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Cortical mapping and neurophysiological monitoring during resection of an arteriovenous malformation in the rolandic region

L. Vega-Zelaya, M. Pedrosa-Sánchez, J. Pastor [REV NEUROL 2014;59:20-24] PMID: 24965927 DOI: https://doi.org/10.33588/rn.5901.2013583

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Volumen 59 | Number 01 | Nº of views of the article 7.784 | Nº of PDF downloads 406 | Article publication date 01/07/2014

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ABSTRACT

INTRODUCTION Surgery of arteriovenous malformations of eloquent areas has a significant risk of causing severe neurological deficits.

CASE REPORT A 39 years old woman having a headache, showed an arteriovenous malformation in right rolandic region. During resection, performed under general anesthesia, a neurophysiological mapping and subsequently intraoperative neurophysiological monitoring of motor and somatosensory functions was performed. The temporary closure of an artery resulted in a severe motor impairment, reversible after remove the clipping, so that artery had to be respected during the intervention. After resection, the motor and sensory responses were normal. The patient was discharged without any neurological deficits. CONCLUSION. Functional mapping and intraoperative neurophysiological monitoring were very helpful for the identification and protection of eloquent areas. The use of these techniques for resection of arteriovenous malformations located in functionally relevant areas, allows a safely surgery in patients under general anesthesia. KeywordsAnesthetized craniotomy Cerebral cortex surgery Direct cortical stimulation Motor evoked potentials Somatosensory evoked potentials CategoriesTécnicas exploratorias

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Nota Clínica

Cortical mapping and neurophysiological monitoring during resection of an arteriovenous malformation in the rolandic region