The Use of Reflex Responses for IOM
Fig. 8.1 Spinal cord central pattern generator (CPG) components. The point of control is the level of excitability of segmental interneurons, which is determined by the integrated activity of the…
Intraoperative Neuromonitoring in Pediatric Surgery
Modality Age affected Factors Manifestation Adaptive strategy MN, UN SSEPs Birth—2 years Central myelination Broad, low-amplitude delayed cortical potentials Decrease stimulus rate; increase pulse length PTN SSEPs Birth—4–6 years Dorsal…
Intramedullary Spinal Cord Surgery
Fig. 36.1 Magnetic resonance images of an extensive intramedullary tumor in lower thoracic spinal cord with complete obstruction of the spinal canal (a), significant enhancement (b), and dark T2-signal indicating…
Intraoperative Monitoring in Tethered Cord Surgery
Clinical feature Patients, n (%) Muscular weakness 46 (78) Back pain 43 (73) Bladder dysfunction 42 (71) Altered sensation 40 (68) Leg pain or sciatica 33 (56) Cutaneous stigmata 15…
Intracranial Pressure Monitoring
Fig. 15.1 Graphical representation of the Monro–Kellie doctrine . Any increase in a single component of intracranial volume (blood, cerebrospinal fluid [CSF], tissue) must be matched by a decrease in…
Neurophysiological Monitoring in Thoracic Spine Surgery
Fig. 34.1 Chest radiographs taken preoperatively of the patient in Case 1 showing the spine instrumentation After failure of conservative therapy and facet joint injections, she was scheduled for posterior…
Carotid Surgery
Fig. 30.1 This MRI angiogram is from a patient with left carotid artery stenosis just above the level of the carotid artery bifurcation (arrowhead) The neurologist discussed the two possible…
Trigeminal Microvascular Decompression
Fig. 25.1 Technical ABR changes . The first tracing on the top is the baseline while the second set (second from top) was taken during obstruction of the silicone earpiece…
Anesthesia Management and Intraoperative Electrophysiological Monitoring
Fig. 19.1 IOM techniques can be divided into four groups depending on susceptibility to the effects of muscle relaxants and to the effects of halogenated anesthetics The second consideration is…
ENT and Anterior Neck Surgery
Pharmacologic agent Effect Modality: electrocochleography Resistant to effects of anesthesia Modality: auditory brainstem response Inhalation anesthetics (enflurane, halothane, isoflurane) Delay of 0.5–1.0 ms prolongation of wave V; I–V interpeak latency…
