Document Detail

Permissible temporary occlusion time in aneurysm surgery as evaluated by evoked potential monitoring.
MedLine Citation:
PMID:  8413875     Owner:  NLM     Status:  MEDLINE    
To clarify the permissible time for temporary vascular occlusion during aneurysm surgery, we have undertaken a retrospective analysis of the results of intraoperative median nerve somatosensory evoked potential (SEP) monitoring in 97 patients with middle cerebral artery (MCA) (46 patients) or internal carotid artery (ICA) (51 patients) aneurysms. All patients underwent temporary vascular occlusion, lasting from 2 to 70 minutes, under the administration of a mixed solution of 20% mannitol with phenytoin and vitamin E. The mean occlusion time was 20.3 minutes for the MCA patients and 15.8 minutes for the ICA patients. The SEP disappeared during occlusion in 42 patients (30 MCA and 12 ICA). All but three eventually recovered the SEP to the baseline level after recirculation, and none of the 39 patients had postoperative sequelae. The time period from the start of occlusion until the complete loss of the SEP averaged 8.6 minutes among these 39 patients, and the occlusion time from total SEP loss until recirculation averaged 12 minutes. In the remaining 3 of the 42 patients (all 3 being ICA aneurysm patients), however, the SEP did not recover after recirculation and all 3 patients showed postoperative sequelae. In two of these three patients, vascular occlusions were performed at the multiple sites (i.e., at the ICA, MCA, anterior cerebral artery, and posterior communicating artery) and the SEP disappeared rapidly after the occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)
K Mizoi; T Yoshimoto
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  33     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1993-11-19     Completed Date:  1993-11-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  434-40; discussion 440     Citation Subset:  IM    
Division of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan.
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MeSH Terms
Aneurysm, Ruptured / physiopathology,  surgery*
Brain Damage, Chronic / physiopathology,  prevention & control
Carotid Artery Diseases / physiopathology,  surgery*
Electric Stimulation
Evoked Potentials, Somatosensory / physiology*
Intracranial Aneurysm / physiopathology,  surgery*
Intraoperative Complications / physiopathology,  prevention & control
Median Nerve / physiopathology
Middle Aged
Monitoring, Intraoperative*
Neurologic Examination
Reaction Time / physiology
Somatosensory Cortex / physiopathology
Subarachnoid Hemorrhage / physiopathology,  surgery*
Time Factors

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

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