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intraoperative neurophysiology

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https://www.readbyqxmd.com/read/28623598/cost-effectiveness-of-two-decision-strategies-for-shunt-use-during-carotid-endarterectomy
#1
Joe L P Kolkert, Rolf H H Groenwold, Vanessa J Leijdekkers, Joep Ter Haar, Clark J Zeebregts, Anco Vahl
BACKGROUND: Arterial shunting during carotid endarterectomy (CEA) is essential in some patients because of insufficient cerebral perfusion during cross-clamping. However, the optimal diagnostic modality identifying these patients is still debated. None of the currently used modalities has been proved superior to another. The aim of this study was to assess the cost-effectiveness of two modalities, stump pressure measurement (SPM) versus electroencephalography (EEG) combined with transcranial Doppler (TCD) during CEA...
June 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28620788/comparison-of-intraoperative-neurophysiologic-monitoring-outcomes-between-cervical-and-thoracic-spine-surgery
#2
Shujie Wang, Yuan Tian, Xiangquan Lin, Zhifu Ren, Yu Zhao, Jiliang Zhai, Xiaojuan Zhang, Yanwei Zhao, Yingyue Dong, Congran Zhao, Ye Tian
PURPOSE: The objective is to compare the intraoperative monitoring (IOM) outcomes between degenerative cervical and thoracic spine decompression surgery. METHOD: A total of 97 patients with cervical compression myelopathy (CCM) and 75 patients with thoracic compression myelopathy (TCM) were prospectively collected between December 2012 and June 2015 in our spine center. Somatosensory-evoked potentials (SSEP) and motor-evoked potentials (MEP) were used for IOM. The postoperative neurologic status of each patient was assessed immediately after surgery...
June 15, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28571911/a-spotlight-on-intraoperative-neurophysiological-monitoring-of-the-lower-brainstem
#3
EDITORIAL
Francesco Sala
No abstract text is available yet for this article.
July 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28534074/facial-nerve-sparing-surgery-for-large-vestibular-schwannomas
#4
Paolo Ferroli, Lorenzo Bosio, Morgan Broggi
BACKGROUND: Nowadays, there is a general trend in vestibular schwannoma (VS) surgery favoring near-total or subtotal tumor resection (NTR/STR) with facial nerve (FN) function preservation rather than gross total resection (GTR) with high risk of FN damage. METHODS: The surgical technique of FN sparing in large VS includes patient-tailored image-guided craniotomy, continuous intraoperative neurophysiological monitoring (INM), intracapsular wide tumor debulking, and only final extracapsular dissection with FN course identification and brainstem decompression...
July 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28532908/the-safety-and-efficiency-of-pvcr-without-anterior-support-applied-in-treatment-of-yang-s-a-type-severe-thoracic-kyphoscoliosis
#5
Wen-Yuan Sui, Zi-Fang Huang, Yao-Long Deng, Heng-Wei Fan, Jing-Fan Yang, Fo-Bao Li, Jun-Lin Yang
OBJECT: To assess the clinical and radiographic outcomes of posterior vertebral column resection (PVCR) without anterior support in treatment of Yang's A type severe rigid thoracic kyphoscoliosis. METHODS: The records of 27 Yang's A type severe thoracic kyphoscoliosis patients treated with PVCR without anterior support from January 2010 to September 2013 were retrospectively analyzed. Intraoperative multimodal neurophysiological monitoring (IONM) (6 modes: Somatosensory evoked potential (SSEP), Motor evoked potential (MEP), Descending neurogenic evoked potential (DNEP), Spinal cord evoked potential (SCEP), and Electromyography, both triggered and free run EMG) was conducted in all patients...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28526648/somatosensory-evoked-potentials-during-temporary-arterial-occlusion-for-intracranial-aneurysm-surgery-predictive-value-for-perioperative-stroke
#6
Ahmed I Kashkoush, Brian T Jankowitz, Paul Gardner, Robert M Friedlander, Yue-Fang Chang, Donald J Crammond, Jeffrey R Balzer, Parthasarathy D Thirumala
BACKGROUND: Temporary arterial occlusion (TAO) is a valuable tool for minimizing intraoperative rupture risk during intracranial aneurysm microsurgery; however, it may also be associated with ischemic injury. OBJECTIVE: This study aims to identify surgical and intraoperative neurophysiological monitoring (IONM) factors that predict perioperative stroke risk after TAO. METHODS: We performed a retrospective chart review of 177 intracranial aneurysm surgeries at our institution, in which TAO was performed before the placement of a permanent clip under monitoring with somatosensory evoked potentials (SSEPs) and electroencephalography (EEG)...
May 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28526642/-asleep-deep-brain-stimulation-surgery-a-critical-review-of-the-literature
#7
REVIEW
Tsinsue Chen, Zaman Mirzadeh, Francisco A Ponce
OBJECTIVE: Although performing deep brain stimulation (DBS) with the patient under general anesthesia without microelectrode recording (MER) or intraoperative test stimulation (ITS) for movement disorders ("asleep" DBS) has become increasingly popular, its feasibility is based on the untested assumption that stereotactic accuracy correlates with positive clinical outcomes. To investigate outcomes after asleep DBS without MER or neurophysiological testing, we reviewed the medical literature on the topic...
May 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28524753/continuous-mapping-of-the-corticospinal-tracts-in-intramedullary-spinal-cord-tumor-surgery-using-an-electrified-ultrasonic-aspirator
#8
Ori Barzilai, Zvi Lidar, Shlomi Constantini, Khalil Salame, Yifat Bitan-Talmor, Akiva Korn
Intramedullary spinal cord tumors (IMSCTs) represent a rare entity, accounting for 4%-10% of all central nervous system tumors. Microsurgical resection of IMSCTs is currently considered the primary treatment modality. Intraoperative neurophysiological monitoring (IONM) has been shown to aid in maximizing tumor resection and minimizing neurological morbidity, consequently improving patient outcome. The gold standard for IONM to date is multimodality monitoring, consisting of both somatosensory evoked potentials, as well as muscle-based transcranial electric motor evoked potentials (tcMEPs)...
May 19, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28506486/preoperative-and-intraoperative-neurophysiological-investigations-for-surgical-resections-in-functional-areas
#9
G Huberfeld, A Trébuchon, L Capelle, J-M Badier, S Chen, J-P Lefaucheur, M Gavaret
Brain regions are removed to treat lesions, but great care must be taken not to disturb or remove functional areas in the lesion and in surrounding tissue where healthy and diseased cells may be intermingled, especially for infiltrating tumors. Cortical functional areas and fiber tracts can be localized preoperatively by probabilistic anatomical tools, but mapping of functional integrity by neurophysiology is essential. Identification of the primary motor cortex seems to be more effectively performed with transcranial magnetic stimulation (TMS) than functional magnetic resonance imaging (fMRI)...
May 12, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28504930/extracorporeal-stimulation-of-sacral-nerve-roots-for-observation-of-pelvic-autonomic-nerve-integrity-description-of-a-novel-methodological-setup
#10
Tomasz Moszkowski, Daniel Kauff, Celine Wegner, Roman Ruff, Karin Somerlik-Fuchs, Thilo Krueger, Piotr Augustyniak, Klaus-Peter Hoffmann, Werner Kneist
INTRODUCTION: Neurophysiologic monitoring can improve autonomic nerve sparing during critical phases of rectal cancer surgery. OBJECTIVES: To develop a system for extracorporeal stimulation of sacral nerve roots. METHODS: Dedicated software controlled a ten-electrode stimulation array by switching between different electrode configurations and current levels. A built-in impedance and current level measurement assessed the effectiveness of current injection...
May 12, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28491050/a-persistent-primitive-hypoglossal-artery-as-the-sole-supply-to-the-brain-associated-with-a-basilar-bifurcation-aneurysm
#11
Ming Wang, Jun Gu, Ping Lan, Shu Wan, Yongqing Zhou, Xiujue Zheng, Renya Zhan
The persistent primitive hypoglossal artery (PPHA) is the second most common persistent carotid-vertebrobasilar anastomosis, with an incidence of 0.027-0.26%. PPHAs change the hemodynamics of the carotid and vertebrobasilar system and may be associated with intracranial vascular anomalies, but basilar bifurcation aneurysms were rarely reported. We describe the first case of a PPHA as the sole supply to the brain associated with a basilar bifurcation aneurysm and review the literature. We reported a 34-year-old woman who presented with subarachnoid hemorrhage due to a ruptured basilar bifurcation aneurysm...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28485777/influences-of-cisatracurium-besylate-and-vecuronium-bromide-on-muscle-relaxant-effects-and-electromyography-of-tracheal-intubation-under-general-anesthesia
#12
D-J Yu, H-Y Gao
OBJECTIVE: To observe the influences of atracurium besylate and vecuronium bromide on muscle relaxant effects and electromyography of patients with tracheal intubation under general anesthesia in thyroid surgery. PATIENTS AND METHODS: 120 patients treated with thyroid surgery were randomly divided into group A and group V. Patients in group A were administered with cisatracurium besylate combined with propofol and fentanyl for induction of tracheal intubation under general anesthesia...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28481390/multimodal-intraoperative-neurophysiologic-monitoring-in-the-neurosurgical-oncology
#13
Sema Brandmeier, Emine Taşkiran, Fatihhan Bölükbaşi, Ramazan Sari, İlhan Elmaci
AIM: Neurosurgical oncology that is performed for lesions located in critical areas like the sensorimotor area has additional risk because it may cause serious neurological deficiencies. Some intraoperative neuromonitoring (IONM) modalities can effectively help the surgeons to maximize resections of this kind of lesions with or without an acceptable neurological deficiency. Our aim was to share our IONM experiences with patients who underwent intracranial lesion surgery in critical areas between September 2013 and January 2015...
March 26, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28469668/anesthetic-considerations-for-patients-with-acute-cervical-spinal-cord-injury
#14
REVIEW
Fang-Ping Bao, Hong-Gang Zhang, Sheng-Mei Zhu
Anesthesiologists work to prevent or minimize secondary injury of the nervous system and improve the outcome of medical procedures. To this end, anesthesiologists must have a thorough understanding of pathophysiology and optimize their skills and equipment to make an anesthesia plan. Anesthesiologists should conduct careful physical examinations of patients and consider neuroprotection at preoperative interviews, consider cervical spinal cord movement and compression during airway management, and suggest awake fiberoptic bronchoscope intubation for stable patients and direct laryngoscopy with manual in-line immobilization in emergency situations...
March 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28442963/sugammadex-to-reverse-neuromuscular-blockade-and-provide-optimal-conditions-for-motor-evoked-potential-monitoring
#15
Mehdi Trifa, Senthil Krishna, Ajay D'Mello, Mumin Hakim, Joseph Drew Tobias
Sugammadex is a novel pharmacologic agent, which reverses neuromuscular blockade (NMB) via a mechanism that differs completely from acetylcholinesterase inhibitors. By encapsulating rocuronium, sugammadex can provide recovery of neuromuscular function even when there is a profound degree of NMB. We report anecdotal experience with the use of sugammadex to reverse NMB to facilitate intraoperative neurophysiological monitoring (motor evoked potentials) in an adolescent with scoliosis during posterior spinal fusion...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28436812/retrospective-waveform-analysis-of-transcranial-motor-evoked-potentials-mep-to-identify-early-predictors-of-impending-motor-deficits-in-spinal-surgeries
#16
Scheherazade Le, Viet Nguyen, Alexander C Ekwueme, S Charles Cho, Leslie Lee, Jaime López
PURPOSE: Although there are guidelines analyzing transcranial motor evoked potentials (MEP) waveform criteria, they vary widely and are not applied universally during intraoperative neurophysiologic monitoring (IONM). The objective is to generate hypotheses to identify early and reliable MEP waveform characteristics prior to complete loss of MEP to predict impending motor spinal cord injuries during spinal surgeries. The ultimate goal is to enhance real-time feedback to prevent injury or detect reversible spinal cord damage...
2017: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/28409732/the-surgical-treatment-of-tumors-of-the-fourth-ventricle-a-single-institution-experience
#17
Sherise D Ferguson, Nicholas B Levine, Dima Suki, Andrew J Tsung, Fredrick F Lang, Raymond Sawaya, Jeffrey S Weinberg, Ian E McCutcheon
OBJECTIVE Fourth ventricle tumors are rare, and surgical series are typically small, comprising a single pathology, or focused exclusively on pediatric populations. This study investigated surgical outcome and complications following fourth ventricle tumor resection in a diverse patient population. This is the largest cohort of fourth ventricle tumors described in the literature to date. METHODS This is an 18-year (1993-2010) retrospective review of 55 cases involving patients undergoing surgery for tumors of the fourth ventricle...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28379572/risk-factors-for-ineffectiveness-of-posterior-decompression-and-dekyphotic-corrective-fusion-with-instrumentation-for-beak-type-thoracic-ossification-of-the-posterior-longitudinal-ligament-a-single-institute-study
#18
Shiro Imagama, Kei Ando, Zenya Ito, Kazuyoshi Kobayashi, Tetsuro Hida, Kenyu Ito, Mikito Tsushima, Yoshimoto Ishikawa, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Hiroaki Nakashima, Norimitsu Wakao, Yoshihiro Nishida, Yukihiro Matsuyama, Naoki Ishiguro
BACKGROUND: Thoracic ossification of the posterior longitudinal ligament (T-OPLL) is treated surgically with instrumented posterior decompression and fusion. However, the factors determining the outcome of this approach and the efficacy of additional resection of T-OPLL are unknown. OBJECTIVE: To identify these factors in a prospective study at a single institution. METHODS: The subjects were 70 consecutive patients with beak-type T-OPLL who underwent posterior decompression and dekyphotic fusion and had an average of 4...
May 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28377841/what-can-we-learn-from-two-consecutive-cases-droperidol-may-abolish-tcmeps
#19
Ángel Saponaro González, Pedro Javier Pérez Lorensu, Santiago Chaves Gómez, Josué Francisco Nodarse Medina, Jose Ángel Torres Dios
Droperidol is a D2 receptor antagonist currently used in Europe for preventing postoperative nausea and vomiting. It was used to perform neurolept anaesthesia in combination with fentanyl until a Food and Drug Administration (FDA) 'black box' warning restricted its use due to cardiovascular side effects in 2001. There is no literature regarding the effects of droperidol on transcranial motor evoked potentials (TcMEPs) elicited by electrical stimulation. Our aim was to report two cases of spine surgery in which TcMEPs were lost due to droperidol administration...
February 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28362960/ipsilateral-motor-innervation-discovered-incidentally-on-intraoperative-monitoring-a-case-report
#20
Jerry Ku, Daniel Mendelsohn, Jason Chew, Jason Shewchuk, Charles Dong, Ryojo Akagami
BACKGROUND AND IMPORTANCE: Lesions in the corticospinal tract above the decussation at the medullary pyramids almost universally produce contralateral deficits. Rare cases of supratentorial lesions causing ipsilateral motor deficits have been reported previously, but only ever found secondary to stroke or congenital pyramidal tract malformations. CLINICAL PRESENTATION: Herein, we report a case of ipsilateral corticospinal tract innervation discovered incidentally with intraoperative monitoring during a microsurgical resection of a vestibular schwannoma...
March 1, 2017: Neurosurgery
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