Adjustable, Dynamic Subcortical Stimulation Technique for Brain Tumor Resection: A Case-Series.

Area of Science:

• Neurosurgery
• Neuromonitoring
• Medical Device Innovation

Background:

• Subcortical stimulation (SCS) is crucial for identifying descending white matter tracts during surgery.
• Dynamic SCS offers advantages over static methods, but adoption of current devices is limited.

Purpose of the Study:

• To develop and evaluate a novel, easily adoptable dynamic SCS device.
• To assess the device's efficacy in identifying the corticospinal tract (CST) during brain tumor resection.

Main Methods:

• A dynamic SCS device was constructed using a stainless-steel suction and common materials.
• The device was used in 14 patients undergoing brain tumor resection, with continuous SCS applied.
• Pre- and postoperative motor function and imaging were analyzed to assess outcomes and tumor resection extent.

Main Results:

• The device facilitated accurate intraoperative identification of the CST.
• Three patients (21.4%) had temporary postoperative motor deficits that resolved by discharge.
• No permanent motor deficits due to mechanical CST injury were observed.

Conclusions:

• The novel dynamic SCS device is readily adoptable and enables precise intraoperative CST identification.
• This facilitates safer resection of tumors located near motor-eloquent structures.
• The technique shows promise for improving surgical outcomes in neuro-oncology.