Summary
In the neurosurgical approach to intracranial aneurysms which are often accompanied by arterial spasm and cortical ischaemia, monitoring procedures aim to obtain useful information on cerebral function.
SEPs evoked by stimulation of the median nerve at the wrist and of the tibial nerve at the medial malleolus were registered in 45 patients with intracranial aneurysms during neurosurgical procedures.
Our results show SEP abnormalities during different stages of neurosurgical procedures in 36 patients out of the monitored 45. Significant abnormalities of SEPs with respect to the control group were decrease of the amplitude of N 20-P 25 complex, lengthening of the absolute latency of the waves N 20-and P 25 and lengthening of the central conduction time (CCT) (N 13-N 20).
The greatest SEP abnormalities were registered during the neurosurgical apporach to aneurysm and during the clipping procedure. However, the changes were reversible in the majority of the patients. The aim of this paper was to focus on early detection of some cerebral function disturbances during the neurosurgical procedure as well as the prevention of possible brain damage.
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References
Caramia M, Zarola F, Gigli GL, Lavaroni F, Rossini PM (1988) Intraoperative monitoring of scalp-recorded SEPs during carotid endarterectomy. In: Evoked potentials. Springer, Wien New York, pp 107–117
Chiappa KH, Ropper AH (1982) Evoked potentials in clinical medicine: Part I. N Engl J Med 306: 1205–1211
Cracco RQ (1980) Scalp-recorded potentials evoked by median nerve stimulation subcortical potentials, traveling waves and somato-motor potentials. Prog Clin Neurophysiol 7: 1–14
Fava E, Ducati A, Bortolani E, Cenzato M, Landi A, Trazzi R (1988) SEP and EEG monitoring during carotid surgery. In: Evoked potentials. Springer, Wien New York pp 97–104
Goodrich JT (1987) Electrophysiologic measurements: intraoperative evoked potential monitoring. Anesth Clin North America 5: 477–489
Grundy BL (1982) Monitoring of sensory evoked potentials during neurosurgical operations: methods and applications. Neurosurg 11: 556–575
Grundy BL, Nelson PB, Lina A, Herros RC (1982) Monitoring of cortical somatosensory evoked potentials to determine the safety of sacrificing the anterior cerebral artery. Neurosurgery 11: 64–67
Grundy BL (1983) Intraoperative monitoring of sensory evoked potentials. Anesthesiology 58: 72–87
Hargadine JR, Branston NM, Symon L (1980) Central conduction time in primate brain ischemia: a study in baboons. Stroke 11: 637–642
Jacobson GP, Tew JM (1987) Intraoperative evoked potential monitoring. J Clin Neurophysiol 4: 145–176
Litle JR, Lesser RP, Luders H (1987) Electro physiological monitoring during basilar aneurysm operation. Neurosurgery 20: 321–427
Lorenz M, Gaab MR (1988) Operations of scull base processes: Value of intraoperative monitoring. 4th International Congress, Scull base study Group, Hannover
Pathak KS, Brown RH, Cascorbi HF (1984) Effects of fentanyl and morphine on intraoperative somatosensory cortical-evoked potentials. Anaesth Analg 63: 833–837
Ropper AH (1986) Evoked potentials in cerebral ischemia. Stroke 1: 3–5
Rosenstein J, Wang ADJ, Symon L, Suzuki M (1985) Relationship between hemispheric cerebral blood flow, central conduction time and clinical grade in aneurysmal subarachnoid haemorrhage. J Neurosurg 62: 5–30
Russ W, Fraidrich G, Hehrlein FW (1985) Intraoperative somatosensory evoked potentials as a prognostic factor of neurologic state after carotid endarterectomy. Thorac Cardiovasc Surg 33: 392–396
Sebel PS, Flynn PJ, Ingram DA (1984) Effect of nitrous oxide on visual auditory and somatosensory evoked potentials. Br J Anesth 56: 1403–1407
Sebel PS, Ingram DA, Flynn PJ, Rogers H (1986) Evoked potentials during Isoflurane anesthesia. Br J Anesth 58: 580–585
Symon L, Wang AD, Costa ne Silva IE, Gentili F (1984) Perioperative use of somatosensory evoked potentials in aneurysm surgery. J Neurosurg 60: 269–275
Symon L, Wang AD (1986) Somatosensory evoked potentials: their clinical utility in patients with aneurysmal subarachnoid hemorrhage. In: Cracco RQ, Bodis-Wollner I (eds) Evoked potentials, Vol 3. AR Liss, New York, pp 390–401
Symon L, Momma F, Schwerdtfeger K, Bentivoglio P, Costa e Silva IE, Wang A (1986) Evoked potentials monitoring in neurosurgical practice. In: Symonet al (eds) Advances and technical standards in neurosurgery, Vol 14. Springer, Wien New York, pp 25–70
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Djurić, S., Milenković, Z., Klopčić-Spevak, M. et al. Somatosensory evoked potential monitoring during intracranial surgery. Acta neurochir 119, 85–90 (1992). https://doi.org/10.1007/BF01541787
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DOI: https://doi.org/10.1007/BF01541787