Direct motor cortex mapping and monitoring: intraoperative CMAP analysis and its prognostic value for the postoperative neurological outcome

Background: Tumor invasion in functional cortex areas, tumor-related mass displacements and functional cortical reorganization can greatly impede intraoperative orientation in eloquent areas of the brain, such as the primary motor cortex (Brodman Area 4). Intraoperative neurophysiological examination methods are nowadays thus indispensable for surgery in or near the motor cortex. Methods: This study analyzed the data obtained from a total of 255 cerebral interventions for lesions with direct contact to (121) or immediately adjacent to (134) Brodman Area 4 in order to optimize stimulation parameters and to search…