NEUROSURGERY Report

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Posts Tagged ‘monitoring

Ahead of Print: Safety of Staged Epilepsy Surgery in Children

Background: Surgical resection of epileptic foci relies on accurate localization of the epileptogenic zone, often achieved by subdural and depth electrodes. Our epilepsy center has treated selected children with poorly localized medically refractory epilepsy with a staged surgical protocol, with at least one phase of invasive monitoring for localization and resection of epileptic foci.

Objective: To evaluate the safety of staged surgical treatments for refractory epilepsy among children.

Methods: Data were retrospectively collected, including surgical details and complications of all patients who underwent invasive monitoring.

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Written by NEUROSURGERY® Editorial Office

October 31, 2013 at 8:00 AM

Ahead of Print: Safe Resection of Arteriovenous Malformations in Eloquent Motor Areas Aided by Functional Imaging and Intraoperative Monitoring

Full article access for Neurosurgery subscribers at Neurosurgery-Online.com.

BACKGROUND: Arteriovenous malformations (AVMs) proximal to motor cortical areas or motor projection systems are challenging to manage due to the risk of severe sensory and motor impairment. Surgical indication in these cases therefore remains controversial.

OBJECTIVE: To propose a standardized approach for centrally situated AVMs, based on functional imaging and intraoperative electrophysiological evaluation.

METHODS: We conducted a retrospective analysis of 15 patients who underwent surgical treatment for AVMs in motor cortical areas or proximal to motor projections. Preoperative assessment included fMRI and 3D-tractography. Operations were performed under continuous electrophysiological monitoring aided by direct brain stimulation. We identified critical bloody supply to the motor areas by temporary occluding the feeding vessels under electrophysiological monitorization. Clinical outcome was evaluated using the modified Rankin Scale.

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Written by NEUROSURGERY® Editorial Office

October 24, 2011 at 3:07 PM

Editor Choice: A Real-Time Monitoring System for the Facial Nerve

Full article access for Neurosurgery subscribers.

Prell, Julian MD; Rachinger, Jens MD; Scheller, Christian MD; Alfieri, Alex MD; Strauss, Christian MD; Rampp, Stefan MD

OBJECTIVE: Damage to the facial nerve during surgery in the cerebellopontine angle is indicated by A-trains, a specific electromyogram pattern. These A-trains can be quantified by the parameter “traintime,” which is reliably correlated with postoperative functional outcome. The system presented was designed to monitor traintime in real-time.

METHODS: A dedicated hardware and software platform for automated continuous analysis of the intraoperative facial nerve electromyogram was specifically designed. The automatic detection of A-trains is performed by a software algorithm for real-time analysis of nonstationary biosignals. The system was evaluated in a series of 30 patients operated on for vestibular schwannoma.

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Written by NEUROSURGERY® Editorial Office

June 1, 2010 at 9:00 AM

Ahead of Print: A Real-Time Monitoring System for the Facial Nerve

Full article access for Neurosurgery subscribers.

Prell, Julian MD; Rachinger, Jens MD; Scheller, Christian MD; Alfieri, Alex MD; Strauss, Christian MD; Rampp, Stefan MD

OBJECTIVE: Damage to the facial nerve during surgery in the cerebellopontine angle is indicated by A-trains, a specific electromyogram pattern. These A-trains can be quantified by the parameter “traintime,” which is reliably correlated with postoperative functional outcome. The system presented was designed to monitor traintime in real-time.

METHODS: A dedicated hardware and software platform for automated continuous analysis of the intraoperative facial nerve electromyogram was specifically designed. The automatic detection of A-trains is performed by a software algorithm for real-time analysis of nonstationary biosignals. The system was evaluated in a series of 30 patients operated on for vestibular schwannoma. Read the rest of this entry »

Written by NEUROSURGERY® Editorial Office

April 13, 2010 at 9:04 AM

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