Search Results

You are looking at 1 - 2 of 2 items for

  • Author or Editor: Elird Bojaxhi x
  • All content x
Clear All Modify Search
Free access

Eva Pamias-Portalatin, Ivan Segura Duran, James Ebot, Elird Bojaxhi, William Tatum, and Alfredo Quiñones-Hinojosa

Cavernomas make up approximately 8%–15% of all intracranial vascular malformations, and the most common presenting symptom is seizures. Complete resection of the cavernoma and removal of the surrounding gliotic core presents a cure but poses a challenge if an eloquent brain is involved or with incomplete resection of the epileptogenic foci. The authors present the case of a 53-year-old man with intractable seizures from a left posterior temporal lobe cavernoma who underwent an awake craniotomy with intraoperative seizure monitoring via electrocorticography.

The video can be found here:

Restricted access

Karim ReFaey, Kaisorn L. Chaichana, Anteneh M. Feyissa, Tito Vivas-Buitrago, Benjamin H. Brinkmann, Erik H. Middlebrooks, Jake H. McKay, David J. Lankford, Shashwat Tripathi, Elird Bojaxhi, Grayson E. Roth, William O. Tatum, and Alfredo Quiñones-Hinojosa


Epilepsy is common among patients with supratentorial brain tumors; approximately 40%–70% of patients with glioma develop brain tumor–related epilepsy (BTRE). Intraoperative localization of the epileptogenic zone during surgical tumor resection (real-time data) may improve intervention techniques in patients with lesional epilepsy, including BTRE. Accurate localization of the epileptogenic signals requires electrodes with high-density spatial organization that must be placed on the cortical surface during surgery. The authors investigated a 360° high-density ring-shaped cortical electrode assembly device, called the “circular grid,” that allows for simultaneous tumor resection and real-time electrophysiology data recording from the brain surface.


The authors collected data from 99 patients who underwent awake craniotomy from January 2008 to December 2018 (29 patients with the circular grid and 70 patients with strip electrodes), of whom 50 patients were matched-pair analyzed (25 patients with the circular grid and 25 patients with strip electrodes). Multiple variables were then retrospectively assessed to determine if utilization of this device provides more accurate real-time data and improves patient outcomes.


Matched-pair analysis showed higher extent of resection (p = 0.03) and a shorter transient motor recovery period during the hospitalization course (by approximately 6.6 days, p ≤ 0.05) in the circular grid patients. Postoperative versus preoperative Karnofsky Performance Scale (KPS) score difference/drop was greater for the strip electrode patients (p = 0.007). No significant difference in postoperative seizures between the 2 groups was present (p = 0.80).


The circular grid is a safe, feasible tool that grants direct access to the cortical surgical surface for tissue resection while simultaneously monitoring electrical activity. Application of the circular grid to different brain pathologies may improve intraoperative epileptogenic detection accuracy and functional outcomes, while decreasing postoperative complications.