Intracranial electroencephalograms (EEGs) recordings are an additional form of intracranial monitoring that involves placing electrodes on the subdural membrane (subdural grids or strips) or deeper in the brain (depth electrodes).
Intracranial electrodes may be using during surgery to identify epileptogenic (ability to cause an epileptic seizure) areas of the brain and the eloquent cortex where control of the motor, sensory, and speech functions are located. When these electrodes are only temporarily employed during surgery and then removed, it’s called intraoperative electrocorticography. Electrodes that are left in place after surgery to monitor and record electrical brain activity are considered extraoperative monitoring.
Regardless of whether you need intraoperative electrocorticography or extraoperative monitoring, a craniotomy is necessary to situate the electrodes on or in the brain. A smaller skull opening called a burr hole may be used to insert subdural strips or depth electrodes, but subdural grids often require larger craniotomies.
Subdural strips are most often used to identify the hemisphere generating epileptic seizures. Small burr holes provide an opening in the skull through which the electrode strips are implanted.
Subdural grids are lattices with implanted electrodes. These larger grids are placed during craniotomy procedures and are used to cover a larger portion of the cortex.
Depth electrodes are placed deep inside the brain using MRI imaging tools to navigate to a precise location. Destinations may involve mesial temporal lobes including the amygdala and the hippocampus.
Compared to traditional electroencephalography electrodes that are placed extracranially (outside the skull), intracranial electroencephalography has a number of advantages:
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