Intraoperative brain-stem auditory evoked potentials during posterior fossa microvascular decompression

1985 ◽  
Vol 62 (4) ◽  
pp. 552-557 ◽  
Author(s):  
William A. Friedman ◽  
Barry J. Kaplan ◽  
Dietrich Gravenstein ◽  
Albert L. Rhoton
Keyword(s):  
Brain Stem ◽  
Posterior Fossa ◽  
Microvascular Decompression ◽  
Auditory Evoked Potentials ◽  
Evoked Potential ◽  
Auditory Evoked Potential ◽  
Complete Disappearance ◽  
Content Type ◽  
Technological Advances ◽  
Evoked Potential Monitoring

✓ Recent technological advances have led to increased interest in intraoperative evoked potential monitoring. Although theoretically valuable, its precise role remains to be defined, and useful criteria for predicting neurological deficit are not well established. The authors used brain-stem auditory evoked potential (BAEP) monitoring during 21 posterior fossa microvascular decompression procedures to assess the value of this technique in predicting postoperative deficit. The surgeon was notified only if there was complete disappearance of wave V. Although no patients had postoperative deafness, BAEP latencies changed significantly in all cases. In four patients, wave V totally disappeared during cerebellar retraction. The BAEP appears to be a very sensitive monitor of auditory function, such that “false positive” results will be frequent if latency criteria alone are used to trigger alterations in surgical technique.

Intraoperative monitoring of brain-stem auditory evoked potentials

1982 ◽  
Vol 57 (3) ◽  
pp. 341-348 ◽  
Author(s):  
Peter A. Raudzens ◽  
Andrew G. Shetter
Keyword(s):  
Evoked Potentials ◽  
Brain Stem ◽  
Auditory Evoked Potentials ◽  
Neurological Deficits ◽  
Additional Patient ◽  
Content Type ◽  
Intracranial Surgery ◽  
Surgical Measures ◽  
Evoked Potential Monitoring ◽  
Operating Surgeon

✓ Intraoperative brain-stem auditory evoked potentials (BAEP's) were monitored in 46 patients undergoing intracranial surgery for a variety of pathological conditions to determine whether this technique was capable of providing useful information to the operating surgeon. Intraoperative BAEP's were unchanged throughout surgery in 34 patients (74%), and these individuals had no postoperative hearing deficits. Four patients (9%) developed an abrupt ipsilateral loss of all waveform components beyond Wave I and had postoperative evidence of a pronounced hearing loss in the affected ear. An additional patient demonstrated BAEP loss contralateral to the side of surgery, and this was associated with subsequent signs of severe brain-stem dysfunction. Seven patients (15%) developed intraoperative delays of BAEP waveform latency values, but maintained recognizable waveforms beyond Wave I. Postoperatively, their hearing was either normal or mildly impaired, and there were no indications of other brain-stem abnormalities. This group represents the individuals who may have been benefited by evoked potential monitoring, since corrective surgical measures were taken when latency delays were observed. Intraoperative BAEP's can be reliably and routinely recorded in an operating room environment. They provide a good predictor of postoperative auditory status, and may have prevented permanent neurological deficits in a small segment of patients by alerting the surgeon to potentially reversible abnormalities.

Direct brainstem recording of auditory evoked potentials during vestibular schwannoma resection: nuclear BAEP recording

1997 ◽  
Vol 86 (6) ◽  
pp. 1057-1062 ◽  
Author(s):  
Cordula Matthies ◽  
Madjid Samii
Keyword(s):  
Vestibular Schwannoma ◽  
Auditory Evoked Potentials ◽  
Evoked Potential ◽  
Conventional Technique ◽  
Auditory Evoked Potential ◽  
New Technique ◽  
Recording Site ◽  
Content Type ◽  
Direct Recording ◽  
A New Technique

✓ The usefulness of intraoperative monitoring in cerebellopontine angle surgery should be improved by obtaining faster and stronger brainstem auditory evoked potential (BAEP) responses. A new technique of direct recording at the brainstem has been developed, which is applicable to all tumor sizes. By placing a retractor with electrodes attached to its tip at the cerebellomedullary junction, the authors have recorded BAEP amplitudes that are 10 times greater than those recorded using the conventional technique. Only small sampling numbers (64–256 recordings) are required and are obtained in 5 to 15 seconds. The technique has been applied successfully in 34 patients who underwent vestibular schwannoma resections. It has also been tested in patients with intrameatal—extrameatal meningiomas and in those with vascular compressive disorders; there have been no false results. The advantages of this new technique are: 1) identification of BAEP components is easier and faster; 2) reliable BAEP responses are obtained in some cases in which conventional BAEP responses are lost or severely deformed; and 3) BAEP response deterioration and improvement are recognized earlier than would occur using the conventional technique. This last advantage provides the surgeon with a useful warning at a stage of surgery at which BAEP changes are still temporary and can be reversed. This method is different from other trials of intradural BAEP recordings in three respects: its use is not limited to particular tumor sizes; there is no interference with the surgical process; and, most important, the obtained responses correlate well with those of conventional BAEP responses, probably because the recording site is in the vicinity of the anterior cochlear nucleus. In conclusion, the chances of useful monitoring feedback with adequate adaptation of the microsurgical strategy are improved considerably.

scholarly journals Parameters for Applying the Brainstem Auditory Evoked Potential with Speech Stimulus: Systematic Review

2017 ◽  
Vol 22 (04) ◽  
pp. 460-468 ◽  
Author(s):  
Luísa Gabriel ◽  
Luíza Vernier ◽  
Maria Ferreira ◽  
Adriana Silveira ◽  
Márcia Machado
Keyword(s):  
Systematic Review ◽  
Evoked Potentials ◽  
Brain Stem ◽  
Auditory Evoked Potentials ◽  
Evoked Potential ◽  
Sampling Rate ◽  
Presentation Rate ◽  
Auditory Evoked Potential ◽  
Speech Stimulus ◽  
Brainstem Auditory Evoked Potential

Introduction Studies using the Brainstem Auditory Evoked Potential with speech stimulus are increasing in Brazil, and there are divergences between the methodologies used for testing. Objectives To analyze the parameters used in the study of the Brainstem Auditory Evoked Potentials with speech stimulus. Data Synthesis The survey was performed using electronic databases. The search strategy was as follows: “Evoked potentials, auditory” OR “Brain stem” OR “Evoked potentials, auditory, brain stem” AND “Speech.” The survey was performed from June to July of 2016. The criteria used for including articles in this study were: being written in Portuguese, English or Spanish; presenting the description of the testing parameters and the description of the sample. In the databases selected, 2,384 articles were found, and 43 articles met all of the inclusion criteria. The predominance of the following parameters was observed to achieve the potential during study: stimulation with the syllable /da/; monaural presentation with greater use of the right ear; intensity of 80 dB SPL; vertical placement of electrodes; use of in-ear headphones; patient seated, distracted in awake state; alternating polarity; use of speech synthesizer software for the elaboration of stimuli; presentation rate of 10.9/s; and sampling rate of 20 kHz. Conclusions The theme addressed in this systematic review is relatively recent. However, the results are significant enough to encourage the use of the procedure in clinical practice and advise clinicians about the most used procedures in each parameter.

Fusiform Basilar Artery Aneurysm in a 33-Month-Old Child

Neurosurgery ◽  
1986 ◽  
Vol 19 (4) ◽  
pp. 631-634 ◽  
Author(s):  
John R. Little ◽  
Mark V. Larkins ◽  
Hans LÜders ◽  
Joseph F. Hahn ◽  
Gerald Erenberg
Keyword(s):  
Brain Stem ◽  
Basilar Artery ◽  
Evoked Potential ◽  
Artery Aneurysm ◽  
Artery Occlusion ◽  
Auditory Evoked Potential ◽  
Basilar Artery Occlusion ◽  
Acute Subarachnoid Hemorrhage ◽  
Rare Lesion ◽  
Evoked Potential Monitoring

Abstract A 33-month-old girl presented with acute subarachnoid hemorrhage from a ruptured multilobulated fusiform aneurysm of the midbasilar artery. This rare lesion was treated surgically by occluding the basilar artery. Intraoperative brain stem auditory evoked potential and somatosensory evoked potential monitoring results did not change with basilar artery occlusion, suggesting that the occlusion would be tolerated. However, the amplitudes of brain stem auditory evoked potential Waves III-V to right ear stimulation were transiently reduced during left pontine retraction during the aneurysm exposure. The patient made a complete clinical recovery.

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