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A prediction of postoperative neurological deficits following intracranial aneurysm surgery using somatosensory evoked potential deterioration duration

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机构： [1]Neuroelectrophysiology Room of Beijing Neurosurgical Institute, Capital Medical University, Beijing, China [2]Beijing Neurosurgical Institute, Capital Medical University Beijing Tiantan Hospital, 119, South Fourth Ring West Road, Fengtai District, Beijing, 100070, China

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关键词： Aneurysm Duration of SSEP deterioration Intraoperative monitoring Postoperative neurological deficit SSEP monitoring

摘要：

Although the application of somatosensory evoked potential (SSEP) in intracranial aneurysm surgery has been well demonstrated, the relationship between the duration of SSEP deterioration and postoperative neurological deficits (PNDs) is still not clear. The objectives of this study were (1) to detect the relationship between the SSEP deterioration duration and PND; and (2) detect the relationship between SSEP deterioration duration and postoperative computed tomography (CT) findings. Data from 587 patients were reviewed and 40 patients with SSEP deterioration were enrolled. Four patients presented irreversible disappearance and 36 patients presented reversible deterioration (including 9 [25%] patients with reversible reduction and 27 [75%] patients with reversible disappearance). In the patients with reversible SSEP deterioration, 17 patients had PNDs, and the SSEP deterioration duration was 42 ± 46 min, ranging from 5 to 180 min. Nineteen patients did not have PNDs, and their duration of SSEP deterioration was 11 ± 9 min (range 2–40 min). The SSEP deterioration duration significantly differed between patients with or without PND (P < 0.01). Eleven minutes is the optimal cut-off value of motor evoked potential change duration avoiding PND (area under the curve = 0.84). Patients with a SSEP deteriorating duration > 11 min had a significant higher incidence rate of abnormal CT finding postoperatively (p < 0.05). According to these results, we conclude that the duration of SSEP deterioration is extremely important to postoperative neurological function, and in order to avoid PND, the SSEP deterioration duration must not exceed 10 min. The SSEP deterioration duration is also associated with postoperative CT findings. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

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出版当年[2018]版：

大类 | 4 区医学

小类 | 3 区外科 4 区临床神经病学

最新[2023]版：

大类 | 3 区医学

小类 | 3 区临床神经病学 3 区外科

第一作者：

第一作者机构： [1]Neuroelectrophysiology Room of Beijing Neurosurgical Institute, Capital Medical University, Beijing, China [2]Beijing Neurosurgical Institute, Capital Medical University Beijing Tiantan Hospital, 119, South Fourth Ring West Road, Fengtai District, Beijing, 100070, China

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通讯作者：

通讯机构： [1]Neuroelectrophysiology Room of Beijing Neurosurgical Institute, Capital Medical University, Beijing, China [2]Beijing Neurosurgical Institute, Capital Medical University Beijing Tiantan Hospital, 119, South Fourth Ring West Road, Fengtai District, Beijing, 100070, China

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