• T Reithmeier, M Krammer, H Gumprecht, W Gerstner, and C B Lumenta.
• Department of Neurosurgery, Academic Hospital Munich-Bogenhausen, Technical University of Munich, Munich, Germany. Thomas.Reithmeier@web.de
• Minim Invas Neurosur. 2003 Apr 1; 46 (2): 65-71.

AbstractThe purpose of this study was to achieve a more radical resection of tumors in the area of the motor cortex via minimal craniotomy using a combination of neuronavigation and neurophysiological monitoring with direct electrical cortical stimulation and to compare retrospectively the clinical outcome and postoperative magnetic resonance imaging with a control group that was operated on in our service when the combination of these monitoring techniques was not available. A total of 42 patients with tumors in or near the central region underwent surgery with neuronavigation guidance and neurophysiological monitoring. The primary motor cortex was identified intraoperatively by the somatosensory evoked phase reversal method and direct cortical stimulation. The functional areas were transferred into the neuronavigation system. By stimulating the identified primary motor cortex and displaying the motor area in the operating microscope a permanent control of the motor function was possible during the whole operation. Using these techniques a more radical tumor resection - evaluated by postoperative MRI - was achieved in the study group (p = 0.04) and also a trend toward a better neurological outcome.

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