Document Detail


Intraoperative monitoring of the corticospinal motor evoked potential (D-wave): clinical index for postoperative motor function and functional recovery.
MedLine Citation:
PMID:  15185755     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The corticospinal motor evoked potential was investigated as a monitoring index of motor function to perform maximal resection of brain tumors located around the motor cortex in 37 patients with glioma. Tumor resections were performed under general anesthesia with muscle relaxant and completely controlled ventilation. No special arrangements for anesthesia were required. Direct cortical stimulation revealed that if one electrode was placed on the posterior half of the precentral gyrus, the D-wave could be recorded even when using an electrode separation of 10 mm, and the amplitude was larger with anodic rather than cathodic stimulation. Monitoring of the D-wave enabled the function of the corticospinal tract to be evaluated selectively. Postoperative persistent motor disturbance remained in six patients who had a decrease of over 30% in amplitude of the D-wave during tumor resection. A decrease of less than 30% may indicate postoperative preservation of motor function, including transient motor disturbance with subsequent complete recovery. Intraoperative monitoring of the D-wave is suitable for open cranial surgery with general anesthesia, can detect the primary motor cortex, and allow maximal resection of brain tumors located around the motor cortex.
Authors:
Takamitsu Yamamoto; Yoichi Katayama; Takafumi Nagaoka; Kazutaka Kobayashi; Chikashi Fukaya
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurologia medico-chirurgica     Volume:  44     ISSN:  0470-8105     ISO Abbreviation:  Neurol. Med. Chir. (Tokyo)     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-06-09     Completed Date:  2004-07-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0400775     Medline TA:  Neurol Med Chir (Tokyo)     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  170-80; discussion 181-2     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan. nusmyama@med.nihon-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Brain Neoplasms / diagnosis,  physiopathology,  surgery*
Electric Stimulation
Electrodes, Implanted
Evoked Potentials, Motor*
Glioma / diagnosis,  physiopathology,  surgery*
Humans
Magnetic Resonance Imaging
Monitoring, Intraoperative*
Motor Cortex* / pathology
Movement*
Postoperative Period
Pyramidal Tracts*
Recovery of Function

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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