[Surgery of the rolandic region guided by the peroperative localization of the primary motor cortex and neuro-navigation].

Surgery close to the central motor area carries the risk of a new or increased postoperative motor deficit. One reason is the difficulty of localizing the motor cortex when it is displaced by the tumor. Neurosurgeons have long recognised the need for anatomical and functional localisations during any procedure and nowhere is this more important than in and around the central region. For ten years, we have used modern imaging techniques which provide a wealth of information concerning anatomy and pathophysiology and a new method of intraoperative localization of the primary motor cortex based on the application of single anodal electric pulses to the brain surface. In fifty patients, lesions within or adjacent to the motor area were microsurgically resected using a minimally invasive surgical technique.