Intraoperative nerve monitoring and intraoperative cortical stimulation and subcortical stimulation
Intraoperative nerve monitoring:
In addition to the extensive preoperative planning of neurosurgical procedures, it is very important to monitor crucial neurological functions intraoperatively. While DTI fibre tracking and nTMS mark functionally important structure, the intraoperative nerve monitoring (MEPs, SEPs, AEP, etc.) provides the real-time visualization and acoustic representation of neurophysiological functions and thus another element to ensure safe operating on eloquent areas.
Intraoperative cortical stimulation and subcortical stimulation:
Besides the pre-operative stimulation (for example, transcranial magnetic stimulation) also an intraoperative stimulation can occur. For this purpose, after exposure of the brain surface, an electrode is placed on the motion area and a continuous stimulation for example of the hand muscles is caused.
In the operation of subcortical (located under the cortex) lesions near the pyramidal tract, a subcortical exploration (stimulation) can be carried out of the pyramidal tract. To this end, the pyramidal tract is sought by means of a stimulation instrument and not the nerve cells themselves, but the descending fiber tracts are simulated.
