DIRECT CORTICAL STIMULATION IN THE ABLATION OF GLIAL CEREBRAL TUMORS IN THE MOTOR AREAS

Abstract

Objectives. The genesis of tumors is unknown in our days. Surgery represents an effective treatment of this disorder. According to many studies of brain tumor surgery, a motor deficit rate of 30% has been observed, postoperatively, after surgeries on brain tumors in the motor areas. The aim of the study was to evaluate the direct cortical stimulation in the surgical treatment of glial brain tumors, in motor areas. Material and Methods. The examination group included 35 patients with brain tumors, localized in the parasilvian region. Direct cortical stimulation was used intraoperatively, in order to establish the motor areas. For the evaluation of the neurological deficit, a comparative analysis of the pre- and postoperative motor deficit was performed. Results. Direct cortical stimulation was performed in 35 patients. During its stimulation, the motor areas were detected in 32 patients. Under the control of Direct Cortical Stimulation, subtotal and partial tumor resection was performed in 31 patients and, due to the location of the tumor in the motor area, biopsy was performed in 1 patient. The worsening of the postoperative motor deficit was recorded in the partial ablation for 2 patients and biopsy for 1 patient, where the tumor was directly localized in the motor area. Direct cortical stimulation, in the extent of total and subtotal ablation, prevented postoperative motor deficit at discharge in 22 patients. Conclusions. In order to avoid postoperative neurological consequences and improve the patients' quality of life, it is appropriate to use intraoperative direct cortical stimulation.

Keywords

• brain tumors
• eloquent motor areas
• direct cortical stimulation