Intraoperative functional cortical localization

Cortical mapping for clinical and scientific inquiry is as old as modern neurosurgery itself and continues to be an important endeavor. Indeed, the last several decades have widely expanded the tools available for detailed mapping of both pathology as well as physiological cortical function. Here we broadly summarize these tools, describing their application and relative utility. There are many non-invasive options that have recently become available, especially with the advent and ongoing expansion of the capabilities of magnetic resonance imaging. However, invasive modalities are expanding and evolving as well. The implantation of electrodes for active stimulation as well as passive recording continues to evolve and yield new insights into cortical function, for both individual patients and also more broadly for the advancement of knowledge. Awake intraoperative mapping remains a very useful and beneficial approach in select clinical scenarios at centers where the necessary investments in equipment and training have been made. All of these approaches culminate in a field dedicated to the surgical removal of brain pathology while maintain the maximum possible level of cortical function. The technology describes herein is utilized to maintain the quality of life of those with often life threatening cortical pathology.