The Use of the Target Cancellation Task to Identify Eloquent Visuospatial Regions in Awake Craniotomies: Technical...

Area of Science:

• Neurosurgery
• Cognitive Neuroscience
• Medical Technology

Background:

• Awake craniotomies require simple, reproducible tasks for intraoperative functional mapping.
• Existing visuospatial mapping tests have limitations.
• Hemineglect is a potential postoperative complication.

Purpose of the Study:

• To introduce a novel software-based target cancellation task for intraoperative visuospatial mapping.
• To evaluate the feasibility and efficacy of this task during awake craniotomy.
• To assess its ability to prevent postoperative hemineglect.

Main Methods:

• Development of an interactive target cancellation software for portable devices.
• Intraoperative testing of seven patients undergoing awake craniotomy for non-dominant hemisphere tumors.
• Comparison of target cancellation with line bisection tasks for visuospatial mapping.

Main Results:

• Target cancellation successfully identified visuospatial function sites in 3 of 7 patients.
• The line bisection task alone did not identify any visuospatial function sites.
• Complete mapping was achieved in under 10 minutes per patient.
• No patients experienced preoperative or postoperative hemineglect.

Conclusions:

• The target cancellation technique is feasible and effective for intraoperative visuospatial mapping during awake craniotomy.
• This method aids in preventing postoperative hemineglect.
• It offers a valuable alternative for patients unable to perform other mapping modalities.