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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.
"...this book is a valuable resource for neurophysiologists and neurosurgeons involved in neurosurgical procedures that may require intraoperative neurophysiological monitoring. The major strengths of the book include a very comprehensive coverage of MEPs, cranial nerve/brainstem/peripheral nerve monitoring, and the emerging techniques of microelectrode recording. Another major strenght of the book is its combination of comprehensive discussions of some neurosurgical techniques and their indications together with corresponding neurophysiological techniques." -Journal of Neurosurgery (June 2003)
| Contributors | p. xi |
| Preface | p. xiii |
| Acknowledgments | p. xv |
| Motor Evoked Potentials/Neurophysiological Base (Background) | |
| Animal and Human Motor System Neurophysiology Related to Intraoperative Monitoring | p. 3 |
| Introduction | p. 4 |
| Corticospinal Responses | p. 5 |
| Muscle Responses | p. 18 |
| Intraoperative Neurophysiology and Methodologies Used to Monitor the Functional Integrity of the Motor System | p. 25 |
| Intraoperative Monitoring of the Motor System: A Brief History | p. 26 |
| New Methodologies | p. 29 |
| Methodological Aspects of TES During General Anesthesia | p. 31 |
| Recording of MEPs over the Spinal Cord (Epidural and Subdural Space) Using Single Pulse Stimulation Technique | p. 34 |
| Recording of MEPs in Limb Muscles Elicited by a Multipulse Stimulating Technique | p. 41 |
| Conclusion | p. 49 |
| Intraoperative Neurophysiology of the Spinal Cord (Spinal Cord Monitoring) | |
| Spinal Cord Surgery | p. 55 |
| Introduction | p. 56 |
| Epidemiology and Histology | p. 56 |
| Clinical Presentation | p. 57 |
| Diagnostic Studies | p. 58 |
| Surgical Management | p. 60 |
| Outcome Following Surgery | p. 68 |
| Surgical Complications | p. 69 |
| Conclusion | p. 70 |
| Motor Evoked Potential Monitoring for Intramedullary Spinal Cord Tumor Surgery | p. 73 |
| Introduction | p. 74 |
| Neurophysiology | p. 76 |
| Anesthesia | p. 79 |
| Safety | p. 80 |
| Clinical Assessment and Correlation | p. 80 |
| Practical Surgical Application of Intraoperative Neurophysiological Information | p. 81 |
| Illustrative Cases | p. 85 |
| Summary | p. 89 |
| Selective Spinal Cord Lesioning Procedures for Spasticity and Pain | p. 93 |
| Selective Lesioning Procedures in Spinal Roots and Spinal Cord for Treatment of Spasticity | p. 94 |
| Procedures | p. 94 |
| Indications | p. 101 |
| Conclusion | p. 104 |
| Selective Spinal Cord Lesioning Procedures for Treatment of Pain: DREZ Lesions | p. 104 |
| Microsurgical DREZotomy | p. 105 |
| Radiofrequency (RF) Thermocoagulation Procedure | p. 111 |
| DREZ Procedures with the Laser Beam | p. 112 |
| Ultrasonic DREZ Procedure | p. 113 |
| Indications for DREZ | p. 113 |
| Neurophysiological Monitoring During Endovascular Procedures on the Spine and the Spinal Cord | p. 119 |
| Spinal Cord Vascularization and Ischemia | p. 120 |
| Neurophysiological Monitoring | p. 124 |
| Endovascular Treatment of Vascular Malformations and Tumors of the Spine and the Spinal Cord | p. 133 |
| Conclusions | p. 147 |
| Intraoperative Neurophysiological Mapping of the Spinal Cord's Dorsal Columns | p. 153 |
| Introduction | p. 154 |
| Methods of Intraoperative Recording of SEPs with Miniature Electrodes | p. 156 |
| Results | p. 157 |
| Discussion | p. 160 |
| Conclusion | p. 164 |
| Intraoperative Neurophysiology of Peripheral Nerves, Nerve Roots and Plexuses | |
| Intraoperative Neurophysiology of the Peripheral Nervous System | p. 169 |
| Background | p. 170 |
| Nerve Regeneration | p. 174 |
| Equipment for Intraoperative Recording | p. 175 |
| Electrodes for Intraoperative Recording and Stimulation | p. 178 |
| Anesthetic Considerations | p. 182 |
| Recording CNAPs Intraoperatively | p. 182 |
| Criteria for Appraising a CNAP | p. 183 |
| Operative Results | p. 185 |
| Troubleshooting | p. 190 |
| Conclusions | p. 194 |
| Intraoperative Neurophysiological Monitoring of the Sacral Nervous System | p. 197 |
| Introduction | p. 198 |
| Functional Anatomy | p. 199 |
| Clinical Neurophysiological Tests in Diagnostics | p. 202 |
| Intraoperative Clinical Neurophysiology | p. 203 |
| Discussion and Conclusions | p. 212 |
| Sensory Rhizotomy for the Treatment of Childhood Spasticity | p. 219 |
| Introduction | p. 219 |
| Modern Development of Selective Dorsal Rhizotomy | p. 220 |
| Physiologic Basis of Current Techniques | p. 223 |
| Outcome | p. 225 |
| Conclusion | p. 228 |
| Neurophysiological Monitoring During Pedicle Screw Placement | p. 231 |
| Introduction | p. 232 |
| Techniques for Assessing Nerve Root Function and Pedicle Screw Placement | p. 233 |
| Personal Experience | p. 255 |
| Conclusions | p. 259 |
| Intraoperative Neurophysiology of Cranial Nerves and Brainstem | |
| Surgery of Brainstem Lesions | p. 267 |
| Introduction | p. 268 |
| Patient Selection and Rationale for Surgery | p. 269 |
| General Principles of the Surgical Strategy | p. 270 |
| Postoperative Care | p. 279 |
| Neurophysiological Monitoring | p. 285 |
| Conclusion | p. 286 |
| Monitoring and Mapping the Cranial Nerves and the Brainstem | p. 291 |
| Introduction | p. 292 |
| Monitoring Cranial Motor Nerves | p. 292 |
| Monitoring Sensory Cranial Nerves | p. 301 |
| Monitoring the Brainstem | p. 309 |
| Mapping the Floor of the Fourth Ventricle | p. 310 |
| Monitoring That Can Guide the Surgeon During an Operation | p. 311 |
| Conclusions | p. 315 |
| Brainstem Mapping | p. 319 |
| Introduction | p. 320 |
| Methodology of BSM | p. 322 |
| Results of BSM | p. 323 |
| Surgical Implications of BSM | p. 325 |
| Clinical Limitations of BSM | p. 327 |
| Representative Case of BSM | p. 328 |
| Clinical Application of BSM | p. 331 |
| Summary | p. 332 |
| Intraoperative Neurophysiology of Supratentorial Procedures | |
| Intraoperative Neurophysiological Mapping and Monitoring for Supratentorial Procedures | p. 339 |
| Introduction | p. 340 |
| Somatosensory Evoked Potentials | p. 342 |
| Intraoperative and Perioperative Neurophysiological Functional Mapping | p. 353 |
| MEP Monitoring | p. 367 |
| Safety and Anesthesia | p. 387 |
| Value and Limitations from a Clinical Perspective | p. 390 |
| Intraoperative Neurophysiology During Stereotactic Neurosurgery for Movement Disorders | |
| Neurophysiological Monitoring During Neurosurgery for Movement Disorders | p. 405 |
| Introduction | p. 406 |
| History and Theory | p. 406 |
| Operating Room Environment and Basic Equipment | p. 417 |
| Technique for Movement Disorder Surgery | p. 424 |
| Conclusion | p. 439 |
| Intraoperative Neurophysiology and Anesthesia Management | |
| Anesthesia and Motor Evoked Potential Monitoring | p. 451 |
| Introduction | p. 452 |
| Overview | p. 452 |
| Effects of Specific Anesthetic Agents | p. 455 |
| Conclusion: Anesthetic Choice for Motor Tract Monitoring | p. 468 |
| Index | p. 475 |
| Color Plates | |
| Table of Contents provided by Syndetics. All Rights Reserved. |
ISBN: 9780122090363
ISBN-10: 0122090365
Audience:
Professional
Format:
Hardcover
Language:
English
Number Of Pages: 512
Published: 12th August 2002
Dimensions (cm): 22.9 x 15.2
x 2.7
Weight (kg): 0.826
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