METHOD FOR INTRAOPERATIVE NEUROPHYSIOLOGICAL MONITORING OF MOTOR AND LANGUAGE ZONES OF BRAIN

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely neurosurgery, neurophysiology, neurology, and can be used for neurophysiological monitoring of functionally significant brain areas during neurosurgical operations. Recording electrodes for intraoperative mapping are installed in muscle-targets: orbicularis oris, biceps brachii, triceps brachii, extensor digitorum, abductor pollicis brevis, abductor digiti minimi, vastus lateralis, gastrocnemius, tibialis anterior, abductor hallucis contralateral to involved hemisphere, electrodes are additionally installed in muscle-targets of orofacial area: palatopharyngeus, lingua, submandibularis area. Total intravenous anesthesia (TIVA) is carried out with propofol 5–6 mg/kg/h in combination with opioid analgesic fentanyl 5.0 mcg/kg/h. A dura mater is opened in an operative intervention area, and the cerebral cortex is tested with a monopolar electrode, the boundaries of the motor and speech zones are determined. That is followed by resection of volume formation with simultaneous testing of subcortical structures with a monopolar electrode fixed on a surgical aspirator. If motor responses appear, this zone is considered to be functionally significant and is bypassed in resection of volume formation.;EFFECT: method of treating enables to reduce the percentage of adverse reactions on the part of the patient and reduce the length of surgical treatment, reducing the number of hemodynamic and infectious complications in the postoperative period ensured by the possibility to perform the intraoperative neurophysiological monitoring of motor-speech centers of the dominant hemisphere cerebrum without the patient's awakening.;1 cl, 4 dwg, 2 ex