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Multimodal neuromonitoring

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https://www.readbyqxmd.com/read/29088949/unraveling-the-complexities-of-invasive-multimodality-neuromonitoring
#1
Saurabh Sinha, Eric Hudgins, James Schuster, Ramani Balu
Acute brain injuries are a major cause of death and disability worldwide. Survivors of life-threatening brain injury often face a lifetime of dependent care, and novel approaches that improve outcome are sorely needed. A delayed cascade of brain damage, termed secondary injury, occurs hours to days and even weeks after the initial insult. This delayed phase of injury provides a crucial window for therapeutic interventions that could limit brain damage and improve outcome. A major barrier in the ability to prevent and treat secondary injury is that physicians are often unable to target therapies to patients' unique cerebral physiological disruptions...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28965444/intraoperative-neuromonitoring-alerts-in-a-pediatric-deformity-center
#2
Maria Zuccaro, James Zuccaro, Amer F Samdani, Joshua M Pahys, Steven W Hwang
OBJECTIVE Intraoperative neuromonitoring (IONM) involves the use of somatosensory evoked potentials (SSEPs) and transcranial electric motor evoked potentials (TceMEPs). In this retrospective study the authors examined the sensitivity and specificity of both SSEPs and TceMEPs during pediatric spinal deformity surgeries. METHODS The authors performed a retrospective quantitative analysis of data obtained in 806 patients (197 males and 609 females) treated from December 2011 until October 2015. All patients were diagnosed with scoliosis that was classified as one of the following: adolescent idiopathic scoliosis (AIS) (38%), congenital scoliosis (22%), or syndromic scoliosis (40%)...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28958609/the-importance-of-bilateral-monitoring-of-cerebral-oxygenation-nirs-clinical-case-of-asymmetry-during-cardiopulmonary-bypass-secondary-to-previous-cerebral-infarction
#3
S Matcan, P Sanabria Carretero, M Gómez Rojo, L Castro Parga, F Reinoso-Barbero
Cerebral oximetry based on near infrared spectroscopy (NIRS) technology is used to determine cerebral tissue oxygenation. We hereby present the clinical case of a 12-month old child with right hemiparesis secondary to prior left middle cerebral artery stroke 8 months ago. The child underwent surgical enlargement of the right ventricular outflow tract (RVOT) with cardiopulmonary bypass. During cardiopulmonary bypass, asymmetric NIRS results were detected between both hemispheres. The utilization of multimodal neuromonitoring (NIRS-BIS) allowed acting on both perfusion pressure and anesthetic depth to balance out the supply and demand of cerebral oxygen consumption...
September 25, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28938340/paediatric-traumatic-brain-injury-prognostic-insights-and-outlooks
#4
Alicia K Au, Robert S B Clark
PURPOSE OF REVIEW: Traumatic brain injury (TBI) is a leading cause of death and disability in children. Prognostication of outcome following TBI is challenging in this population and likely requires complex, multimodal models to achieve clinically relevant accuracy. This review highlights injury characteristics, physiological indicators, biomarkers and neuromonitoring modalities predictive of outcome that may be integrated for future development of sensitive and specific prognostic models...
September 21, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28938277/multimodality-neuromonitoring-in-adult-traumatic-brain-injury-a-narrative-review
#5
Martin Smith
Neuromonitoring plays an important role in the management of traumatic brain injury. Simultaneous assessment of cerebral hemodynamics, oxygenation, and metabolism allows an individualized approach to patient management in which therapeutic interventions intended to prevent or minimize secondary brain injury are guided by monitored changes in physiologic variables rather than generic thresholds. This narrative review describes various neuromonitoring techniques that can be used to guide the management of patients with traumatic brain injury and examines the latest evidence and expert consensus guidelines for neuromonitoring...
September 22, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28805756/-an-experience-of-neurophysiological-monitoring-in-neurosurgery
#6
A G Vasyatkina, E A Levin, K Yu Orlov, V V Kobozev
AIM: To evaluate the efficacy of neuromonitoring methods in prevention of postoperative neurological complications and estimation of predictive power of intraoperative changes in monitored characteristics. MATERIAL AND METHODS: Retrospective study examined 240 patients, operated in the years 2014-2015 using intraoperative neurophysiological monitoring. One hundred and seventy-three patients suffered from hemispheric lesions and 67 had lesions located in or near the brainstem...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28619491/the-accuracy-of-multimodality-intraoperative-neuromonitoring-to-predict-postoperative-neurologic-deficits-following-cervical-laminoplasty
#7
Junichi Oya, John F Burke, Todd Vogel, Bobby Tay, Dean Chou, Praveen Mummaneni
BACKGROUND: Intraoperative neuromonitoring (IONM) has been reported to be sensitive and specific in the detection of neurologic injury during spinal surgery. The purpose of this study was to clarify the incidence of C5 palsy using multimodality IONM and to compare the accuracy of multimodality IONM to predict postoperative C5 palsy with isolated transcranial motor evoked potentials (MEPs). METHODS: We retrospectively reviewed 135 consecutive patients at a single institution with cervical spondylotic myelopathy who underwent open door laminoplasty using MEPs combined with somatosensory evoked potentials and free-running electromyography...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28614970/effect-of-cerebrospinal-fluid-drainage-on-brain-tissue-oxygenation-in-traumatic-brain-injury
#8
Omar S Akbik, Mark Krasberg, Edwin M Nemoto, Howard Yonas
The effectiveness of cerebrospinal fluid (CSF) drainage in lowering high intracranial pressure (ICP) is well established in severe traumatic brain injury (TBI). Recently, however, the use of external ventricular drains (EVDs) and ICP monitors in TBI has come under question. The aim of this retrospective study was to investigate the effect of CSF drainage on brain tissue oxygenation (PbtO2). Using a multi-modality monitoring system, we continuously monitored PbtO2 and parenchymal ICP during CSF drainage events via a ventriculostomy in 40 patients with severe TBI...
November 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28481390/multimodal-intraoperative-neurophysiologic-monitoring-in-the-neurosurgical-oncology
#9
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/28452617/intradiploic-encephalocele-of-the-primary-motor-cortex-in-an-adult-patient-electrophysiological-implications-during-surgery
#10
Luca Valci, Martina Dalolio, Dominique Kuhlen, Emanuele Pravatà, Claudio Gobbi, Michael Reinert
Encephaloceles are herniations of brain parenchyma through congenital or acquired osseous-dural defects of the skull base or cranial vault. Different types of symptoms, due to CSF fistulas, meningitis, or seizures, are often associated with this condition. The authors present a rare case of spontaneous right frontal parasagittal encephalocele in a 70-year-old man who was experiencing a spastic progressive paresis of his left lower limb. Results of routine electrophysiological workup (motor evoked potentials, somatosensory evoked potentials, and electroneuromyography), as well as those of MRI of the spinal cord, were normal...
April 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28387139/intracortical-electrophysiological-correlates-of-blood-flow-after-severe-sah-a-multimodality-monitoring-study
#11
Brandon Foreman, David Albers, J Michael Schmidt, Cristina Maria Falo, Angela Velasquez, E Sander Connolly, Jan Claassen
Subarachnoid hemorrhage (SAH) is a devastating form of stroke. Approximately one in four patients develop progressive neurological deterioration and silent infarction referred to as delayed cerebral ischemia (DCI). DCI is a complex, multifactorial secondary brain injury pattern and its pathogenesis is not fully understood. We aimed to study the relationship between cerebral blood flow (CBF) and neuronal activity at both the cortex and in scalp using electroencephalography (EEG) in poor-grade SAH patients undergoing multimodality intracranial neuromonitoring...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28343456/implementation-of-neurocritical-care-is-associated-with-improved-outcomes-in-traumatic-brain-injury
#12
Mypinder S Sekhon, Peter Gooderham, Brian Toyota, Navid Kherzi, Vivien Hu, Vinay K Dhingra, Morad S Hameed, Dean R Chittock, Donald E Griesdale
Background Traditionally, the delivery of dedicated neurocritical care (NCC) occurs in distinct NCC units and is associated with improved outcomes. Institution-specific logistical challenges pose barriers to the development of distinct NCC units; therefore, we developed a consultancy NCC service coupled with the implementation of invasive multimodal neuromonitoring, within a medical-surgical intensive care unit. Our objective was to evaluate the effect of a consultancy NCC program on neurologic outcomes in severe traumatic brain injury patients...
July 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28263931/multimodal-intraoperative-neuromonitoring-in-aneurysm-surgery
#13
COMMENT
Giovanni Grasso, Alessandro Landi, Concetta Alafaci
No abstract text is available yet for this article.
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28201539/endovascular-rescue-therapies-for-refractory-vasospasm-after-subarachnoid-hemorrhage-a-prospective-evaluation-study-using-multimodal-continuous-event-neuromonitoring
#14
Walid Albanna, Miriam Weiss, Marguerite Müller, Marc Alexander Brockmann, Annette Rieg, Catharina Conzen, Hans Clusmann, Anke Höllig, Gerrit Alexander Schubert
BACKGROUND: Critical hypoperfusion and metabolic derangement are frequently encountered with refractory vasospasm. Endovascular rescue therapies (ERT) have proven beneficial in selected cases. However, angioplasty (AP) and intraarterial lysis (IAL) are measures of last resort and prospective, quantitative results regarding the efficacy (cerebral oxygenation, metabolism) are largely lacking. OBJECTIVE: To evaluate the efficacy of ERTs for medically refractory vasospasm using multimodal, continuous event neuromonitoring...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28187816/multimodal-neurologic-monitoring
#15
REVIEW
G Korbakis, P M Vespa
Neurocritical care has two main objectives. Initially, the emphasis is on treatment of patients with acute damage to the central nervous system whether through infection, trauma, or hemorrhagic or ischemic stroke. Thereafter, attention shifts to the identification of secondary processes that may lead to further brain injury, including fever, seizures, and ischemia, among others. Multimodal monitoring is the concept of using various tools and data integration to understand brain physiology and guide therapeutic interventions to prevent secondary brain injury...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187068/computed-tomography-based-three-dimensional-measurements-of-spine-shortening-distance-after-posterior-three-column-osteotomies-for-the-treatment-of-severe-and-stiff-scoliosis
#16
Xue-Shi Li, Zi-Fang Huang, Yao-Long Deng, Heng-Wei Fan, Wen-Yuan Sui, Chong-Wen Wang, Jun-Lin Yang
STUDY DESIGN: Retrospective study. OBJECTIVES: This study is to measure and analyze the changes of three-dimensional (3D) distances of spinal column and spinal canal at the three-column osteotomy sites and address their clinical and neurologic significance. SUMMARY OF BACKGROUND DATA: Three-column osteotomies were developed to treat severe and stiff spine deformities with insufficient understanding on the safe limit of spine shortening and the relationship between the shortening distance of the spinal column and that of the spinal canal...
July 15, 2017: Spine
https://www.readbyqxmd.com/read/28175409/170%C3%A2-the-accuracy-of-multimodality-intraoperative-neuromonitoring-to-predict-postoperative-neurological-deficits-following-cervical-laminoplasty
#17
John Frederick Burke, Junichi Ohya, Todd Douglas Vogel, Michael Virk, Dean Chou, Praveen V Mummaneni
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28089809/sensitivity-and-specificity-of-intraoperative-neuromonitoring-for-identifying-safety-and-duration-of-temporary-aneurysm-clipping-based-on-vascular-territory-a%C3%A2-multimodal-strategy
#18
Brittany Staarmann, Kelly O'Neal, Mark Magner, Mario Zuccarello
BACKGROUND: Patients who undergo clipping of cerebral aneurysms face an inherent risk for new postoperative neurologic deficits. Intraoperative neuromonitoring (IONM) is used often for early detection of ischemic changes, while it is still potentially reversible. However, the value, safety, and efficacy of temporary clipping and multimodal IONM to minimize risks are debated. Our retrospective series examined the sensitivity and specificity of IONM using transcranial motor evoked potentials and somatosensory evoked potentials and quantified the safety of temporary clipping by duration and vascular territory...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089323/neurophysiological-monitoring-of-lumbar-spinal-nerve-roots-a-case-report-of-postoperative-deficit-and-literature-review
#19
Yuguang Chen, Baoqing P Wang, Junlin Yang, Yaolong Deng
INTRODUCTION: Intraoperative neurophysiological monitoring (IONM) has proven to help reduce the probability of postoperative neurological deficit for spinal deformity correctional surgeries. However, in rare cases new deficits may still happen. We report a surgical case in which the patient had postoperative paralysis. We would like to call for more case reports with postoperative neurological deficits as they present difficult clinical cases. PRESENTATION OF CASE: A 61-year-old male patient with severe thoracolumbar kyphoscoliosis underwent posterior spinal correction and fusion with segmental T10-L5 pedicle screws and rods instrumentation with IONM...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28078360/multimodal-nerve-monitoring-during-periacetabular-osteotomy-identifies-surgical-steps-associated-with-risk-of-injury
#20
Eduardo N Novais, Travis Heare, Lauryn Kestel, Patricia Oliver, Willy Boucharel, Jason Koerner, Kim Strupp
PURPOSE: Sciatic nerve palsy after periacetabular osteotomy (PAO) is a serious complication. The purpose of this study was to determine whether a multimodal sciatic monitoring technique allows for identification of surgical steps that place the sciatic nerve at risk. METHODS: Transcranial electrical motor evoked potentials (TcMEPs), somatosensory evoked potentials (SSEPs), and spontaneous electromyography (EMG) were monitored in a consecutive series of 34 patients (40 hips) who underwent PAO for the treatment of symptomatic hip dysplasia between January 2012 and November 2014...
August 2017: International Orthopaedics
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