Extratemporal Cortical Resection (cont.)
What Happens Before Surgery?
Candidates for extratemporal cortical resection undergo an extensive pre-surgery evaluation including video electroencephalographic (EEG) seizure monitoring, magnetic resonance imaging (MRI) and positron emission tomography (PET). Other tests include neuropsychological memory testing, WADA test (to lateralize the side of language), ictal SPECT and magnetic resonance spectroscopy. These tests help to pinpoint the seizure focus and determine if surgery is possible.
What Happens During Surgery?
An extratemporal cortical resection requires exposing an area of the brain using a procedure called a craniotomy. (Crani refers to the skull and otomy means "to cut into.") After the patient is put to sleep (general anesthesia), the surgeon makes an incision (cut) in the scalp, removes a piece of bone and pulls back a section of the dura, the tough membrane that covers the brain. This creates a "window" in which the surgeon inserts special instruments to remove brain tissue. Surgical microscopes are used to give the surgeon a magnified view of the area of the brain involved. The surgeon utilizes the information gathered during the pre-operative evaluation--as well as during surgery--to define, or map out, the route to the correct area of the brain.
In some cases, a portion of the surgery is performed while the patient is awake, using medication to keep the person relaxed and pain free. This is done so that the patient can help the surgeon find and avoid areas in the brain responsible for vital functions such as brain regions of language and motor control. While the patient is awake, the doctor uses special probes to stimulate various areas of the brain. At the same time, the patient may be asked to count, identify pictures or perform other tasks. The surgeon can then identify the area of the brain associated with each task.
After the brain tissue is removed, the dura and bone are fixed back into place, and the scalp is closed using stitches or staples.
Next: What happens after surgery? »
- Seizure (Epilepsy) - Learn about epilepsy, or seizure disorder. Causes include head injury, trauma, prenatal injury, poisoning, medications, stroke, heart attacks, alcoholism, infection, and more. Symptoms, diagnosis, and treatment information is included in the information.
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