Excision of intra-dural dorsal spine meningioma with intra-operative neuromonitoring in a patient with post-pneumonectomy status- an anaesthetic challenge

Post-pneumonectomy status is associated with various anatomical and physiological changes. Intra-operative neuromonitoring allows for safe neurosurgery with minimal neurological damage. Intra-operative neuromonitoring requires that the anaesthetic technique be modified taking into considerations the effects of various anaesthetic agents on evoked potentials to allow for optimal monitoring. We present a case of 65 year old female patient, with post-pneumonectomy status posted for excision of intra-dural D10 meningioma with intra-operative neuromonitoring. The case was successfully conducted with meticulous planning and preparation with complete excision of lesion and no neurological deficit post-operatively.

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The influence of the dynamics and the level of maturity of the cortical functions as a prerequisite for the development of speech in children

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh180510046d ◽

2019 ◽

Vol 147 (3-4) ◽

pp. 199-204

Author(s):

Maja Davidovic ◽

Jadranka Otasevic ◽

Nada Dobrota-Davidovic ◽

Ivana Petronic ◽

Dragomir Davidovic ◽

...

Keyword(s):

Motor Control ◽

Evoked Potentials ◽

Physiological Changes ◽

Articulation Disorder ◽

Significant Difference ◽

Cortical Responses ◽

Quasi Experimental ◽

Waveform Amplitude ◽

And Control ◽

The Impact

Introduction/Objective. The development of speech is the result of interaction of different systems of the cortex, which gradually acquires the ability of phonological presentation and motor control, in the presence of a series of physical and physiological changes in the morphology of the articulation system. The objective of the study was to examine the impact of laterality and cortical responses on the development of speech in children. Methods. Research is a quasi-experimental design with two groups. The sample covered 60 children from Belgrade, of both sexes, ages 5.5?7 years, divided into two groups, experimental (30) and control (30). We used the following instruments: test for assessing laterality and ascertaining evoked potentials. Results. On the visual lateralization subtest there was a statistically significant difference (?2 = 7.56, p < 0.05) between the observed groups. The visual evoked potentials on all measured parameters gave a statistically significant difference between the groups: waveform cortical responses ? left (?2 = 30.00, df = 1, p < 0.05); cortical responses ? right (?2 = 6.667, df = 1 , p < 0.05); waveform amplitude ? left (?2 = 13.469, df = 1, p < 0.05); amplitude ? right (?2 = 40.00, df = 1, p < 0.05), somatosensory potentials (?2 = 18.261, df = 1, p <0.05); waveform amplitude (?2 = 12.000, df = 1, p < 0.05); waveform latency (?2 = 5.455, df = 1, p < 0.05). Conclusion. Visual laterality, as well as visual and somatosensory cortical responses to stimuli is better in children without the present articulation disorder, which could be used for timely prevention planning.

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Neurosurgery and pregnancy

Journal of Neuroanaesthesiology and Critical Care ◽

10.4103/2348-0548.139095 ◽

2014 ◽

Vol 01 (03) ◽

pp. 166-172 ◽

Cited By ~ 1

Author(s):

Rajkumar Subramanian ◽

Arijit Sardar ◽

S. Mohanaselvi ◽

Puneet Khanna ◽

Dalim Baidya

Keyword(s):

Point Of View ◽

Morbidity And Mortality ◽

Physiological Changes ◽

Significant Morbidity ◽

Anaesthetic Agents

AbstractPregnant patients rarely present with neurosurgical emergencies, but can cause significant morbidity and mortality to the mother and the foetus. Physiological changes of pregnancy in relevance to neurosurgery, effects of anaesthetic agents on the foetus, common neurosurgical emergencies, and anaesthetic implications both from obstetric and neurosurgical point of view are discussed in this review.

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Monitoring of Somatosensory Evoked Potentials during Surgery for Middle Cerebral Artery Aneurysms

Neurosurgery ◽

10.1227/00006123-199107000-00014 ◽

1991 ◽

Vol 29 (1) ◽

pp. 83-88 ◽

Cited By ~ 69

Author(s):

William A. Friedman ◽

Geraldine M. Chadwick ◽

Frank J. S. Verhoeven ◽

Michael Mahla ◽

Arthur L. Day

Keyword(s):

Evoked Potentials ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Somatosensory Evoked Potentials ◽

Neurological Deficit ◽

Type I ◽

Type Ii ◽

Type Iii ◽

Significant Change ◽

Sep Monitoring

Abstract Somatosensory evoked potentials (SEPs) were monitored during 53 procedures for aneurysms of the middle cerebral artery (MCA). “Significant” changes were reported to the surgeon, who took corrective action when possible. Changes in the SEPs were categorized as follows: Type I, no change; Type II, significant change with complete return to baseline; Type III, significant change with incomplete return to baseline; Type IV, complete loss with no return; and Type V, no response at baseline. Only 1 of 37 patients with a Type I SEP had a new neurological deficit, and this was a patient who could not be examined for several days after surgery because he was in a pentobarbital coma. All 4 patients with Type III and IV changes had new postoperative neurological deficits. Perhaps of greater importance, 4 of 5 patients with Type II changes had no new deficit. These patients all had changes in SEPs that were completely reversible by clip adjustment (2), prompt removal of temporary clips (1), and inducing hypertension after aneurysm trapping (1). These cases may, therefore, represent instances in which SEP monitoring allowed the clinicians to prevent a neurological deficit. The MCA supplies the area of the somatosensory cortex that controls the hand. Median nerve SEPs are, therefore, a theoretically ideal monitor during surgery for MCA aneurysms. This study suggests that the results of MCA aneurysm surgery may be accurately predicted and improved with SEP monitoring. (Neurosurgery 29:83-88, 1991)

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Peripheral Ossifying Fibroma in Rare Site: A Clinicopathological Report

Journal of Health Sciences & Research ◽

10.5005/jp-journals-10042-1023 ◽

2015 ◽

Vol 6 (2) ◽

pp. 60-64

Author(s):

Nagaraj Kalburgi ◽

Apoorva Kamat ◽

Jane Mary ◽

Ankita Kotecha

Keyword(s):

Female Patient ◽

Benign Tumor ◽

High Recurrence Rate ◽

Ossifying Fibroma ◽

Common Occurrence ◽

Complete Excision ◽

Peripheral Ossifying Fibroma ◽

Rare Site ◽

Interdental Papilla ◽

Pedunculated Tumor

ABSTRACT Peripheral ossifying fibroma (POF) is a slowly growing benign tumor with a high recurrence rate. It is a common occurrence in the maxilla. A nodular mass, either pedunculated or sessile, usually emanating from the interdental papilla. Complete excision of the lesion, including the periosteum, is important to prevent recurrence. Peripheral ossifying fibroma occurring in the mandible at the age of 50 in the posterior mandible is an occasional entity. This article describes a case of a female patient with a slowly growing pedunculated tumor in the posterior mandible, which was diagnosed as POF. How to cite this article Koregol AC, Kalburgi N, Kamat A, Mary J, Kotecha A. Peripheral Ossifying Fibroma in Rare Site: A Clinicopathological Report. J Health Sci Res 2015;6(2):60-64.

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Traumatic spondyloptosis of the dorsal spine with incomplete neurological deficit

Injury ◽

10.1016/0020-1383(83)90159-6 ◽

1983 ◽

Vol 15 (1) ◽

pp. 35-37 ◽

Cited By ~ 6

Author(s):

W.S.El Masri ◽

J.R. Silver

Keyword(s):

Neurological Deficit ◽

Dorsal Spine

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Is There Any Benefit of Neuromonitoring during Descending and Thoracoabdominal Aortic Aneurysm Repair?

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000187 ◽

2015 ◽

Vol 10 (5) ◽

pp. 342-348 ◽

Cited By ~ 4

Author(s):

Matthew Fok ◽

Fatemeh Jafarzadeh ◽

Elena Sancho ◽

David Abello ◽

Lara Rimmer ◽

...

Keyword(s):

Evoked Potentials ◽

Somatosensory Evoked Potentials ◽

Neurological Deficit ◽

Motor Evoked Potentials ◽

Surgical Techniques ◽

Thoracoabdominal Aortic Aneurysm ◽

Quality Data ◽

Current Evidence ◽

Clinical Criteria ◽

Permanent Neurological Deficit

Objective Paraplegia remains the most feared and a devastating complication after descending and thoracoabdominal aneurysm operative repair (DTA and TAAAR). Neuromonitoring, particularly use of motor-evoked potentials (MEPs), for this surgery has gained popularity. However, ambiguity remains regarding its use and benefit. We systematically reviewed the literature to assess the benefit and applicability of neuromonitoring in DTA and TAAAR. Methods Electronic searches were performed on 4 major databases from inception until February 2014 to identify relevant studies. Eligibility decisions, method quality, data extraction, and analysis were performed according to predefined clinical criteria and end points. Results Among the studies matching our inclusion criteria, 1297 patients had MEP monitoring during DTA and TAAAR. In-hospital mortality was low (6.9% ± 3.6). Immediate neurological deficit was low (3.5% ± 2.6). In one third of patients (30.4% ± 14.2), the MEPs dropped below threshold, which were 30.4% and 29.4% with threshold levels of 75% and 50%, respectively. A range of surgical techniques were applied after reduction in MEPs. Most patients whose MEPs dropped and remained below threshold had immediate permanent neurological deficit (92.0% ± 23.6). Somatosensory-evoked potentials were reported in one third of papers with little association between loss of somatosensory-evoked potentials and permanent neurological deficit (16.7% ± 28.9%). Conclusions We demonstrate that MEPs are useful at predicting paraplegia in patients who lose their MEPs and do not regain them intraoperatively. To date, there is no consensus regarding the applicability and use of MEPs. Current evidence does not mandate or support MEP use.

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Respiratory epithelial adenomatoid hamartoma in the nasopharynx

The Journal of Laryngology & Otology ◽

10.1258/0022215054273124 ◽

2005 ◽

Vol 119 (6) ◽

pp. 476-478 ◽

Cited By ~ 22

Author(s):

R M Metselaar ◽

H V Stel ◽

S van der Baan

Keyword(s):

Case Report ◽

Female Patient ◽

Nasal Obstruction ◽

Benign Lesion ◽

Pathological Features ◽

Complete Excision ◽

Respiratory Epithelial Adenomatoid Hamartoma ◽

Respiratory Epithelial ◽

Clinical And Pathological Features

We present a case report of a female patient with complaints of single-sided nasal obstruction. A polypoid structure was seen in the nasopharynx. Histologic examination showed a respiratory epithelial adenomatoid hamartoma – a rare, benign lesion. Therapy consisted of complete excision. In line with previous reports, the lesion did not recur during 13 months of follow up. The clinical and pathological features of this abnormality are discussed.

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