Surgery of perirolandic mass lesions with central sulcus mapping

In a series of forty eight consecutive patients with parenchymatous mass lesions in the perirolandic area the central sulcus was identified intraoperatively in forty six. In patients in whom the mass lesion was seen on the surface, the relationship of the lesion to the somatosensory cortex and its underlying white matter was precisely determined. When the lesion was subcortical, the relationship of the mass lesion to the central sulcus on the MR image together with the central sulcus identified peroperatively, again, helped to determine the exact site of the tumour. Knowledge of the exact location of the tumour in relation to the central sulcus helped in the radical excision of seventy seven percent of these tumours. The morbidity following the operation was minimal.