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Multimodal neuromonitoring

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https://www.readbyqxmd.com/read/28619491/the-accuracy-of-multimodality-intraoperative-neuromonitoring-to-predict-postoperative-neurological-deficits-following-cervical-laminoplasty
#1
Junichi Oya, John F Burke, Todd Vogel, Boby Tay, Dean Chou, Praveen Mummaneni
BACKGROUND: Intraoperative neuromonitoring (IONM) has been reported to be sensitive and specific in the detection of neurological injury during spinal surgery. However, utilizing multimodality IONM to predict postoperative neural deficits following cervical laminoplasty remains unclear. OBJECTIVE: The purpose of this study is to clarify the incidence of C5 palsy utilizing multimodality IONM and to compare the accuracy of multimodality IONM to predict postoperative C5 palsy against isolated transcranial motor-evoked potential (MEP)...
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28614970/effect-of-cerebrospinal-fluid-drainage-on-brain-tissue-oxygenation-in-traumatic-brain-injury
#2
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). However, recently the use of external ventricular drains and intracranial pressure monitors in traumatic brain injury 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 multimodality monitoring system, we continuously monitored brain tissue oxygenation (PbtO2) and parenchymal ICP during CSF drainage events via a ventriculostomy in 40 patients with severe traumatic brain injury (TBI)...
June 14, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28481390/multimodal-intraoperative-neurophysiologic-monitoring-in-the-neurosurgical-oncology
#3
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
#4
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
#5
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
#6
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...
March 27, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28263931/multimodal-intraoperative-neuromonitoring-in-aneurysm-surgery
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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...
November 19, 2016: 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
#14
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...
January 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28004334/noninvasive-neuromonitoring-current-utility-in-subarachnoid-hemorrhage-traumatic-brain-injury-and-stroke
#15
Luisa Vinciguerra, Julian Bösel
Noninvasive neuromonitoring is increasingly being used to monitor the course of primary brain injury and limit secondary brain damage of patients in the neurocritical care unit. Proposed advantages over invasive neuromonitoring methods include a lower risk of infection and bleeding, no need for surgical installation, mobility and portability of some devices, and safety. The question, however, is whether noninvasive neuromonitoring is practical and trustworthy enough already. We searched the recent literature and reviewed English-language studies on noninvasive neuromonitoring in subarachnoid hemorrhage, traumatic brain injury, and ischemic and hemorrhagic stroke between the years 2010 and 2015...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27837190/hyperoxia-results-in-increased-aerobic-metabolism-following-acute-brain-injury
#16
Arnab Ghosh, David Highton, Christina Kolyva, Ilias Tachtsidis, Clare E Elwell, Martin Smith
Acute brain injury is associated with depressed aerobic metabolism. Below a critical mitochondrial pO2 cytochrome c oxidase, the terminal electron acceptor in the mitochondrial respiratory chain, fails to sustain oxidative phosphorylation. After acute brain injury, this ischaemic threshold might be shifted into apparently normal levels of tissue oxygenation. We investigated the oxygen dependency of aerobic metabolism in 16 acutely brain-injured patients using a 120-min normobaric hyperoxia challenge in the acute phase (24-72 h) post-injury and multimodal neuromonitoring, including transcranial Doppler ultrasound-measured cerebral blood flow velocity, cerebral microdialysis-derived lactate-pyruvate ratio (LPR), brain tissue pO2 (pbrO2), and tissue oxygenation index and cytochrome c oxidase oxidation state (oxCCO) measured using broadband spectroscopy...
January 1, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27594826/a-user-configurable-headstage-for-multimodality-neuromonitoring-in-freely-moving-rats
#17
Kanokwan Limnuson, Raj K Narayan, Amrit Chiluwal, Eugene V Golanov, Chad E Bouton, Chunyan Li
Multimodal monitoring of brain activity, physiology, and neurochemistry is an important approach to gain insight into brain function, modulation, and pathology. With recent progress in micro- and nanotechnology, micro-nano-implants have become important catalysts in advancing brain research. However, to date, only a limited number of brain parameters have been measured simultaneously in awake animals in spite of significant recent progress in sensor technology. Here we have provided a cost and time effective approach to designing a headstage to conduct a multimodality brain monitoring in freely moving animals...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27574545/multimodal-brain-monitoring-in-fulminant-hepatic-failure
#18
REVIEW
Fernando Mendes Paschoal, Ricardo Carvalho Nogueira, Karla De Almeida Lins Ronconi, Marcelo de Lima Oliveira, Manoel Jacobsen Teixeira, Edson Bor-Seng-Shu
Acute liver failure, also known as fulminant hepatic failure (FHF), embraces a spectrum of clinical entities characterized by acute liver injury, severe hepatocellular dysfunction, and hepatic encephalopathy. Cerebral edema and intracranial hypertension are common causes of mortality in patients with FHF. The management of patients who present acute liver failure starts with determining the cause and an initial evaluation of prognosis. Regardless of whether or not patients are listed for liver transplantation, they should still be monitored for recovery, death, or transplantation...
August 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27521197/brain-oxygenation-monitoring
#19
REVIEW
Matthew A Kirkman, Martin Smith
A mismatch between cerebral oxygen supply and demand can lead to cerebral hypoxia/ischemia and deleterious outcomes. Cerebral oxygenation monitoring is an important aspect of multimodality neuromonitoring. It is increasingly deployed whenever intracranial pressure monitoring is indicated. Although there is a large body of evidence demonstrating an association between cerebral hypoxia/ischemia and poor outcomes, it remains to be determined whether restoring cerebral oxygenation leads to improved outcomes. Randomized prospective studies are required to address uncertainties about cerebral oxygenation monitoring and management...
September 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27521195/multimodality-neuromonitoring
#20
REVIEW
Matthew A Kirkman, Martin Smith
The monitoring of systemic and central nervous system physiology is central to the management of patients with neurologic disease in the perioperative and critical care settings. There exists a range of invasive and noninvasive and global and regional monitors of cerebral hemodynamics, oxygenation, metabolism, and electrophysiology that can be used to guide treatment decisions after acute brain injury. With mounting evidence that a single neuromonitor cannot comprehensively detect all instances of cerebral compromise, multimodal neuromonitoring allows an individualized approach to patient management based on monitored physiologic variables rather than a generic one-size-fits-all approach targeting predetermined and often empirical thresholds...
September 2016: Anesthesiology Clinics
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