Comparative analysis of anatomical orientes and direct electrical stimulation of the brain cortex in the identification of motor areas of the brain

Introduction: Surgery of tumors localized in the motor cortex is challenging because of the accompanying risk of de novo occurrence of motor deficits. Materials and methods: We report a series of 34 patients with slow-growing brain tumors localized in and around the motor areas of the brain, which were treated at the Institute of Neurosurgery, Clinical Center in Belgrade in the period 2008-2012. Result. The average distance of the central sulcus in relation to the coronary suture verified ES is 18.38 mm ± 9,564 mm, the strength of the current required to obtain motor responses was 9.26±1.286 mA. If the distance from the coronary suture is higher, the current intensity required to cause the motor response is lower (p<0,01). The smaller amount of current is needed to identify the motor areas of tumors where the degree of surgical resection was subtotal to the level of reduction compared to radical surgery (p<0,05). Conclusion. Direct electrostimulation of the cortex is a reliable method for identification of motor areas of the brain, and it is necessary for additional prevention - iatrogenic neurological deficits.