Neurophysiologic intraoperative monitoring (IOM) neurologic monitoring during complex operative procedures is increasingly used to help prevent damage to the nervous system during surgery. Intraoperative Neurophysiology discusses all aspects of IOM with a hands- on approach to this challenging and exciting new frontier. Everything is covered from set-up, monitoring and mapping, troubleshooting, interpretation of results, and medical management. Interweaving contributions from neurologists and surgeons, the book presents a practical integrated blueprint for effective neurophysiological testing in the operating theater. Intraoperative Neurophysiology is visual and comprehensive in scope and coverage. It begins by reviewing basic neurophysiologic and neuroanatomic knowledge and presents detailed technical information on each basic test, providing the foundation necessary for choosing the right test and customizing monitoring and mapping according to the specifics of individual surgical procedures. Intraoperative Neurophysiology utilizes a unique structure to provide insights into successful monitoring practices and techniques. The book uses the steps of each surgical procedure as the skeleton upon which the IOM procedure is built, thereby presenting a developmental step-by-step approach to IOM procedures and the possible complications and pitfalls - that may arise at different moments of the surgery. In addition, it promotes and encourages the use of EEG in the operating room, and offers unprecedented coverage of ECoG, functional mapping, and EEG monitoring. With over 275 illustrations, numerous tables, and the most important clinical points made in writing and exemplified graphically, Intraoperative Neurophysiology: Monitoring and Mapping delivers in words and pictures everything one needs to know to master the art and science of intraoperative neurophysiologic procedure and reduce the operative risk of neurological damage in surgical patients.
Author(s): Mirela V. Simon
Edition: 1
Year: 2009
Language: English
Pages: 368
Contents......Page 8
Preface......Page 12
Acknowledgments......Page 14
Contributors......Page 16
II. Electroencephalogram (EEG)......Page 20
III. Short-latency Somatosensory Evoked Potentials (SSEPs)......Page 24
IV. Motor Evoked Potentials (MEPs)......Page 35
V. Free-Run and Triggered EMG (fEMG and CMAPs)......Page 46
VI. Nerve-to-Nerve or Nerve Action Potentials (NAPs) Recordings......Page 52
VII. Brainstem Auditory Evoked Potentials (BAEPs)......Page 56
VIII. Combinations of Tests......Page 60
IX. Safety Issues......Page 61
References......Page 63
II. Principles of Monitoring CEAs......Page 66
III. Methods......Page 85
IV. Interpretation......Page 91
References......Page 110
II. Historical Perspective......Page 114
III. The Controversial Role of ECoG in Epilepsy Surgery......Page 115
IV. Indications......Page 117
V. Methodology......Page 134
VI. Interpretation......Page 136
VII. Anesthesia Considerations......Page 143
References......Page 146
I. Introduction......Page 150
II. Surgical Preparation......Page 151
III. Sensorimotor Mapping......Page 152
IV. Language Mapping......Page 168
V. Cortical Mapping Threshold Variability......Page 174
VI. ECoG During Functional Mapping......Page 176
References......Page 192
II. The Role of Intraoperative Neurophysiology......Page 196
III. A Historical Perspective......Page 197
IV. Intraoperative Neurophysiologic Monitoring......Page 198
References......Page 226
I. Introduction......Page 228
II. Intraoperative Neurophysiologic Monitoring: A Step-By-Step Approach......Page 229
References......Page 239
I. Introduction......Page 242
III. The Nuts and Bolts of Deformity Surgery......Page 243
IV. The Role of Intraoperative Neurophysiology......Page 244
V. Intraoperative Neurophysiologic Monitoring: A Step-By-Step Approach......Page 245
References......Page 253
I. Introduction......Page 256
II. The Vascularization of the Spinal Cord......Page 257
III. Operative Techniques: Preventing Acute Spinal Cord Ischemia......Page 259
IV. Delayed Neurologic Events and Surgical Outcomes......Page 280
V. Conclusion......Page 281
References......Page 282
I. Introduction......Page 286
II. Surgery at the Level of the Cauda Equina and Nerve Root......Page 287
III. Nerve Tumor Surgery......Page 298
IV. Never Injury Surgery......Page 303
References......Page 316
I. Introduction......Page 318
II. Midbrain......Page 320
III. Pons......Page 322
IV. Medulla......Page 336
References......Page 340
II. Benzodiazepines......Page 344
IV. Propofol......Page 345
V. Narcotics......Page 346
VI. Inhalational Agents......Page 347
VIII. Ketamine......Page 348
X. Muscle Relaxants......Page 349
References......Page 351
A......Page 354
C......Page 355
E......Page 357
F......Page 359
M......Page 360
N......Page 361
P......Page 362
S......Page 363
T......Page 366
U......Page 367
Y......Page 368
