Significance of Intraoperative Monitoring with Median Nerve Somatosensory Evoked Potentials during Operation for Cerebral Aneurysm. |
Kim, Yoon Tae , Choi, Jin Hong , Lee, Hyoung Chul , Kim, Dal Soo , Huh, Pil Woo , Yoo, Do Sung |
1Department of Rehabilitation Medicine, Catholic University College of Medicine. 2Department of Neurosurgery, Catholic University College of Medicine. |
뇌동맥류 수술중 정중신경 체성감각유발전위 추적감시의 의의 |
김윤태, 최진홍, 이형철, 김달수1, 허필우1, 유도성1 |
가톨릭대학교 의과대학 재활의학교실, 1신경외과학교실 |
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Abstract |
Objective Intraoperative somatosensory evoked potentials (SEPs) are widely used for the early detections of cerebral ischemia during temporary occlusive procedures of the parent vessels in aneurysm surgery. This study intended to evaluate the usefulness of median nerve SEPs during intracranial aneurysm surgery. Method Between September 1995 and June 1997, we monitored 42 aneurysm patients in Uijongbu St. Mary's hospital. Median nerve SEPs were detected on scalp and cervical spine during surgery. We measured latencies, amplitudes of N20 and N13 waveforms and central conduction time (CCT, N20-N13). We analyzed pre- and post-surgical radiologic findings and changes of neurologic signs. Results The delayed latencies, CCT, and reduced amplitudes of median nerve SEPs during intraoperative monitoring were closely related to neurological deficits after surgery. Conclusion Intraoperative SEPs are useful in preventing clinical neurological injury during surgery of intracranial aneurysm and in predicting which patients will have unfavourable outcomes. |
Key Words:
Cerebral aneurysm, Median nerve somatosensory evoked potential (SEP), Intraoperative monitoring |
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