METHOD AND APPARATUS FOR INTRAOPERATIVE MONITORING OF FUNCTIONAL INTEGRITY OF CORTICOSPINAL TRACT IN OPERATIONS ON BRAIN

摘要

FIELD: medicine.;SUBSTANCE: group of inventions relates to medicine, namely to a method for intraoperative monitoring of the functional integrity of the corticospinal tract when conducting surgical intervention on the brain and to an apparatus for implementation thereof. The apparatus for intraoperative monitoring is configured to continuously directly stimulate the cerebral cortex. The flexible electrode strip of the apparatus comprises point electrodes fixed on a flexible substrate and is attached to a cylinder connected by a catheter with an air injection apparatus equipped with a pressure gauge. The cylinder is made of an elastic material, configured to be installed on the cerebral cortex ensuring a tight fit of the electrodes of the electrode strip against the cerebral cortex during surgical intervention. After performing a craniotomy, the dura mater (dura) is opened in the projection of the pathology and the electrode strip with the cylinder is inserted under the edge of the bone defect so as to be located in the projection of the motor cortex of the brain. The position of the electrode strip is visually monitored, and in the absence of contact of the electrodes thereof with the dura, air is supplied to the cylinder to provide such contact. A control signal is provided, recording the amplitude of the response Amax signal. The operation is performed under neurophysiological control, in the process whereof, as the brain retracts, the cylinder is inflated to ensure a tight fit of the electrodes of the apparatus against the cerebral cortex while the value of the amplitude of the response signal A is monitored ensuring compliance with the condition A≤Amax.;EFFECT: intervention on the brain is conducted with a reduction in the risk of injury to the corticospinal and corticobulbar tracts, increasing the safety of neurosurgical intervention and reducing the risks of neurological complications due to the use of an electrode strip following the relief of the surface of the cerebral cortex when placed thereon with distribution of pressure along the length of the electrode strip for improved contact of the electrodes with cerebral tissues without the risk of compression disruption of the blood supply in the contact area.;2 cl, 15 dwg, 1 ex