CASE REPORT   

Journal of Neurosurgical Sciences 2021 February;65(1):75-7

DOI: 10.23736/S0390-5616.17.04186-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Ultrasound assisted awake epilepsy surgery for type IIB focal cortical dysplasia in eloquent areas

Matteo MARTINONI ¹ ✉, Gianluca MARUCCI ², Stefano MELETTI ^{3, 4}, Lilia VOLPI ⁵, Roberto MICHELUCCI ⁵, Marco GIULIONI ⁶

¹ Unit of Neurosurgery, Department of Neurosciences, OCSAE Hospital, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy; ² Department of Neuropathology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy; ³ Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; ⁴ OCSAE Hospital, AOU of Modena, Modena, Italy; ⁵ Division of Neurology, IRCCS Institute of Neurological Science of Bologna, Bellaria Hospital, Bologna, Italy; ⁶ Division of Neurosurgery, IRCCS Institute of Neurological Science of Bologna, Bellaria Hospital, Bologna, Italy

Focal cortical dysplasia (FCD) type IIb is a frequent cause of pharmacoresistant epilepsy. However, intraoperative identification of the pathological tissue still remains a challenge despite the use of neuronavigation, particularly when it lies in eloquent areas. We here report a case of intraoperative identification of a right frontal FCD type IIB through ultrasound assisted neuronavigation during awake surgery in a patient with drug-resistant epilepsy. Intraoperative ultrasound may have a role in focal cortical dysplasia localization optimizing its resection. In selected patient submitted to epilepsy surgery the integration of disposable technologies (i.e. brain neuronavigation, fMRI and iUS) with awake surgery could improve FCD identification preventing unacceptable neurological morbidity.

KEY WORDS: Epilepsy; Surgery; Ultrasonography; Cortical dysplasia-focal epilepsy syndrome; Malformations of cortical development