A method for placing Heschl gyrus depth electrodes: Technical note

Chandan G REDDY; Nader S DAHDALEH; Gregory ALBERT; Fangxiang Chen; Daniel HANSEN; Kirill NOURSKI; Hiroto KAWASAKI; Hiroyuki OYA; Matthew A HOWARD

doi:10.3171/2009.7.JNS09404

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A method for placing Heschl gyrus depth electrodes: Technical note

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A method for placing Heschl gyrus depth electrodes: Technical note

Chandan G REDDY, Nader S DAHDALEH, Gregory ALBERT, Fangxiang Chen, Daniel HANSEN, Kirill NOURSKI, Hiroto KAWASAKI, Hiroyuki OYA and Matthew A HOWARD

Journal of neurosurgery, Vol.112(6), pp.1301-1307

2010

DOI: 10.3171/2009.7.JNS09404

PMID: 19663547

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https://www.ncbi.nlm.nih.gov/pmc/articles/3816376View

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Abstract

A wide range of devices is used to obtain intracranial electrocorticography recordings in patients with medically refractory epilepsy, including subdural strip and grid electrodes and depth electrodes. Penetrating depth electrodes are required to access some brain regions, and 1 target site that presents a particular technical challenge is the first transverse temporal gyrus, or Heschl gyrus (HG). The HG is located within the supratemporal plane and has an oblique orientation relative to the sagittal and coronal planes. Large and small branches of the middle cerebral artery abut the pial surface of the HG and must be avoided when planning the electrode trajectory. Auditory cortex is located within the HG, and there are functional connections between this dorsal temporal lobe region and medial sites commonly implicated in the pathophysiology of temporal lobe epilepsy. At some surgical centers, depth electrodes are routinely placed within the supratemporal plane, and the HG, in patients who require intracranial electrocorticography monitoring for presumed temporal lobe epilepsy. Information from these recordings is reported to facilitate the identification of seizure patterns in patients with or without auditory auras. To date, only one implantation method has been reported to be safe and effective for placing HG electrodes in a large series of patients undergoing epilepsy surgery. This well-established approach involves inserting the electrodes from a lateral trajectory while using stereoscopic stereotactic angiography to avoid vascular injury. In this report, the authors describe an alternative method for implantation. They use frameless stereotaxy and an oblique insertion trajectory that does not require angiography and allows for the simultaneous placement of subdural grid arrays. Results in 19 patients demonstrate the safety and efficacy of the method.

Neurosurgery

Biological and medical sciences

Medical sciences

Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases

Details

Title: Subtitle: A method for placing Heschl gyrus depth electrodes: Technical note
Creators: Chandan G REDDY - Department of Neurosurgery, University of Iowa, Iowa City, Iowa, United States
Nader S DAHDALEH - Department of Neurosurgery, University of Iowa, Iowa City, Iowa, United States
Gregory ALBERT - Department of Neurosurgery, University of Iowa, Iowa City, Iowa, United States
Fangxiang Chen - Department of Neurosurgery, University of Iowa, Iowa City, Iowa, United States
Daniel HANSEN - Department of Neurosurgery, University of Iowa, Iowa City, Iowa, United States
Kirill NOURSKI - Department of Neurosurgery, University of Iowa, Iowa City, Iowa, United States
Hiroto KAWASAKI - Department of Neurosurgery, University of Iowa, Iowa City, Iowa, United States
Hiroyuki OYA - Department of Neurosurgery, University of Iowa, Iowa City, Iowa, United States
Matthew A HOWARD - Department of Neurosurgery, University of Iowa, Iowa City, Iowa, United States
Resource Type: Journal article
Publication Details: Journal of neurosurgery, Vol.112(6), pp.1301-1307
DOI: 10.3171/2009.7.JNS09404
PMID: 19663547
NLM abbreviation: J Neurosurg
ISSN: 0022-3085
eISSN: 1933-0693
Publisher: American Association of Neurological Surgeons; Charlottesville, VA
Language: English
Date published: 2010
Academic Unit: Neurology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9984020610402771

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