Abstract:
BACKGROUND:Neurophysiological monitoring is routinely used during neurosurgical procedures. Use of neurophysiological monitoring has extended to neuroendovascular procedures, but evidence of its impact on clinical outcome in this arena is limited. OBJECTIVE:To report the incidence of significant intraoperative somatosensory evoked potential (SSEP) changes during neuroendovascular surgery and to correlate SSEP changes with clinical outcomes. METHODS:Patients who underwent neuroendovascular surgery at our institution between 2011 and 2013 were included in the analysis. Medical charts and imaging studies were reviewed retrospectively for sex, age, lesion type and size, clinical presentation, type of endovascular procedure, duration of SSEP change, reversibility of SSEP change, incidence of intraoperative complications and related mortalities, presence of new infarction within 72 hours of intervention, and discharge outcome. RESULTS:Of 873 consecutive patients, 52 (6%) had clinically significant intraoperative SSEP changes. Twenty-four patients (46%) had SSEP changes that were corrected, and 28 patients (54%) had changes that were not reversed before the end of surgery. Both decreased duration and reversal of SSEP changes were associated with a lower incidence of postoperative infarction and more favorable clinical outcome on discharge. The positive predictive value of an irreversible SSEP change for postoperative infarction in our study was 21%, and the negative predictive value was 83%. CONCLUSION:The approximate incidence of SSEP changes is 6% during neuroendovascular procedures. Rapid reversal of SSEP changes is associated with better outcomes. SSEP monitoring may be a valuable tool for preventing complications after neuroendovascular interventions.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Phillips JL,Chalouhi N,Jabbour P,Starke RM,Bovenzi CD,Rosenwasser RH,Wilent WB,Romo VM,Tjoumakaris SIdoi
10.1227/NEU.0000000000000510subject
Has Abstractpub_date
2014-11-01 00:00:00pages
560-7; discussion 566-7; quiz 567issue
5eissn
0148-396Xissn
1524-4040journal_volume
75pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract:INTRODUCTION:Isolated spinal aneurysms are rare; only a few have been reported. To the best of our knowledge, this series represents the largest experience with four ruptured spinal aneurysms, all of which were treated surgically. METHODS:Clinical information from the hospital charts and diagnostic images of four pati...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000186010.34779.10
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:The Pipeline Embolization Device is a widely utilized flow diverter in the treatment of intracranial aneurysms. OBJECTIVE:To assess the incidence, clinical significance, predictors, and outcomes of in-Pipeline stenosis (IPS). METHODS:Angiographic studies in 139 patients treated between 2011 and 2013 were i...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000908
更新日期:2015-12-01 00:00:00
abstract::An unusual case of benign stem glioma with a 15-year survival is presented. In spite of 12 years of clinical quiescence, a focus of the tumor in the upper brain stem was found at necropsy. Morphologically, the tumor was a cystic pilocytic astrocytoma. The few previously reported similar cases in the same location were...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198204000-00015
更新日期:1982-04-01 00:00:00
abstract:BACKGROUND:Glioblastoma is a heterogeneous disease characterized by its infiltrative growth, rendering complete resection impossible. Diffusion tensor imaging (DTI) shows potential in detecting tumor infiltration by reflecting microstructure disruption. OBJECTIVE:To explore the heterogeneity of glioblastoma infiltrati...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyy388
更新日期:2019-10-01 00:00:00
abstract::We undertook a prospective study of 43 wrists in 32 patients who had been clinically diagnosed as having carpal tunnel syndrome (study group) and 5 wrists in people who had no symptoms (control group), correlating the clinical, electrodiagnostic, intraoperative, and magnetic resonance imaging (MRI) findings. MRI of th...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199512000-00009
更新日期:1995-12-01 00:00:00
abstract::Over 90 000 people are expected to be diagnosed with melanoma in the United States this year. The development of brain metastases is particularly difficult to manage. Over the past few years, melanoma patients with multiple unresectable brain metastases for which stereotactic surgery might also not be a viable option ...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1093/neuros/nyaa076
更新日期:2020-09-01 00:00:00
abstract::We present seven patients with multilevel cervical spondylotic myelopathy and superimposed midline soft disc herniation who were treated by decompressive laminectomies of the spondylotic segments followed by transdural excision of the anteriorly located disc extrusion. There was no perioperative neurological morbidity...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199404000-00010
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:Recent studies of age-related effects on cognition and performance have raised concerns about the appropriate timing and regulatory surveillance of retirement for surgeons. Little is known about the practice patterns and retirement plans of aging neurosurgeons. Analyses of informed opinions on possible regula...
journal_title:Neurosurgery
pub_type: 共识发展会议,杂志文章
doi:10.1227/01.NEU.0000349932.37540.02
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:To test the spatial accuracy of coordinates generated from magnetic resonance imaging (MRI) scans, using the Brown-Roberts-Wells head frame and localizer system (Radionics, Inc., Burlington, MA). METHODS:An anthropomorphic head phantom, consisting of a two-dimensional lattice of acrylic spheres (4-mm diamete...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199912000-00030
更新日期:1999-12-01 00:00:00
abstract::In a review of 147 patients with intracranial aneurysms surgically treated by one surgeon (FAD) between 1980 and 1987, 36 selected patients received intraoperative barbiturate protection with sodium thiopental during temporary arterial occlusion. Thiopental doses of 5 to 15 mg/kg were used. Twenty-nine of 36 (81%) had...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-198907000-00010
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:Rugby is characterized by high-speed collisions among the players that predispose them to injuries, particularly to the head, neck, and spine. OBJECTIVE:To evaluate the effectiveness of current neurological injury prevention strategies in rugby union. METHODS:Systematic review in May 2010. We assessed the ...
journal_title:Neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1227/NEU.0b013e3181f209f1
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To describe a novel approach to recanalizing symptomatic extracranial internal carotid artery near occlusion using proximal and distal emboli protection devices. METHODS:Patients presenting with symptomatic extracranial internal carotid artery near occlusion who underwent endovascular recanalization between ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000279742.38178.f6
更新日期:2007-07-01 00:00:00
abstract::We have recently shown that seizures induce significant and sustained elevations of thyrotropin-releasing hormone (TRH) in specific extrahypothalamic rat brain regions associated with epileptic foci including amygdala, hippocampus, pyriform cortex, and anterior cortex. Seizures were induced in dogs to further study th...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199211000-00017
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:The use of flow diverters such as the pipeline embolization device (PED) for treatment of intracranial aneurysms carries the risk of side branch occlusion. OBJECTIVE:To determine the incidence and clinical outcomes associated with supraclinoid internal carotid artery (ICA) branch occlusion after deployment ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000595
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:It is a prevalent myth that a postoperative infection may actually confer a survival advantage in patients with malignant glioma. This contention is based largely on anecdotal reports. Recently, a single-center study showed there was no survival advantage in those patients who had glioblastoma with postopera...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e318222adfa
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Patient-reported experience is often used as a measure for quality of care, but no reports on patient satisfaction after cranial neurosurgery exist. OBJECTIVE:To study the association of overall patient satisfaction and surgical outcome and to evaluate the applicability of overall patient satisfaction as a ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000931
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Study of the corticosubcortical functional anatomy of reading and picture naming. OBJECTIVE:To study the role of the left basal occipitotemporal area and its white matter pathways. METHODS:Three patients underwent awake surgery for lesions in the left basal posterotemporal region with intraoperative electr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e318282a361
更新日期:2013-04-01 00:00:00
abstract::A patient with air gun bullets in the 3rd ventricle associated with delayed ventricular hemorrhage is presented. Through an anterior transcallosal approach, the surgeon successfully removed the bullets without any significant permanent sequelae. ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198702000-00022
更新日期:1987-02-01 00:00:00
abstract::This experiment was designed to study the effects of intravascular volume expansion with crystalloid and colloid agents on intracranial pressure (ICP) and computerized electroencephalographic (EEG) data in dogs with cerebral vasogenic edema. A liquid nitrogen cold lesion was produced in the right parietal lobes of 30 ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-198908000-00004
更新日期:1989-08-01 00:00:00
abstract::Combining the power of stereotactic precision with open craniotomy in a stereotactic craniotomy technique decreases surgical time, morbidity, and postoperative hospitalization. Indications for its use are deep intrinsic masses 3.5 cm or less in diameter; small, superficial lesions otherwise difficult to localize; and ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Liponeurocytomas are rare cerebellar neoplasms in adults, with benign histological features and a favorable clinical prognosis. Current clinical opinion is based on a total of less than 20 published cases and suggests that gross total resection and long-term follow-up monitoring, with possible ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000093430.61239.7e
更新日期:2003-12-01 00:00:00
abstract::Seventy-nine patients harboring recurrent brain tumors received four cycles of infraophthalmic carotid injections of 160 mg of carmustine. Two milligrams of intravenous vincristine and 50 mg of oral procarbazine was also administered three times daily for 1 week in conjunction with each BCNU treatment. The response ra...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1227/00006123-199202000-00012
更新日期:1992-02-01 00:00:00
abstract::Until recently, in standard hospital settings the tissue blood supply could be inferred only from indirect measures such as assessment of the clinical signs and intracranial pressure (ICP) monitoring. This critical parameter can now be imaged directly with stable xenon-enhanced computed tomographic (CT) imaging. The p...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198510000-00018
更新日期:1985-10-01 00:00:00
abstract:OBJECTIVE:We analyzed a consecutive series of patients operated for a foramen magnum (FM) meningioma located on the ventral aspect of the medulla oblongata via a posterolateral suboccipital retrocondylar approach with regard to long-term surgical outcome. METHODS:Clinical data in a consecutive series of 25 patients ex...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1227/01.NEU.0000245629.77968.37
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:To determine the usefulness of endovascular embolization for treatment of dural arteriovenous fistulae of the superior petrosal sinus. METHODS:We performed a retrospective review of 18 patients treated during a 16-year period. Transarterial and/or transvenous embolizations were performed as a preoperative ad...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000068790.37318.24
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Temporal lobe arteriovenous malformations (AVMs) represent a subgroup of intracranial AVMs with particular characteristics and management issues. OBJECTIVE:To characterize the surgical outcomes of temporal lobe AVMs with emphasis on visual field deficits (VFDs) and seizures. METHODS:Between 1992 and 2008, ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000122
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:The energy index (EI) is a measure of dose homogeneity within a target volume calculated by the integral dose divided by the product of prescription dose and tumor volume. OBJECTIVE:To assess whether a higher EI is associated with greater local control for brain metastases (BMs) treated by Gamma Knife radio...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000750
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:The lateral extracavitary approach (LECA) and costotransversectomy (CTE) are 2 dorsolateral approaches that avoid entrance into the pleural cavity and facilitate ventral decompression. The indications and outcomes of each of these approaches have not been fully defined in the literature. OBJECTIVE:To assess...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e3182706102
更新日期:2012-12-01 00:00:00
abstract::This study compares the acute and chronic response of brain tissue to injury by equal power density, focused argon (Ar) and carbon dioxide (CO2) laser beams. A cortical incision from 0.2-second laser pulses of 12.5 X 10(3) W/cm2 power density was made in the exposed cortex of 32 rats using either the CO2 or the Ar las...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198211000-00004
更新日期:1982-11-01 00:00:00
abstract::Coronary thrombolysis with streptokinase or tissue plasminogen activator is useful for the treatment of acute myocardial infarction in selected patients. This treatment is associated with local hemorrhagic complications and age-related cerebral hemorrhage. Coronary thrombolysis is contraindicated in patients with tran...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199209000-00025
更新日期:1992-09-01 00:00:00