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A Cost-Effective, Adjustable, Dynamic Subcortical Stimulation Device - Technical Note.

Justin W Silverstein1,2, Jacob D Greisman3, Nicholas B Dadario3

  • 1Department of NeurologyLenox Hill Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, New York.

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Neurosurgeons can now perform dynamic subcortical stimulation (SCS) mapping using modified, cost-effective suction devices. This innovation enhances brain tumor resection safety by improving identification of critical white matter tracts.

Keywords:
Brain tumorcorticospinal tractmotor evoked potentialsneuromonitoringsubcortical stimulation

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Area of Science:

  • Neurosurgery
  • Neuroscience
  • Medical Devices

Background:

  • Brain mapping and neuromonitoring are crucial for safe brain tumor resection.
  • Subcortical stimulation (SCS) identifies white matter tracts.
  • Current dynamic SCS devices are expensive and lack universal compatibility.

Purpose of the Study:

  • To modify conventional suction devices into cost-effective monopolar probes for dynamic SCS.
  • To present a novel technique for creating a versatile SCS probe.

Main Methods:

  • Conventional variable suction devices were electrified using an alligator clip and insulated with a red rubber catheter.
  • The catheter length was adjusted to create a monopolar stimulation probe.
  • The modified device was integrated into an established neuromonitoring protocol.

Main Results:

  • A novel, cost-effective dynamic SCS suction probe was successfully fashioned.
  • The probe is compatible with various suction device styles and sizes.
  • The modified probe enables both cortical and subcortical monopolar stimulation.

Conclusions:

  • Modified suction devices offer a practical and economical alternative for dynamic SCS.
  • This technique can potentially improve the accessibility of advanced neuromonitoring during brain tumor surgery.
  • Further prospective studies are needed to validate efficacy and utility.