Abstract
Rapid presurgical neuromagnetic localization of the somatosensory cortex was performed successfully on five patients with a large-array biomagnetometer by a protocol called magnetic source imaging (MSI). Determination of the location of the central sulcus is important in assessing operative risk and determining the optimal operative approach to structural lesions in the vicinity of the motor strip. The use of magnetic resonance imaging anatomical methods and intraoperative visual identification can be imprecise, whereas invasive localization prolongs operative time, adds cost, and entails added risk. Until the recent development of large-array biomagnetometer systems, neuromagnetic localization of the central sulcus had been demonstrated in research but was so time consuming and laborious as to preclude routine clinical use. In this study, the validity of MSI localizations was confirmed intraoperatively by direct cortical recording of somatosensory evoked potentials and/or direct motor stimulation. Complete agreement was found between MSI and intraoperative mapping in locating the central sulcus. Objective confirmations considered together with the speed and reliability of the procedure and with the presurgical availability of the results suggests the potential utility of MSI for routine surgical planning.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Aged
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Astrocytoma / pathology
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Astrocytoma / physiopathology
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Astrocytoma / surgery
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Brain Mapping / instrumentation*
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Brain Neoplasms / pathology
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Brain Neoplasms / physiopathology
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Brain Neoplasms / secondary
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Brain Neoplasms / surgery*
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Carcinoma, Squamous Cell / pathology
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Carcinoma, Squamous Cell / physiopathology
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Carcinoma, Squamous Cell / secondary
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Carcinoma, Squamous Cell / surgery
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Craniotomy
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Electric Stimulation
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Electrodes, Implanted
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Equipment Design
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Evoked Potentials, Somatosensory / physiology*
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Female
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Humans
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Intracranial Arteriovenous Malformations / pathology
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Intracranial Arteriovenous Malformations / physiopathology
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Intracranial Arteriovenous Malformations / surgery*
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Lung Neoplasms / pathology
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Lung Neoplasms / physiopathology
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Lung Neoplasms / surgery
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Magnetic Resonance Imaging / instrumentation*
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Magnetoencephalography / instrumentation*
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Male
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Median Nerve / physiopathology
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Melanoma / pathology
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Melanoma / physiopathology
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Melanoma / secondary
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Melanoma / surgery
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Meningeal Neoplasms / pathology
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Meningeal Neoplasms / physiopathology
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Meningeal Neoplasms / surgery
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Meningioma / pathology
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Meningioma / physiopathology
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Meningioma / surgery
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Middle Aged
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Monitoring, Intraoperative / instrumentation
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Motor Cortex / pathology
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Motor Cortex / physiopathology
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Skin Neoplasms / pathology
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Skin Neoplasms / physiopathology
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Skin Neoplasms / surgery
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Somatosensory Cortex / pathology
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Somatosensory Cortex / physiopathology*