Brain mapping during resection of high-grade brain arteriovenous malformation

Eloquent brain creates a challenge when resecting brain arteriovenous malformations (bAVMs). Here the authors present their technique of using subcortical motor mapping as an adjunct to increase safety during resection of a high-grade bAVM involving somatosensory cortex as well as cortical spinal tracts and visual tracts. After a bilateral craniotomy, they use direct cortical stimulation of the left motor cortex and subcortical stimulation using a suction stimulator to dynamically map motor tracts during the resection. They get within 3 mm of the corticospinal tracts by stimulation. The video can be found here: https://stream.cadmore.media/r10.3171/2024.10.FOCVID24107.