TMS-induced motor evoked potential in the preliminary diagnosis of intracranial cavernous hemangioma: A case report

Tang, Xiaorong; Li, Minying; Xu, Yan; Xu, Mindong; Sun, Wei; Li, Guanlu; Xu, Nenggui; Lin, Weili

doi:10.1016/j.brs.2018.07.053

Cited by 1 publication

(2 citation statements)

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“…To date, preoperative functional assessment in CCM has only been reported in case reports. 34,38,39 However, we do not want to show that treatment decisions should purely be based on the results of a functional mapping, such as nTMS. The aim of this study was to show that noninvasive functional mapping enables us to include reliable functional data into the decision-making process.…”

Section: Impact On the Treatment Of Ccmmentioning

confidence: 99%

“…[34][35][36][37] However, preoperative functional assessment in patients suffering from CCM has only been evaluated in case reports or series. 34,38,39 We aimed to prospectively assess the impact of noninvasive functional mapping and function-based tractography on the decision-making process as well as the influence of its intraoperative use on postoperative functional outcome in patients with eloquently located CCM.…”

mentioning

confidence: 99%

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Impacting the Treatment of Highly Eloquent Supratentorial Cerebral Cavernous Malformations by Noninvasive Functional Mapping—An Observational Cohort Study

Ille

Schroeder

Hostettler

et al. 2021

ONSURG

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BACKGROUND Cerebral cavernous malformations (CCM) may cause cavernoma-related epilepsy (CRE) and intracranial hemorrhage (ICH). Functional mapping has shown its usefulness during the resection of eloquent lesions including the treatment of brain arteriovenous malformations. OBJECTIVE To evaluate the impact of noninvasive functional mapping on decision-making and resection of eloquently located CCM. METHODS Of 126 patients with intracranial cavernomas, we prospectively included 40 consecutive patients (31.7%) with highly eloquent CCM between 2012 and 2020. We performed functional mapping via navigated transcranial magnetic stimulation (nTMS) motor mapping in 30 cases and nTMS language mapping in 20 cases. Twenty patients suffered from CRE. CCM caused ICH in 18 cases. RESULTS We used functional mapping data including function-based tractography in all cases. Indication toward (31 cases) or against (9 cases) CCM resection was influenced by noninvasive functional mapping in 36 cases (90%). We resected CCMs in 24 cases, and 7 patients refused the recommendation for surgery. In 19 and 4 cases, we used additional intraoperative neuromonitoring and awake craniotomy, respectively. Patients suffered from transient postoperative motor or language deficits in 2 and 2 cases, respectively. No patient suffered from permanent deficits. After 1 yr of follow-up, anti-epileptic drugs could be discontinued in all patients who underwent surgery but 1 patient. CONCLUSION Surgery-related deficit rates are low even for highly eloquent CCM and seizure outcome is excellent. The present results show that noninvasive functional mapping and function-based tractography is a useful tool for the decision-making process and during microsurgical resection of eloquently located CCM.

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Section: Impact On the Treatment Of Ccmmentioning

confidence: 99%