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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\u00b0 high-density ring-shaped cortical electrode assembly device, called the \u201ccircular grid,\u201d that allows for simultaneous tumor resection and real-time electrophysiology data recording from the brain surface.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>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 \u2264 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).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2019.4.jns19261","type":"journal-article","created":{"date-parts":[[2019,7,13]],"date-time":"2019-07-13T00:07:34Z","timestamp":1562976454000},"page":"443-450","source":"Crossref","is-referenced-by-count":16,"title":["A 360\u00b0 electronic device for recording high-resolution intraoperative electrocorticography of the brain during awake craniotomy"],"prefix":"10.3171","volume":"133","author":[{"given":"Karim","family":"ReFaey","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaisorn L.","family":"Chaichana","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anteneh M.","family":"Feyissa","sequence":"additional","affiliation":[{"name":"Neurology, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tito","family":"Vivas-Buitrago","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin H.","family":"Brinkmann","sequence":"additional","affiliation":[{"name":"Departments of Neurology and"},{"name":"Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik H.","family":"Middlebrooks","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake H.","family":"McKay","sequence":"additional","affiliation":[{"name":"Neurology, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Lankford","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashwat","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Department of Mathematics, University of Texas at Austin, Austin, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elird","family":"Bojaxhi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Mayo Clinic, Jacksonville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grayson E.","family":"Roth","sequence":"additional","affiliation":[{"name":"Neurology, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William O.","family":"Tatum","sequence":"additional","affiliation":[{"name":"Neurology, Mayo Clinic, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Qui\u00f1ones-Hinojosa","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Epilepsia","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1111\/j.1528-1167.2005.66404.x","article-title":"The first case of invasive EEG monitoring for the surgical treatment of epilepsy: historical significance and context","volume":"46","author":"Almeida AN","year":"2005","unstructured":"Almeida AN, Martinez V, Feindel W: The first case of invasive EEG monitoring for the surgical treatment of epilepsy: historical significance and context. 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