Evaluation of brain function in neurosurgery

Abstract

The ability to evaluate brain function pre- and intra-operatively has been essential in maintaining the quality of life in patients undergoing functional neurosurgery. These evaluations which were originally developed for studies in epilepsy are now essential in neurosurgery for brain tumors and vascular diseases. The goal of functional brain mapping augumented by function monitoring, is to perform surgery more safely and effectively for better outcomes. Among the multiple modern modalities for brain functional evaluation, we should consider the physiological aspects of each of these methods from a view point of functional recovery or compensation. Clinical usefulness and differences between intraoperative electrical stimulation of the motor cortex and subcortical fibers (i.e., pyramidal tracts) and voluntary movement to preserve affected or unaffected motor function during neurosurgery is also discussed. Further consideration of the network among each eloquent area may lead to a new concept in neurosurgery as well as neuroscience.