second case, they removed 1 essential area located in the tumor and recorded an uneventful clinical response soon thereafter. They continued to monitor the patient without stimulation and stopped the resection when the patient was close to the criteria valid for defining spatial neglect. The signs of spatial neglect were present for 3 days postoperatively and then cleared spontaneously. Subtotal tumor removal was achieved in both cases. Conclusions Evidence in the present study reveals that areas for visuospatial functions cannot be assessed with the same criteria used for language functions, since essential areas located in the tumor can be safely removed.