Journals / Turkish Neurosurgery / 2018 / Cilt: 28 - Sayı: 2

Multimodal Intraoperative Neurophysiological Monitoring in Neurosurgical Oncology

Pages
204–210
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Using only one modality is not sufficient, whereas a combination of modalities is required to obtain a better outcome

📌 3 Key Takeaways

🎯
Objective & Hypothesis: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.
📊
Key Findings & Data:Our aim was to share our IONM experiences with patients who underwent intracranial lesion surgery in critical areas between September 2013 and January 2015.
💡
Conclusion & Impact:Using only one modality is not sufficient, whereas a combination of modalities is required to obtain a better outcome
🔬Design:Review & Systematic Survey
📍Scope:2013 Verileri
⚙️Variables:Domain Parameters

Özet

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. MATERIAL and METHODS: This retrospective study was performed on 31 patients who underwent brain surgery for the resection of lesions located in eloquent areas. Demographic characteristics, lesion localizations, lesion pathologies, surgery, IONM recordings, and pre- and postoperative neurological examinations were reviewed. RESULTS: Five of the 31 patients had lesions in the cerebellopontine angle and 26 patients had lesions close to critical locations. Transcranial motor evoked potentials and somatosensory evoked potentials were performed in 27, electroencephalography in 31, auditory evoked potentials in 8, visual evoked potentials in 2, triggered electromyography in 8, and central sulcus determination and brain mapping in 17 patients. Motor evoked potential changes occurred in 2 patients intraoperatively. One had right hemiparesia lasting 3 days while the other had monoparesia which improved within 2 months. Permanent neurological deficit was not observed. CONCLUSION: Intraoperative neuromonitoring helps the surgeons to maximize resection of lesions in or close to eloquent areas of the brain. Using only one modality is not sufficient, whereas a combination of modalities is required to obtain a better outcome

🔖

Cite This Article

BRANDMEIER, S., TAŞKIRAN, E., BÖLÜKBAŞI, F. H., SARI, R., ELMACI, İ. (2018). Multimodal Intraoperative Neurophysiological Monitoring in Neurosurgical Oncology. Turkish Neurosurgery, Cilt: 28 - Sayı: 2, 204–210. https://ajindex.com/articles/404511

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (1)

  1. Chang SD, López JR, Steinberg GK: Intraoperative electrical stimulation for identification of cranial nerve nuclei. Muscle Nerve 22(11):1538-1543, 1999 2. Deletis V: Intraoperative neurophysiology and methodologies used to monitor the functional integrity of the motor system. In: Deletis V, Shils JL (eds). Neurophysiology in Neurosurgery. San Diego: Academic Press, 2002:25-51 3. Dong CC, Macdonald DB, Akagami R, Westerberg B, Alkhani A, Kanaan I, Hassounah M: Intraoperative facial motor evoked potential monitoring with transcranial electrical stimulation during skull base surgery. Clin Neurophysiol 116(3):588-596, 2005 4. Feng B, Qiu G, Shen J, Zhang J, Tian Y, Li S, Zhao H, Zhao Y: Impact of multimodal intraoperative monitoring during surgery for spine deformity and potential risk factors for neurological monitoring changes. J Spinal Disord Tech 25(4):E108-114, 2012 5. Fujiki M, Furukawa Y, Kamida T, Anan M, Inoue R, Abe T, Kobayashi H: Intraoperative corticomuscular motor evoked potentials for evaluation of motor function: A comparison with corticospinal D and I waves. J Neurosurg 104(1):85-92, 2006 6. Katayama Y, Tsubokawa T, Maejima S, Hirayama T, Yamamoto T: Corticospinal direct response in humans: Identification of the motor cortex during intracranial surgery under general anaesthesia. J Neurol Neurosurg Psychiatry 51(1):50-59, 1988 7. Kimura J: Electrodiagnosis in diseases of nerve and muscle. In: Kimura J (ed). Principles and Practice. Philadelphia: Davis, 1989 8. Korvenoja A, Kirveskari E, Aronen HJ, Avikainen S, Brander A, Huttunen J, Ilmoniemi RJ, Jääskeläinen JE, Kovala T, Mäkelä JP, Salli E, Seppä M: Sensorimotor cortex localization: Comparison of magnetoencephalography, functional MR imaging, and intraoperative cortical mapping. Radiology 241(1):213-222, 2006 9. Kuruvilla A, Flink R: Intraoperative electrocorticography in epilepsy surgery: Useful or not? Seizure 12(8):577-584, 2003 10. Li F, Deshaies EM, Allott G, Canute G, Gorji R: Direct cortical stimulation but not transcranial electrical stimulation motor evoked potentials detect brain ischemia during brain tumor resection. Am J Electroneurodiagnostic Technol 51(3):191- 197, 2011 11. Macdonald DB, Skinner S, Shils J, Yingling C; American Society of Neurophysiological Monitoring: Intraoperative motor evoked potential monitoring - a position statement by the American Society of Neurophysiological Monitoring. Clin Neurophysiol 124(12):2291-2316, 2013 12. Malcharek MJ, Loeffler S, Schiefer