The Significance of Intraoperative Monitoring of Muscle Motor Evoked Potentials during Unruptured Large and Giant Cerebral Aneurysm Surgery
| Autor: | Seiji Takebayashi, Katsumi Takizawa, Tohru Kobayashi, Hiroyasu Kamiyama, Norihiro Saitoh |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
giant cerebral aneurysm intraoperative monitoring Parent artery Motor function Postoperative Complications Monitoring Intraoperative medicine Humans In patient Intraoperative Complications Paresis business.industry Intracranial Aneurysm Arteriosclerosis Blood flow medicine.disease Evoked Potentials Motor Prognosis Surgery Anesthesia Aneurysm surgery Original Article Neurology (clinical) Neurosurgery medicine.symptom muscle motor evoked potentials business |
| Zdroj: | Neurologia medico-chirurgica |
| ISSN: | 1349-8029 0470-8105 |
| Popis: | The goal of this study was to characterize the utility of muscle motor evoked potentials (MMEPs) elicited by direct cortical stimulation as a means of monitoring during unruptured large and giant cerebral aneurysm surgery. This analysis focused on intraoperative changes in MMEPs and their relationship to postoperative motor function. The study population consisted of 50 patients who underwent surgery for large (n = 31) or giant (n = 19) cerebral aneurysms. Intraoperative MMEPs were continuously and successfully obtained in muscles belonging to the vascular territory of interest. There was no postoperative motor paresis in 31 (62%) patients in whom intraoperative MMEPs remained unchanged. Transient MMEP change occurred in 15 (30%) of the 50 patients, but 9 of those patients had no postoperative motor deficits, 5 had transient motor deficits, and 1 suffered permanent motor deficits resulting from postoperative delayed blood flow insufficiency due to arteriosclerosis of the parent artery. Permanent MMEP loss occurred in 4 (8%) of 50 patients, all of whom developed severe and permanent postoperative motor deficits. MMEP is a useful monitoring modality in patients undergoing surgery for large or giant cerebral aneurysms. This strategy can help predict functional prognosis or guide the neurosurgeon intraoperatively in an effort to promote better outcomes. |
| Databáze: | OpenAIRE |
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