Archives of Neurosurgery

Corresponding Author

Dr.Ramiro Antonio Perez de la Torre . Michigan Head and Spine Institute/ Neurosciences Department 29275 Northwestern Hwy. Suite 100 Southfield, MI, USA 48034

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Commentaries to published articles - Invited


As clinicians, we rely on various imaging methods to identify abnormal brain lesions. We can distinguish this myriad of neurological disorders by using imaging alone or together with either or both electrophysiological monitoring and direct cortical stimulation. This last alternative is the most frequently used approach to diagnosing brain lesions requiring awake craniotomies for adequate management. Awake craniotomies have become the standard of care for focal lesions, including vascular malformations like cavernous angiomas, intrinsic brain tumors, gliomas, vasculitic brain lesions, postinfectious brain lesions, brain metastasis, and also for epilepsy surgery. Surgery for epileptic patients requires multidisciplinary team interactions and a variety of surgical adjuncts. The clinical decision-making proceeds with a specific protocol following a rigorously defined technique for awake craniotomies. Using a systematic approach affords a reliable and reproducible method for epilepsy treatment while avoiding postoperative complications. While direct cortical stimulation remains the mainstay for postoperative neurological deficit evaluation, there is undoubtedly a need for new technologies that can help increase the sensitivity and specificity of abnormal findings and thus help management decisions.

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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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