[Super selective amytal test for functional evaluation of the brain--a less invasive functional test]

In the neurosurgical field, it is very important to evaluate localized function of the affected region preoperatively. In order to investigate lateralized and localized brain function, we have developed an alternative to the original Wada test, and refer to it as the super selective amytal test (SSAT). We performed super selective catheterization of the target artery after conventional carotid angiography, injected Amytal (amobarbital, 30-100 mg) through a micro-catheter, and identified potential local function. In ten cases, including AVM, aneurysm, and brain tumor, we investigated localized function of the affected site preoperatively by SSAT, and chose our treatment based on the results of this test. There was a good correlation between the results of the SSAT and the results of surgery in every case. There were no prolonged neurological complications of this test. Evaluation of the results of the SSAT should be interpreted under precise DSA control, since blood flow in the brain differ among individuals. This test may contribute to our knowledge of localized function in the cerebral cortex and deep brain areas in neurosurgical patients.