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Special article
DOI: 10.1016/j.neucie.2017.07.004
Neurophysiological monitoring options in brain tumour resections. Consensus statement from the Spanish Society of Neurosurgery's (SENEC) Neuro-oncology Working Group and the Spanish Society of Clinical Neurophysiology (SENFC)
Opciones de monitorización neurofisiológica en la resección de tumoraciones cerebrales. Documento de consenso entre el Grupo de Trabajo de Neurooncología de la Sociedad Española de Neurocirugía (SENEC) y la Sociedad Española de Neurofisiología Clínica (SENFC)
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Cristian de Quintana-Schmidta,
Corresponding author
, Estela Lladó-Carbob, Victoria Eugenia Cortés-Doñatec, Neuro-Oncology Working Group (GTNO) and the Spanish Society of Clinical Neurophysiology (SENFC)
a Servicio de Neurocirugía, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
b Servicio de Neurofisiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
c Servicio de Neurofisiología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Table 1. Comparison of monopolar and bipolar stimulation of the motor pathway.
Abstract

Brain tumours located in or in proximity to eloquent areas are a significant neurosurgical challenge. Performing this kind of surgery with neurophysiological monitoring to improve resections with reduced permanent focal neurological deficit has become widely accepted in the literature. However, how to conduct this monitoring, the exact definition of an eloquent area and whether to perform this surgery with the patient awake or asleep are still subject to rigorous scientific debate.

Members of the Neuro-oncology Working Group (GTNO) of the Spanish Society of Neurosurgery (SENEC) and members of the Spanish Society of Clinical Neurophysiology (SENFC) have published a consensus statement to explain the different neurophysiological monitoring options currently available in awake and asleep patients to obtain better surgical resection without neurological deficits. An exhaustive review of the literature has also been conducted.

Keywords:
Eloquent area
Awake brain surgery
Neurophysiological monitoring
Brain mapping
Neurophysiology
Brain tumour
Resumen

Las tumoraciones cerebrales que se encuentran cerca o en áreas elocuentes siguen siendo un importante reto neuroquirúrgico. Existe consenso en la literatura respecto a que la realización de este tipo de cirugías con monitorización neurofisiológica nos permite conseguir resecciones mayores con una mayor seguridad y menor presencia de focalidades neurológicas permanentes. Sin embargo, la forma de realizar este tipo de monitorización, la definición exacta de área elocuente, la forma de realizar la cirugía con el paciente despierto o dormido es objetivo de un gran debate a nivel científico.

Miembros del Grupo de Trabajo de Neurooncología (GTNO) de la Sociedad Española de Neurocirugía (SENEC) y miembros de la Sociedad Española de Neurofisiología Clínica (SENFC) han elaborado un documento de consenso con el objetivo de exponer las diferentes opciones de monitorización neurofisiológica que tenemos a día de hoy, tanto en el paciente despierto como en el dormido, para obtener mejores resecciones quirúrgicas preservando la función neurológica del paciente y se ha realizado una exhaustiva revisión bibliográfica.

Palabras clave:
Área elocuente
Cirugía paciente despierto
Monitorización neurofisiológica
Mapeo cerebral
Neurofisiología
Tumor cerebral

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