Motor evoked potential mapping and monitoring by direct brainstem stimulation
| Autor: | Hiroshi Ujiie, Tomokatsu Hori, Satoshi Tanaka, Junko Takanashi, Kiyotaka Fujii |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Central nervous system disease Meningioma Aneurysm Arachnoid cyst Monitoring Intraoperative medicine Humans Evoked potential Child Aged Brain Diseases Brain Mapping Palsy business.industry General Medicine Middle Aged Evoked Potentials Motor medicine.disease Trunk Electric Stimulation Anesthesia Female Brainstem business Brain Stem |
| Zdroj: | Journal of Neurosurgery. 107:1053-1057 |
| ISSN: | 1933-0693 0022-3085 |
| Popis: | ✓Motor evoked potentials (MEPs) by direct brainstem stimulation were generated during 12 neurosurgical operations performed in five posterior fossa tumors, six vertebrobasilar aneurysms, and an arachnoid cyst. The anterior aspect of the brainstem was exposed using a subtemporal approach (in six cases), a presigmoid approach (one case), or a lateral suboccipital approach (five cases). A train of five monopolar 5 to 25 mA pulses was then applied, and MEPs were recorded from the extremities. Motor evoked potentials were recorded in all patients (four mappings and seven monitorings) except in a 12-year-old child who underwent surgery for a posterior cerebral artery aneurysm. Although he experienced postoperative motor palsy, the aneurysm ruptured before electrodes could be placed. Two patients with postoperative motor palsy, one with a clival meningioma and one with a basilar trunk aneurysm, had shown significant decreases in MEP amplitude and even complete disappearance of MEPs during intraoperative brainstem stimulation. Motor evoked potentials elicited by direct brainstem stimulation seem to be an accurate neurophysiological monitoring method during operations around the anterior and lateral aspects of the brainstem. |
| Databáze: | OpenAIRE |
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