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Intraoperative neurophysiological monitoring

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https://www.readbyqxmd.com/read/29134342/an-introduction-and-overview-of-machine-learning-in-neurosurgical-care
#1
REVIEW
Joeky T Senders, Mark M Zaki, Aditya V Karhade, Bliss Chang, William B Gormley, Marike L Broekman, Timothy R Smith, Omar Arnaout
BACKGROUND: Machine learning (ML) is a branch of artificial intelligence that allows computers to learn from large complex datasets without being explicitly programmed. Although ML is already widely manifest in our daily lives in various forms, the considerable potential of ML has yet to find its way into mainstream medical research and day-to-day clinical care. The complex diagnostic and therapeutic modalities used in neurosurgery provide a vast amount of data that is ideally suited for ML models...
November 13, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29110082/continuous-monitoring-of-the-recurrent-laryngeal-nerve
#2
Aitor De la Quintana Basarrate, Arantza Iglesias Martínez, Iciar Salutregui, Leire Agirre Etxabe, Ainhoa Arana González, Izaskun Yurrebaso Santamaría
OBJECTIVE: The objective of this study was to assess the safety and utility of continuous intraoperative neuromonitoring for the prevention of recurrent laryngeal nerve injury during thyroidectomy. METHODS: A prospective cohort study was conducted in consecutive patients undergoing thyroidectomy. Variations in amplitude and distal latency of the electromyogram (EMG) were assessed. In the case of suspicious events, restorative manoeuvers were performed to attempt to recover the potentials...
November 6, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29101613/retained-medullary-cord-extending-to-a-sacral-subcutaneous-meningocele
#3
Nobuya Murakami, Takato Morioka, Takafumi Shimogawa, Kimiaki Hashiguchi, Nobutaka Mukae, Kazuyoshi Uchihashi, Satoshi O Suzuki, Koji Iihara
BACKGROUND: A retained medullary cord (RMC) is a rare closed spinal dysraphism with a robust elongated neural structure continuous from the conus and extending to the dural cul-de-sac. One case extending down to the base of a subcutaneous meningocele at the sacral level has been reported. CLINICAL PRESENTATION: We report on three cases of closed spinal dysraphism, in which a spinal cord-like tethering structure extended out from the dural cul-de-sac and terminated at a skin-covered meningocele sac in the sacrococcygeal region, which was well delineated in curvilinear coronal reconstructed images of 3D-heavily T2-weighted images (3D-hT2WI)...
November 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29076463/-application-of-intraoperative-electromagnetic-frameless-navigation-in-transcranial-and-endoscopic-neurosurgical-interventions
#4
V A Shurkhay, S A Goryaynov, M A Kutin, S A Eolchiyan, D N Capitanov, D V Fomichev, P L Kalinin, A N Shkarubo, D N Kopachev, A G Melikyan, M V Nersesyan, A M Shkatova, A N Konovalov, A A Potapov
The paper summarizes the experience in using a system of electromagnetic intraoperative frameless navigation in various neurosurgical pathologies of the brain. The electromagnetic navigation technique was used for 102 operations in 98 patients, including 36 transnasal endoscopic interventions. There were no intraoprtative and postoperative complications associated with the use of the system. In the process of using the system, factors influencing the accuracy of navigation and requiring additional control by the surgeon were identified...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/29075532/spinal-nerves-schwannomas-experience-on-367-cases-historic-overview-on-how-clinical-radiological-and-surgical-practices-have-changed-over-a-course-of-60-years
#5
Jacopo Lenzi, Giulio Anichini, Alessandro Landi, Alfonso Piciocchi, Emiliano Passacantilli, Francesca Pedace, Roberto Delfini, Antonio Santoro
BACKGROUND: Spinal schwannomas are common benign spinal tumors. Their treatment has significantly evolved over the years, and preserving neurological functions has become one of the main treatment goals together with tumor resection. STUDY DESIGN AND AIMS: Retrospective review focused on clinical assessment, treatment techniques, and outcomes. METHODS: A retrospective study on our surgical series was performed. Clinical and operative data were analyzed...
2017: Neurology Research International
https://www.readbyqxmd.com/read/29066230/intraoperative-neurophysiologic-monitoring-ionm-changes-associated-with-a-case-of-delayed-thalamic-infarct-implications-for-postoperative-management
#6
Forough Ghavami, Omar Choudhri, Michael Marks, Jaime R López
Treatment of cerebral aneurysms poses a risk of cerebral hemorrhage and/or ischemia; these potential sequelae are usually associated with changes in intraoperative neurophysiologic monitoring (IONM) modalities. Our case demonstrates a patient with significant changes in IONM during the treatment of a right posterior cerebral artery aneurysm who did not develop neurologic deficits until three days postoperatively. IONM changes can represent a guide in postoperative patient management and may pose grounds for closer monitoring of patients with IONM changes that do not develop immediate postoperative deficits...
October 21, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29050170/-a-chinese-experts-consensus-of-neurophysiological-evaluating-for-microvascular-decompression
#7
(no author information available yet)
With the extensive development of microvascular decompression (MVD), perioperative neurophysiological monitoring technology is also developping rapidly in our country. To promote the standardization of neurophysiological monitoring for MVD in China, the experts consensus was published. This consensus includes five sections: indications, stimulation and recording methods, intraoperative assessment and warning criteria, influencing factors, and clinical application recommendations. Furthermore, recommendations for selection of electrophysiological monitoring and recording requirements were attached...
October 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29023306/medical-error-avoidance-in-intraoperative-neurophysiological-monitoring-the-communication-imperative
#8
Stan Skinner, Robert Holdefer, John J McAuliffe, Francesco Sala
Error avoidance in medicine follows similar rules that apply within the design and operation of other complex systems. The error-reduction concepts that best fit the conduct of testing during intraoperative neuromonitoring are forgiving design (reversibility of signal loss to avoid/prevent injury) and system redundancy (reduction of false reports by the multiplication of the error rate of tests independently assessing the same structure). However, error reduction in intraoperative neuromonitoring is complicated by the dichotomous roles (and biases) of the neurophysiologist (test recording and interpretation) and surgeon (intervention)...
October 10, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28982108/intraoperative-neurophysiological-monitoring-motor-and-somatosensory-evoked-potentials-in-dorsal-root-entry-zone-lesioning-for-brachial-plexus-avulsion-pain
#9
Byung-Chul Son, Jin-Gyu Choi, Sang-Woo Ha, Deog-Ryeong Kim
AIMS: To address the feasibility and importance of intraoperative neurophysiological monitoring (IONM) in dorsal root entry zone (DREZ) lesioning for brachial plexus avulsion pain. METHODS: Muscle motor evoked potential (mMEP) and somatosensory evoked potential (SSEP) were applied during DREZ lesioning for brachial plexus avulsion pain. RESULTS: IONM of mMEPs and SSEPs was feasible for monitoring of the spinal cord during DREZ lesioning. With the exception of 3 unrecordable mMEPs in ipsilateral arms, mMEPs were preserved and referenced to look for changes according to lesioning in 6 upper extremities (66...
October 6, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28974413/intradural-spinal-tumors-a-review-of-post-operative-outcomes-comparing-intramedullary-and-extramedullary-tumors-from-a-single-institution-s-experience
#10
Z X Ng, S Ng, V Nga, K J Teo, S Lwin, C Ning, T T Yeo
Intradural spinal tumors are rare and can be classified into extramedullary or intramedullary. They commonly present with symptoms such as intractable back pain or neurological deficits. We retrospectively reviewed 91 cases of intradural spinal tumors that underwent surgery in our institution from 2011 to 2016 and their assessed clinical outcomes. The majority of intradural tumors were extramedullary (89%) and the most common pathology was schwanommas (38.5%) followed by meningiomas (29.7%). Comparing extramedullary vs...
September 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28973400/decision-making-in-surgery-for-nonsaccular-posterior-inferior-cerebellar-artery-aneurysms-with-special-reference-to-intraoperative-assessment-of-collateral-blood-flow-and-neurophysiological-function
#11
Alessandro Narducci, Ran Xu, Peter Vajkoczy
BACKGROUND: Posterior inferior cerebellar artery (PICA) aneurysms represent a challenging pathology. PICA sacrifice is often necessary, due to the high proportion of nonsaccular aneurysms that can be found in this location. Several treatments are available, but the infrequency of these aneurysms and the increasing number of endovascular techniques have limited the development of a standardized algorithm for cases in which open surgery is indicated. OBJECTIVE: We present our series of nonsaccular PICA aneurysms, in the attempt to define an algorithm for their surgical management...
June 27, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28973360/motor-evoked-potentials-correlate-with-magnetic-resonance-imaging-and-early-recovery-after-acute-spinal-cord-injury
#12
Sanjay S Dhall, Jenny Haefeli, Jason F Talbott, Adam R Ferguson, William J Readdy, Jacqueline C Bresnahan, Michael S Beattie, Jonathan Z Pan, Geoffrey T Manley, William D Whetstone
BACKGROUND: While the utilization of neurophysiologic intraoperative monitoring with motor evoked potentials (MEPs) has become widespread in surgery for traumatic spine fractures and spinal cord injury (SCI), clinical validation of its diagnostic and therapeutic benefit has been limited. OBJECTIVE: To describe the use of intraoperative MEP at a large level I trauma center and assess the prognostic capability of this technology. METHODS: The SCI REDCap database at our institution, a level I trauma center, was queried for acute cervical SCI patients who underwent surgery with intraoperative monitoring between 2005 and 2011, yielding 32 patients...
July 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28971046/intraoperative-neurophysiological-monitoring-for-spinal-cord-tumor-surgery-comparison-of-motor-and-somatosensory-evoked-potentials-according-to-tumor-types
#13
Taeha Park, Jinyoung Park, Yoon Ghil Park, Joowon Lee
OBJECTIVE: To identify which combination of motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs) is most reliable for postoperative motor deterioration during spinal cord tumor surgery, according to anatomical and pathologic type. METHODS: MEPs and SEPs were monitored in patients who underwent spinal cord tumor surgery between November 2012 and August 2016. Muscle strength was examined in all patients before surgery, within 48 hours postoperatively and 4 weeks later...
August 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28935546/fluorescein-guided-resection-of-intramedullary-spinal-cord-tumors-results-from-a-preliminary-multicentric-retrospective-study
#14
Francesco Acerbi, Claudio Cavallo, Karl-Michael Schebesch, Mehmet Osman Akcakaya, Camilla de Laurentis, Mustafa Kemal Hamamcioglu, Morgan Broggi, Alexander Brawanski, Jacopo Falco, Roberto Cordella, Paolo Ferroli, Telat Kiris, Julius Höhne
INTRODUCTION: IMSCTs are rare heterogenous lesions usually enhancing at pre-operative MRI, due to a damaged BBB. SF is a dye that accumulates in areas of the CNS with a damaged BBB. Given the pattern of MRI contrast-enhancement of the majority of IMSCTs, the use of this fluorescent tracer could improve tumor visualization and quality of resection. In this paper, we present the first experience on the application of fluorescein-guided technique for surgical removal of IMSCTs. METHODS: 11 patients (6 males, 5 females, mean age 50...
September 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28882353/neurophysiological-monitoring-in-radiofrequency-ablation-of-spinal-osteoid-osteoma-with-a-progressive-time-and-temperature-protocol-in-children
#15
Mariano A Nöel, Martin J Segura, Sergio Sierre, Ida A Francheri Wilson, Carlos A Tello, Eduardo Galaretto, Rodrigo G Remondino, María E Talarico, Ernesto S Bersusky, Lucas Piantoni
STUDY DESIGN: Retrospective. Level IV Evidence. OBJECTIVE: To assess the utility of intraoperative neurophysiological monitoring (IONM) to detect and eventually prevent impending neurovascular damage during computed tomography (CT)-guided radiofrequency ablation (RFA) of spinal osteoid osteoma (OO) in children. SUMMARY AND BACKGROUND DATA: To our knowledge, this is the first case series of spinal OO in pediatric patients treated at a single center employing IONM during RFA...
September 2017: Spine Deformity
https://www.readbyqxmd.com/read/28868196/novel-approach-to-continuous-neurophysiological-monitoring-during-surgery-of-peripheral-nerve-tumors
#16
Ángel Saponaro-González, Pedro Javier Pérez-Lorensu
BACKGROUND: Intraoperative neurophysiological monitoring (IONM) with nerve action potential (NAP) can be useful during peripheral nerve surgery. However, current methodologies are not optimized for continuous recording of the NAP. The use of newer electrodes may make it possible to more conveniently obtain continuous recordings of the NAP during surgery. METHODS: After localizing the nerve of interest and dissecting it from the adjacent soft tissue, two APS(®) (Automatic Periodic Stimulation) electrodes, originally designed for stimulation of the vagus nerve during thyroid surgery, are placed on the nerve on either sides of the tumor for stimulation and recording using two subdermal electroencephalogram (EEG) needles as anode and reference, respectively...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28863007/intraoperative-neurophysiologic-monitoring-for-prediction-of-postoperative-neurological-improvement-in-a-child-with-chiari-type-i-malformation
#17
Yukari Kawasaki, Susumu Uchida, Kouhei Onishi, Masako Toyokuni, Kazuo Okanari, Minoru Fujiki
INTRODUCTION: Although many surgical treatment strategies for Chiari malformation type I (CM-I) have been reported, the most appropriate surgical technique remains controversial. It is wholly ascribable to the complicacy of pathological condition in CM-I. Recently, intraoperative neurophysiologic monitoring (INM) is becoming prevalent in spinal surgery. Indeed, motor-evoked potentials (MEPs) monitoring and somatosensory-evoked potentials (SSEPs) monitoring are standard tools to minimize the risk of neurologic injury and postoperative deficits...
October 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28842233/pattern-of-corticospinal-projections-defined-by-brain-mapping-during-resective-epilepsy-surgery-in-a-patient-with-congenital-hemiparesis-and-intractable-epilepsy
#18
Chen-Ya Yang, Hsin-Hung Chen, Chien Chen, Jan-Wei Chiu, Chen-Liang Chou, Tsui-Fen Yang
BACKGROUND: Congenital or early-onset brain structural lesions often cause contralateral hemiparesis, cognitive deficits, developmental delays, and seizures. Seizure is the most debilitating condition, as it greatly impairs quality of life in both the affected individuals and their caregivers and prevents them from active social participation. CASE DESCRIPTION: A 34-year-old man with hemiparesis and early-onset seizures since childhood owing to a congenital brain lesion developed intractable seizures in the last 2 years and was subsequently admitted for resective epileptic surgery...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28840256/-neurophysiological-monitoring-during-surgical-procedures
#19
REVIEW
P Michels, A Bräuer, M Bauer, M Söhle
The application of intraoperative neurophysiological monitoring (IONM) is gaining more and more importance in daily clinical practice. The use of IONM allows the localization of neural structures and to control functioning of the peripheral and central nervous systems in anesthetized patients. This enables surgeons to identify and to protect neural structures and cerebral areas. The use of IONM also enables anesthesiologists to adjust anesthesia and cardiopulmonary therapy to the individual needs of the patient...
August 24, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28805756/-an-experience-of-neurophysiological-monitoring-in-neurosurgery
#20
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
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