Why Somatosensory Evoked Potential is important in vascular neurosurgery, is really helpful?.
There has been a growing interest in using intraoperative neurophysiological monitoring (IONM) to reduce the incidence of stroke and paralysis in major vascular interventions Like MCA,ACA,ACOM, Aneurysm etc And moya moya disease . Electroencephalography, various neurophysiological evoked potential measurements, transcranial Doppler, and near-infrared spectroscopy are some of the modalities currently being used to detect neural injuries.
Somatosensory Evoked Potential (SSEP, Why Somatosensory Evoked Potential is important
The role of Somatosensory evoked potential to see the changes while clipping and bypass along with collateral supply of artery .
Transcranial electrical motor evoked potential (TCEMEP) is not preferable due to moderate – high current clip can come out and also may disturbed surgical site and most common cause is brain bulging .
Recording, Why Somatosensory Evoked Potential is important.
- Median and Tibial Nerve SSEP from all limbs is most preferable modality .
Alarm criteria
If SSEP signal drops less than two minutes is very much important to inform the surgeon , and significant of signal drop means collateral supply is not enough good , clip can be relocate from the neck of aneurysm . study says if signal drops less than 1-2 minutes possibility of praxia and plegia .
Conclusion
Procedural stroke and spinal cord ischemia remain some of the most devastating complications of major vascular procedures for carotid and aortic diseases. Neurophysiological monitoring modality can preferred in attempts to ascertain the well-being of the nervous system during and after surgery.
Feel free to ask Questions . Why Somatosensory Evoked Potential is important?
- Muscle relaxant drug can use ?.
- Inhalational drug can affect signals?.
- Contraindications?.
- Choice of electrode for placement both peripheral and central?.
- Is SSEP/EEG Effective in vascular surgeries?.
If find this type {Article} useful. Please share and comment down your suggestions.
Related to this short article i will be writing in details to make more understanding
Related to this article.
https://neurointraoperative.com/wp-admin/post.php?post=1990&action=edit
https://ekja.org/m/makeCookie.php?url=/m/journal/view.php?number=3563