Determination of Side of Cerebral Dominance with Amobarbital

Abstract

Every neurosurgeon is well aware of the great risk of a mistake in the identification of the hemisphere which controls speech, or dominant hemisphere. As it has been clearly stated by Dandy, "A surgeon is never justified in carrying out any formidable procedure involving the areas of the brain responsible for speech if any doubt remains as to the side of the speech control."²Strangely enough, however, very little has been done about finding a way of clarifying such doubt. It is well known today that the widespread habit of basing the determination of the side of cerebral dominance on the side of "handedness" may give rise to unpleasant surprises.^4,13Indeed, the only technique specifically elaborated for establishing the side of cerebral dominance seems to be that of Wada.⁸This author made the important observation that it is possible to interfere with the functional activity of only