Purpose: The objective of this prospective, single-centre case series was to investigate feasibility, clinical outcomes, and neural correlates of non-invasive Neuromodulation-Induced Cortical Prehabilitation (NICP) before brain tumor surgery. Previous studies have shown that gross total resection is paramount to increase life expectancy but is counterbalanced by the need of preserving critical functional areas. NICP aims at expanding functional margins for extensive tumor resection without functional sequelae.
View Article and Find Full Text PDFBrain tumours located in or in proximity to eloquent areas are a significant neurosurgical challenge. Performing this kind of surgery with neurophysiological monitoring to improve resections with reduced permanent focal neurological deficit has become widely accepted in the literature. However, how to conduct this monitoring, the exact definition of an eloquent area and whether to perform this surgery with the patient awake or asleep are still subject to rigorous scientific debate.
View Article and Find Full Text PDFThe cerebral metabolic and vascular effects of intravenous norepinephrine have been shown in an animal model using somatosensory-evoked potentials (SSEPs). A case of intravenous norepinephrine resulting in a decrease in SSEP amplitude (of greater than 50%) despite no significant change in blood pressure, prior to cross-clamping during a carotid endarterectomy is presented. This finding may have implications for the use of norepinephrine in the critical care unit as well as the operating room.
View Article and Find Full Text PDFObjective: To establish the methodology for recording corticobulbar motor evoked potentials (CoMEPs) from cricothyroid muscles (CTHY) elicited by transcranial electrical (TES) and direct cortical stimulation (DCS).
Methods: Six healthy subjects and 18 patients undergoing brain surgery were included in the study. In six healthy subjects as well as in nine patients under general anaesthesia, CoMEP was obtained by TES.
Introduction: Patients with meralgia paresthetica (MP) usually experience not only paraesthesias and decreased tactile sensation, but also painful dysesthesias in the distribution of the lateral femoral cutaneous nerve (LFCN). We aimed at assessing whether there is any functional impairment of small fibres of the LFCN in patients with MP.
Methods: We carried out a clinical, psychophysical and neurophysiological study in 14 patients with MP and 14 healthy control subjects.