Journal
JOURNAL OF NEUROSURGERY
Volume 95, Issue 6, Pages 1050-1052Publisher
AMER ASSOC NEUROLOGICAL SURGEONS
DOI: 10.3171/jns.2001.95.6.1050
Keywords
functional localization; cortical stimulation; motor cortex; hemiplegia; metastasis; germ cell tumor
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The goal in this study was to determine if intraoperative electrical stimulation mapping is useful during surgical resection of lesions located in the central region, even in cases of preoperative hemiplegia. This 45-year-old man with a retro-central metastasis from an embryonal carcinoma of the testis suffered an acute complete hemiplegia after intratumoral bleeding. Emergency surgery was performed with the aid of intraoperative. motor mapping despite the preoperative deficit. Cortical stimulations (CSs) elicited motor responses, allowing the detection and hence preservation of the primary motor area during tumor removal. Postoperatively, the patient recovered almost completely within 1 week; the tumor resection was total. It is possible that CSs give an early, and valuable prognostic indicator of motor recovery in cases of complete hemiplegia, at least in patients with acute onset and short duration of the deficit. Consequently, if motor responses can be elicited by CSs, it becomes mandatory for the surgeon to respect the primary motor area despite the preoperative hemiplegia, with the aim of preserving the chances of an eventual recovery.
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