Intra-operative mapping of the subcortical visual pathways using direct electrical stimulations

Acta Neurochir (Wien). 2004 Mar;146(3):265-9; discussion 269-70. doi: 10.1007/s00701-003-0199-7. Epub 2004 Jan 8.

Abstract

Despite the risk of postoperative visual field defect following surgery within the temporo-parieto-occipital region, visual mapping has rarely been described, in particular at the subcortical level. In this report, we successfully performed a subcortical mapping of the visual pathways using intra-operative electrical stimulations (IES), during surgery under local anesthesia for a low-grade glioma invading the whole temporal lobe and the temporo-occipital junction. The optic radiations then constituted the posterior and deep functional boundary of the resection, avoiding the occurrence of a post-operative hemianopsia, in spite of an asymptomatic quadrantanopsia. This preliminary experience illustrates the possibility to use intra-operative direct electrical stimulation during surgery of lesions involving the posterior afferent visual system, in order to identify and then preserve the visual pathways, as previously reported for sensorimotor and language subcortical fibers.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain Mapping / methods*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / physiopathology
  • Brain Neoplasms / surgery*
  • Cerebral Cortex / pathology
  • Cerebral Cortex / physiopathology
  • Cerebral Cortex / surgery*
  • Electric Stimulation / methods
  • Female
  • Glioma / pathology
  • Glioma / physiopathology
  • Glioma / surgery*
  • Hemianopsia / prevention & control
  • Humans
  • Visual Pathways / physiopathology*