The use of functional magnetic resonance imaging in neurosurgery of the central region.: Part I.: General principles

Functional magnetic resonance imaging (fMRI) enables the imaging of functional areas of the brain, activated by the executed motor or language task, or by stimulation of a sensory system. In neurosurgery, this method is promising in solving pathological lesions of the central region, which bring a risk of postoperative neurological deficit. Considering the fact that the method is relatively less well known, this article focuses on the general principles of its use in neurosurgery. After delimiting the possible role of fMRI among other methods and procedures in central region neurosurgery, the principles of the method and the basic properties of fMR imaging are described. Attention is further paid to the relationship of anatomical and functional imaging of eloquent areas and their possible variability. The final section discusses the possibilities of functional imaging use in the preoperative and intraoperative phase, the possibility of integration with neuronavigation and the possible positive impact of fMRI use on the outcome of therapy. Our own experiences with this method are planned to be published as a sequel to this communication.