Objective: This study was to investigate the utility of motor evoked potential monitoring elicited by transcranial electrical stimulation (tcMEP) during CEA in addition to the established median nerve somatosensory evoked potentials (mSSEPs).
Methods: We retrospectively reviewed data from 600 patients undergoing CEA under general anesthesia with monitoring of mSSEPs and tcMEPs in a multicenter study. MSSEP and tcMEP parameters were recorded during internal carotid artery (ICA) cross clamping and compared with the postoperative motor outcome, demographic and patient history data.
Results: The intraoperative monitoring of tcMEPs was successful in 594 of the patients (99%) and selective shunt was performed in 29 of them (4.83%). Nine of the patients showed a transient contralateral loss of tcMEPs, without changes in mSSEPs and required intervention (1.5% "false-negative"). Three of them showed postoperative motor deficits. The time period from tcMEP loss to intervention was significantly longer (p = 0.01) in this group compared to the patients without postoperative motor deficit.
Conclusion: TcMEPs during CEA may be an adjunct to mSSEP monitoring to avoid "false-negative" mSSEP results, as mSSEPs seem to lack specificity for detecting isolated ischemia of corticospinal pathway.
Significance: TcMEPs seem to improve postoperative outcome, especially in case of a timely correction of cerebral ischemia.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.clinph.2012.10.014 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The effect of sciatic nerve block on sciatic nerve depth and pain level in patients with ankle fracture based on different approaches under ultrasound guidance.
J Foot Ankle Surg
January 2025
Anesthesia Surgery Center, the Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, 010000, China. Electronic address:
To investigate the clinical efficacy of using different approach sciatic nerve blocks on the sciatic nerve depth and pain degree in patients with ankle fracture. A retrospective analysis was conducted on 151 patients with ankle fractures who were admitted to the hospital from May 2020 to May 2023. The patients were divided into a control group (n=76) using the greater trochanteric plane approach (GTA) and an observation group (n=75) using the suprapopliteal approach (PA).
View Article and Find Full Text PDFBlunt thoracic aortic injury treated with thoracic endovascular aortic repair in hybrid emergency room: A case report.
Trauma Case Rep
February 2025
Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo 651-0073, Japan.
Background: Hybrid emergency rooms (ERs) allow computed tomography (CT) scanning, interventional radiology, and surgery all in the same suite. Severe trauma patients with blunt thoracic aortic injury (BTAI) require rapid diagnosis and treatment. Hybrid ERs allow the potential for clinicians to implement multiple therapeutic procedures, including thoracic endovascular aortic repair (TEVAR), for these types of conditions without the need to transport the patients.
View Article and Find Full Text PDFBackground Diffuse idiopathic skeletal hyperostosis (DISH) is an age-related condition involving abnormal ossification of soft tissues, including ligaments and joint capsules. Patients with DISH have an increased risk of fractures, especially in ankylosed spines, which increases susceptibility to spinal cord injury. This study aimed to explore the risk factors for neurological symptoms in patients with DISH-related fractures.
View Article and Find Full Text PDFRemimazolam Combined with Andrographolide Improve Postoperative Cognitive Dysfunction in Rats after Cardiopulmonary Bypass through the AMPK/SIRT1 Signaling Pathway.
J Integr Neurosci
January 2025
Department of Anesthesia, Hangzhou Plastic Surgery Hospital, 310000 Hangzhou, Zhejiang, China.
Introduction: The effects of remimazolam (Re) in combination with andrographolide (AP) on learning, memory, and motor abilities in rats following cardiopulmonary bypass (CPB) surgery were studied.
Methods: We hypothesized that the combination of Re and AP could improve postoperative cognitive dysfunction (POCD) in rats after CPB by modulating nervous system inflammation. Cognitive function was assessed using the Morris Water Maze test, and the concentrations of tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6) in serum were measured by enzyme-linked immunosorbent assay (ELISA).
Stroke and Pulmonary Thromboembolism Complicating a Kissing Aneurysm in the M1 Segment of the Right MCA.
J Clin Med
January 2025
Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Kissing aneurysms, a rare and intriguing cerebrovascular anomaly, challenge even the most advanced neurosurgical techniques. These lesions, characterized by two intimately apposed aneurysms with shared arterial walls, often masquerade as single, irregular aneurysms. This report documents a case of ruptured kissing aneurysms in the M1 segment of the right middle cerebral artery (MCA), complicated by ischemic stroke and pulmonary thromboembolism (PTE)-a convergence of severe complications rarely encountered.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!