| Utility and the limit of motor evoked potential monitoring for preventing complications in surgery for cerebral arteriovenous malformation. | |
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MedLine Citation:
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PMID: 20679926 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the usefulness of motor evoked potential (MEP) monitoring and mapping in arteriovenous malformation surgery. METHODS: Intraoperative MEP monitoring was performed in 21 patients whose AVMs were located near the motor area or fed by arteries related to the corticospinal tract to detect blood flow insufficiency and/or direct injury to the corticospinal tract and/or to map the motor area. RESULTS: In 4 of 16 patients monitored for blood flow insufficiency, the MEP changed intraoperatively. In 2 patients, the changes were attributable to temporary occlusion of the feeding artery (anterior choroidal or lenticulostriate artery): 1 patient had a venous infarction around the internal capsule caused by thrombosis of the draining vein and the other bled intraoperatively from the nidus. In 17 patients, the MEP was monitored to rule out direct injury. In 1 patient, the MEP changed on coagulation of fragile vessels around the nidus in the precentral gyrus; it recovered after coagulation was discontinued. In 1 of 5 patients with MEP changes, the MEP did not recover; permanent hemiparesis developed in this patient because of venous infarction. In 1 of 11 patients subjected to MEP mapping of the motor area, we found translocation to the postcentral sulcus. CONCLUSION: In arteriovenous malformation surgery, MEP monitoring facilitates the detection of blood flow insufficiency and/or direct injury of the corticospinal tract and mapping of the motor area. It contributes to reducing the incidence of postoperative motor paresis. |
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Authors:
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Tsuyoshi Ichikawa; Kyouichi Suzuki; Tatsuya Sasaki; Masato Matsumoto; Jun Sakuma; Masahiro Oinuma; Hiromichi Kasuya; Namio Kodama |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 67 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-23 Completed Date: 2010-12-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: ons222-8; discussion ons228 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Fukushima Medical University, Fukushima, Japan. ichikawa@fukushima-med-jrc.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Blood Flow Velocity / physiology Brain Mapping* Cerebral Angiography / methods Child Electroencephalography / methods Evoked Potentials, Motor / physiology* Female Humans Intracranial Arteriovenous Malformations / physiopathology* Male Middle Aged Monitoring, Intraoperative / methods* Retrospective Studies Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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