Neurophysiology in Neurosurgery: A Modern Intraoperative Approach
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Table of contents
- Contentsv
- Contributorsxi
- Prefacexiii
- Acknowledgmentsxv
- Part I: Motor Evoked Potentials/Neurophysiological Base (Background)1
- Chapter 1. Animal and Human Motor System Neurophysiology Related to Intraoperative Monitoring3
- 1 Introduction4
- 2 Corticospinal Responses5
- 3 Muscle Responses18
- Chapter 2. Intraoperative Neurophysiology and Methodologies Used to Monitor the Functional Integrity25
- 1 Intraoperative Monitoring of the Motor System: A Brief History26
- 2 New Methodologies29
- 3 Methodological Aspects of TES During General Anesthesia31
- 4 Recording of MEPs over the Spinal Cord (Epidural and Subdural Space) Using Single Pulse Stimulatio34
- 5 Recording of MEPs in Limb Muscles Elicited by a Multipulse Stimulating Technique41
- 6 Conclusion49
- Part II: Intraoperative Neurophysiology of the Spinal Cord (Spinal Cord Monitoring)53
- Chapter 3. Spinal Cord Surgery55
- 1 Introduction56
- 2 Epidemiology and Histology56
- 3 Clinical Presentation57
- 4 Diagnostic Studies58
- 5 Surgical Management60
- 6 Outcome Following Surgery68
- 7 Surgical Complications69
- 8 Conclusion70
- Chapter 4. Motor Evoked Potential Monitoring for Intramedullary Spinal Cord Tumor Surgery73
- 1 Introduction74
- 2 Neurophysiology76
- 3 Anesthesia79
- 4 Safety80
- 5 Clinical Assessment and Correlation80
- 6 Practical Surgical Application of Intraoperative Neurophysiological Information81
- 7 Illustrative Cases85
- 8 Summary89
- Chapter 5. Selective Spinal Cord Lesioning Procedures for Spasticity and Pain93
- Part I: Selective Lesioning Procedures in Spinal Roots and Spinal Cord for Treatment of Spasticity94
- Part II: Selective Spinal Cord Lesioning Procedures for Treatment of Pain: DREZ Lesions104
- Chapter 6. Neurophysiological Monitoring During Endovascular Procedures on the Spine and the Spinal119
- 1 Spinal Cord Vascularization and Ischemia120
- 2 Neurophysiological Monitoring124
- 3 Endovascular Treatment of Vascular Malformations and Tumors of the Spine and the Spinal Cord133
- 4 Conclusions147
- Chapter 7. Intraoperative Neurophysiological Mapping of the Spinal Cord’s Dorsal Columns153
- 1 Introduction154
- 2 Methods of Intraoperative Recording of SEPs with Miniature Electrodes156
- 3 Results157
- 4 Discussion160
- 5 Conclusion164
- Part III: Intraoperative Neurophysiology of Peripheral Nerves, Nerve Roots and Plexuses167
- Chapter 8. Intraoperative Neurophysiology of the Peripheral Nervous System169
- 1 Background170
- 2 Nerve Regeneration174
- 3 Equipment for Intraoperative Recording175
- 4 Electrodes for Intraoperative Recording and Stimulation178
- 5 Anesthetic Considerations182
- 6 Recording CNAPs Intraoperatively182
- 7 Criteria for Appraising a CNAP183
- 8 Operative Results185
- 9 Troubleshooting190
- 10 Conclusions194
- Chapter 9. Intraoperative Neurophysiological Monitoring of the Sacral Nervous System197
- 1 Introduction198
- 2 Functional Anatomy199
- 3 Clinical Neurophysiological Tests in Diagnostics202
- 4 Intraoperative Clinical Neurophysiology203
- 5 Discussion and Conclusions212
- Chapter 10. Sensory Rhizotomy for the Treatment of Childhood Spasticity219
- 1 Introduction219
- 2 Modern Development of Selective Dorsal Rhizotomy220
- 3 Physiologic Basis of Current Techniques223
- 4 Outcome225
- 5 Conclusion228
- Chapter 11. Neurophysiological Monitoring During Pedicle Screw Placement231
- 1 Introduction232
- 2 Techniques for Assessing Nerve Root Function and Pedicle Screw Placement233
- 3 Personal Experience255
- 4 Conclusions259
- Part IV: Intraoperative Neurophysiology of Cranial Nerves and Brainstem265
- Chapter 12. Surgery of Brainstem Lesions267
- 1 Introduction268
- 2 Patient Selection and Rationale for Surgery269
- 3 General Principles of the Surgical Strategy270
- 4 Postoperative Care279
- 5 Neurophysiological Monitoring285
- 6 Conclusion286
- Chapter 13. Monitoring and Mapping the Cranial Nerves and the Brainstem291
- 1 Introduction292
- 2 Monitoring Cranial Motor Nerves292
- 3 Monitoring Sensory Cranial Nerves301
- 4 Monitoring the Brainstem309
- 5 Mapping the Floor of the Fourth Ventricle310
- 6 Monitoring That Can Guide the Surgeon During an Operation311
- 7 Conclusions315
- Chapter 14. Brainstem Mapping319
- 1 Introduction320
- 2 Methodology of BSM322
- 3 Results of BSM323
- 4 Surgical Implications of BSM325
- 5 Clinical Limitations of BSM327
- 6 Representative Case of BSM328
- 7 Clinical Application of BSM331
- 8 Summary332
- Part V: Intraoperative Neurophysiology of Supratentorial Procedures337
- Chapter 15. Intraoperative Neurophysiological Mapping and Monitoring for Supratentorial Procedures339
- 1 Introduction340
- 2 Somatosensory Evoked Potentials342
- 3 Intraoperative and Perioperative Neurophysiological Functional Mapping353
- 4 MEP Monitoring367
- 5 Safety and Anesthesia387
- 6 Value and Limitations from a Clinical Perspective390
- Part VI: Intraoperative Neurophysiology During Stereotactic Neurosurgery for Movement Disorders403
- Chapter 16. Neurophysiological Monitoring During Neurosurgery for Movement Disorders405
- 1 Introduction406
- 2 History and Theory406
- 3 Operating Room Environment and Basic Equipment417
- 4 Technique for Movement Disorder Surgery424
- 5 Conclusion439
- Part VII: Intraoperative Neurophysiology and Anesthesia Management449
- Chapter 17. Anesthesia and Motor Evoked Potential Monitoring451
- 1 Introduction452
- 2 Overview452
- 3 Effects of Specific Anesthetic Agents455
- 4 Conclusion: Anesthetic Choice for Motor Tract Monitoring468
- Index475
Through real-time assessments of how the patient's nervous system is functioning throughout a surgical procedure, Neurophysiology in Neurosurgery presents vital techniques to guide surgeons in their efforts to minimize the risks of unintentional damage to healthy nervous tissue. This book provides a comprehensive overview of the most up-to-date intraoperative neurophysiological techniques and guidelines for the managment of neuroanesthesia during MEP monitoring. Neurophysiology in Neurosurgery is a valuable educational tool that describes the theoretical and practical aspects of intraoperative monitoring through example.
Neurophysiology in Neurosurgery is a valuable educational tool that describes the theoretical and practical aspects of intraoperative monitoring through example. The authors provide in-depth descriptions of the most advanced techniques in intraoperative neurophysiological monitoring and guidelines for the management of neuroanesthesia during MEP monitoring.
Neurophysiology in Neurosurgery is a valuable educational tool that describes the theoretical and practical aspects of intraoperative monitoring through example. The authors provide in-depth descriptions of the most advanced techniques in intraoperative neurophysiological monitoring and guidelines for the management of neuroanesthesia during MEP monitoring.