Is the Patient State Index a reliable parameter as guide to anaesthesiology in cranial neurosurgery? A first intraoperative study and a literature review.

Background: Patient State Index (PSI) and Suppression Ratio (SR) are two indices calculated by quantitative analysis of EEG used to estimate the depth of anaesthesia but their validation in neurosurgery must be done. Our aim was to investigate the congruity PSI and SR with raw EEG monitoring in neurosurgery.

Methods: We included 34 patients undergoing elective cranial neurosurgery.

Intraoperative Mapping of the Sensory Root of the Trigeminal Nerve in Patients with Pontocerebellar Angle Pathology.

Objective: The aim of the present study was to determine the position of the 3 sensory branches of the trigeminal nerve in the preganglionic tract using intraoperative neurophysiological mapping.

Methods: We included consecutive adult patients who underwent neurosurgical treatment of cerebellopontine angle lesions. The trigeminal nerve was antidromically stimulated at 3 sites along its circumference with different stimulus intensities at a distance of ≤1 cm from the brainstem.

Feasibility of Intraoperative Visual Evoked Potential Monitoring by Cortical Strip Electrodes in Patients During Brain Surgery: A Preliminary Study.

Objective: The role of visual evoked potentials (VEPs) monitoring during neurosurgical procedure in patient remains unclear. The purpose of our study was to determine the feasibility of intraoperative VEP recording using a strip cortical electrode during surgical resection of intracranial lesions.

Methods: In this prospective, monocentric, observational study, we enrolled consecutive patients undergoing neurosurgical procedure for intracranial lesions.

How the work of respiratory physiotherapists changes the tracheostomy management and decannulation in a NICU department: an Italian experience.

Tracheotomy is a clinical procedure that is often necessary though not without complications, hence the need for appropriate and timely decannulation. The inclusion of trained respiratory physiotherapists (RPT) in the staff and the use of shared protocols could help the team to manage the patient with tracheotomy cannula. The objective of this study was to describe the difference in the rate of decannulation and clinical outcomes of tracheostomized patients admitted to a NeuroIntensive Care Unit (NICU) team after the inclusion of a group of physiotherapists specialized in respiratory physiotherapy and a new phoniatric protocol.

Amplitude Instability of Somatosensory Evoked Potentials as an Indicator of Delayed Cerebral Ischemia in a Case of Subarachnoid Hemorrhage.

We describe a 55-year-old male patient with a subarachnoid hemorrhage (SAH) as a result of left middle cerebral artery (MCA) aneurysm rupture, who underwent continuous electroencephalogram (EEG) and somatosensory evoked potential (cEEG-SEP) monitoring that showed an unusual SEP trend pattern. EEG was continuously recorded, and SEPs following stimulation of median nerves were recorded every 50 minutes, with the amplitude and latency of the cortical components automatically trended. An increase in intracranial pressure required a left decompressive craniectomy.

Efficacy of lacosamide on seizures and myoclonus in a patient with epilepsia partialis continua.

A 39-year-old male with epilepsia partialis continua, refractory to first- and second-line antiepileptic drugs, is described. Lacosamide produced a progressive antiepileptic effect on Jacksonian motor seizures and subsequently on positive myoclonus, which developed into negative myoclonus before complete resolution. Our report confirms the efficacy of lacosamide on focal motor refractory status epilepticus and documents a unique effect of lacosamide on seizure semiology.

Cooperative patient general anesthesia (Co.Pa.Ge.A.): the new anesthetic technique for neurological monitoring of the "cooperative" patient during endovascular treatment of elective brain arteriovenous malformations with Onyx18.

Background: An anesthetic technique, which allows for neurological monitoring as well as continuous and safe monitoring of the airways with orotracheal intubation (cooperative patient general anesthesia [Co.Pa.Ge.