Somatosensory Evoked Potentials During Temporary Arterial Occlusion for Intracranial Aneurysm Surgery: Predictive Value for Perioperative Stroke

World Neurosurgery
Ahmed I KashkoushParthasarathy D Thirumala

Abstract

Temporary arterial occlusion (TAO) is valuable for minimizing intraoperative rupture risk during intracranial aneurysm microsurgery; however, it may be associated with ischemic injury. This study aims to identify surgical and intraoperative neurophysiologic monitoring factors that predict perioperative stroke risk after TAO. We performed a retrospective chart review of 177 intracranial aneurysm surgeries at our institution in which TAO was performed before placement of a permanent clip under monitoring with somatosensory evoked potentials (SSEPs) and electroencephalography. Perioperative stroke was defined as a new-onset neurologic deficit that developed within 24 hours postoperatively that was correlated with hypodensity on postoperative computed tomography. Ten (6%) patients developed perioperative stroke in the vascular territory of TAO. SSEP changes were observed in 50% (5/10) of patients with perioperative stroke and in 14% (24/167) of patients without stroke (P = 0.003). Mean maximum single-episode TAO duration for patients who developed perioperative stroke was 12.6 minutes (95% confidence interval 8.1-17.1) and TAO duration for patients without stroke was 8.0 minutes (95% confidence interval 7.3-8.7; P = 0.026). In pati...Continue Reading

References

Mar 1, 1978·Stroke; a Journal of Cerebral Circulation·R B MorawetzR M Crowell
Mar 1, 1991·Annals of Neurology·W J Powers
Jan 1, 1987·Surgical Neurology·A Jabre, L Symon
Feb 1, 1984·Journal of Neurosurgery·L SymonF Gentili
Jan 1, 1980·Acta Neurologica Scandinavica. Supplementum·L Symon
Mar 9, 2002·Journal of Neurosurgery·Steen FridrikssonJan Hillman
Feb 26, 2005·Neurosurgery·Thomas J LeipzigCynthia S Johnson
Feb 18, 2006·Stroke; a Journal of Cerebral Circulation·Peter J HandJoanna M Wardlaw
Oct 18, 2006·American Journal of Electroneurodiagnostic Technology·UNKNOWN American Clinical Neurophysiology Society
Aug 27, 2009·Journal of Korean Neurosurgical Society·Sung-Kon HaYong-Gu Chung
Sep 28, 2010·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Lanjun Guo, Adrian W Gelb
Mar 21, 2012·Critical Care : the Official Journal of the Critical Care Forum·Brandon Foreman, Jan Claassen
Jul 17, 2012·Clinical Neurology and Neurosurgery·Dezhi KangLianghong Yu
Jun 28, 2016·Neurological Research·Parthasarathy D ThirumalaJeffrey R Balzer

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