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Year : 2021  |  Volume : 69  |  Issue : 2  |  Page : 304--306

Removal of Perirolandic Cavernoma with Direct Cortical Stimulation and Neuronavigation with DTI

1 Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
2 Deprartment of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
3 Deprartment of Neuroanaesthesia, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India

Correspondence Address:
Dr. Dhaval Shukla
Professor, M.Ch. Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore - 560 029, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.314528

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Background and Introduction: Intraoperative neuromonitoring for eloquent cortical lesions is irreplaceable in present-day neurosurgery. Objective: We report a novel technique of combining awake craniotomy with direct cortical stimulation of the motor cortex using the NIM© nerve monitoring system. Technique: A 17-year-old boy presenting with focal motor seizures, diagnosed with left perirolandinc cavernoma, underwent awake craniotomy and complete excision under direct cortical stimulation with NIM monopolar stimulator electrode to locate the motor cortex. Result: The patient developed transient weakness of handgrip during surgery, which improved by the same day evening. At 3 months follow-up, he could perform all the activities with his dominant right hand. Conclusion: Cortical stimulation using a nerve monitoring system is a useful technique in case of nonavailability of standard evoked potential monitoring system for motor cortex mapping.


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