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Published on: July 25, 2011
Displacement of central sulcus in cerebral arteriovenous malformation situated in the peri-motor cortex as assessed
N Shimamura1, H Ohkuma, K Ogane
1Department of Neurosurgery, Hirosaki University School of Medicine, Hirosaki, Japan.
Background:
Intra-operative monitoring of the position of the central sulcus (CS) is indispensable to properly treat a peri-motor cortex lesion. Noninvasive preoperative studies for identification of CS are also needed for choosing the optimal operative procedure. Magneto-encephalography (MEG) has recently been introduced for non-invasive preoperative investigation and cortical functional mapping.
Methods:
Stereotactic mapping of functional CS anatomy was performed preoperatively on 13 subjects using somatosensory evoked fields with MRI-linked whole head MEG system. All subjects had a left sided peri-motor cortex lesion with diagnoses including the following conditions: three arteriovenous malformations (AVM), seven gliomas, three meningiomas.
Findings:
Functional CS in supratentorial brain tumor and parietal AVM cases corresponded with anatomical CS identified by MRI. But the AVM cases in whom the nidus was situated within the peri-motor cortex showed discrepancies between anatomical CS and functional CS.
Interpretation:
Careful consideration of the operative procedure combined with non-invasive cortical functional mapping is needed to optimally treat AVM and congenital brain lesions situated in the anatomical peri-motor cortex.
