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academies
Volume 2
June 11-13, 2018 | London, UK
Neurology and Neuroscience
6 th International Conference on
Mapping of Broca’s area in awake surgery using preoperative magnetic and intraoperative electric
stimulation
Zmajevic Schonwald M, Rogic Vidakovic M, Inga Mladic Batinica I, Rotim K and Sajko T
Medical School University of Zagreb, Croatia
Navigated transcranial magnetic stimulation (nTMS) is
used for eliciting corticobulbar motor evoked potentials
(CoMEP) in cricothyroid muscle, where long latency response
(LLR) represents Broca’s area function. Equally, brain mapping
of motor speech areas in awake surgery uses direct cortical
electrical stimulation (DCS) with short train of stimuli (STS)
technique, and causes speech arrest with LLRs recording.
Whether both methods can be combined in awake surgery
remains will describe our experience in glioma
awake surgery with preoperative nTMS and intraoperative STS
DCS brain mapping. Patients were presented with expressive
dysphasia, epileptic seizures, and/or prolonged periods of
impaired consciousness. Positive magnetic resonance imaging
(MRI) confirmed tumor in left frontal region in all patients.
Preoperative nTMS brain mapping was visualized trough 3D
neuronavigation system. During the awake surgery nTMS
cortical spots were confirmed by DCS, and caused speech arrest
with LLR. Suction mapping device for subcortical brain mapping
was used during tumor extirpations. The postoperative course
was uneventful. Patients had preserved receptive language
functions, sometimes with slight temporary difficulties in
speech fluency.The preoperative nTMS was useful in planning
and facilitating the DCS mapping of motor speech areas during
awake brain surgery. More cases are needed to report further
on the double mapping methode.
Speaker Biography
Zmajevic Schonwald M has completed her PhD from Zagreb University, Croatia. She
is neurologist and neurophysiologist specialized in intraoperative neurophysiology,
and the scientific associate at Medical School Zagreb University, Croatia. She works
as the Head of the Intraoperative neurophysiology unit at Neurosurgery Clinic,
Medical Center “Sisters of Mercy”, Zagreb, Croatia, and has over 20 publications
connected with neurophysiology, intraoperative neurophysiology that mostly have
been included in Current Contents database. She has been serving as intraoperative
neurologist/neurophysiologist of the first awake neurosurgery team in Croatia.
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