Intraoperative SEP monitoring in neurosurgery around the brain stem and cervical spinal cord: differential recording of subcortical components

1994 ◽  
Vol 81 (2) ◽  
pp. 213-220 ◽  
Author(s):  
Wolfgang Wagner ◽  
Lydia Peghini-Halbig ◽  
Johannes C. Mäurer ◽  
Axel Perneczky
Keyword(s):  
Spinal Cord ◽  
Brain Stem ◽  
Cervical Spinal Cord ◽  
False Negative ◽  
False Negative Rate ◽  
Content Type ◽  
Negative Rate ◽  
Neurosurgical Patients ◽  
The Brain

✓ The results of intraoperative monitoring of median nerve somatosensory evoked potentials (SEP's) were evaluated in 75 neurosurgical patients in order to assess the role of differential derivation of brain stem (P14) and spinal cord (N13) wave activity. These components were compared with the conventionally recorded neck potential (“N13”) that reflects overlap of P14 and N13. The spinal cord N13 wave was recorded from the posterior to anterior lower aspect of the neck and the brain stem P14 wave from the midfrontal scalp to the nasopharynx; both derivations enabled isolated low-artifact recording of these components. In 18.7% of patients, moderate to major latency and/or amplitude shifts of N13 or P14 were found that were masked in conventional neck-scalp recordings of “N13”. There was a 6.7% false-negative rate in this series. Using a neck-scalp derivation alone, a 14.7% false-negative rate would have resulted and an isolated worsening of the P14 component (with stable neck potential) in six cases would have been overlooked. It is concluded that the proposed SEP recording technique allows independent assessment of spinal cord and brain stem activity. It is, therefore, superior to the conventional neck-scalp derivation technique, in which important information may be concealed or even lost due to the overlap of the brain stem P14 and spinal cord N13 potentials.

Cervical spinal cord in experimental hydrocephalus

1972 ◽  
Vol 37 (5) ◽  
pp. 538-542 ◽  
Author(s):  
George J. Dohrmann
Keyword(s):  
Spinal Cord ◽  
Brain Stem ◽  
Cervical Spinal Cord ◽  
Central Canal ◽  
Content Type ◽  
Experimental Hydrocephalus ◽  
Physiological Pressure ◽  
The Brain ◽  
Shunting Procedure ◽  
Fine Print

✓ Adult dogs were rendered hydrocephalic by the injection of kaolin into the cisterna magna. One group of dogs was sacrificed 1 month after kaolin administration, and ventriculojugular shunts were performed on the other group. Hydrocephalic dogs with shunts were sacrificed 1 day or 1 week after the shunting procedure. All dogs were perfused with formalin at physiological pressure, and the brain stem and cervical spinal cord were examined by light microscopy. Subarachnoid granulomata encompassed the superior cervical spinal cord and dependent surface of the brain stem. Rarefaction of the posterior white columns and clefts or cavities involving the gray matter posterior to the central canal and/or posterior white columns were present in the spinal cords of both hydrocephalic and shunted hydrocephalic dogs. Predominantly in the dogs with shunts, hemorrhages were noted in the spinal cord in association with the clefts or cavities. A mechanism of ischemia followed by reflow of blood is postulated to explain the hemorrhages in the spinal cords of hydrocephalic dogs with shunts.

Role of the brain stem in generating the 2- to 6-Hz oscillation in sympathetic nerve discharge

1993 ◽  
Vol 265 (5) ◽  
pp. R1026-R1035 ◽  
Author(s):  
S. Zhong ◽  
Z. S. Huang ◽  
G. L. Gebber ◽  
S. M. Barman
Keyword(s):  
Brain Stem ◽  
Sympathetic Nerve ◽  
Cervical Spinal Cord ◽  
Ventrolateral Medulla ◽  
Population Activity ◽  
A Value ◽  
Decerebrate Cats ◽  
The Brain ◽  
Nerve Discharge

We tested the hypothesis that brain stem circuits normally generate a 2- to 6-Hz oscillation in sympathetic nerve discharge (SND). Experiments were performed on baroreceptor-denervated decerebrate cats and urethan-anesthetized rats in which renal or splanchnic SND was recorded along with field potentials (population activity) from sites in the rostral ventrolateral medulla, medullary raphe, or medullary lateral tegmental field. Our major findings were as follows. 1) Population activity recorded from the three medullary regions contained a 2- to 6-Hz oscillation. 2) The 2- to 6-Hz oscillation in population activity recorded from some medullary sites was correlated to that in SND. Peak coherence in the 2- to 6-Hz band approached a value of 1 in some cases. 3) Whereas cervical spinal cord transection abolished or markedly reduced SND, the 2- to 6-Hz oscillation in medullary activity was essentially unchanged. These results support the view that the 2- to 6-Hz oscillation in SND can be generated in the brain stem of cats and rats.

Fatal injuries of the brain stem and/or upper cervical spinal cord in traffic accidents: nine autopsy cases

1995 ◽  
Vol 35 (3) ◽  
pp. 197-201 ◽  
Author(s):  
T. Kondo ◽  
K. Saito ◽  
J. Nishigami ◽  
T. Ohshima
Keyword(s):  
Spinal Cord ◽  
Brain Stem ◽  
Traffic Accidents ◽  
Cervical Spinal Cord ◽  
Upper Cervical ◽  
The Brain ◽  
Fatal Injuries

scholarly journals Morphologic and Immunoperoxidase Study of Neurologic Lesions in Naturally Acquired Rabies of Raccoons

1992 ◽  
Vol 4 (4) ◽  
pp. 369-373 ◽  
Author(s):  
A. N. Hamir ◽  
G. Moser ◽  
C. E. Rupprecht
Keyword(s):  
Spinal Cord ◽  
Brain Stem ◽  
Ganglion Cells ◽  
Cervical Spinal Cord ◽  
Fluorescent Antibody ◽  
Antibody Test ◽  
Immunoperoxidase Method ◽  
Spinal Cord Regions ◽  
Trigeminal Nerves ◽  
The Brain

Histopathologic (hematoxylin and eosin [HE]) and immunoperoxidase (streptavidin-biotin complex) methods were used for examination of formalin-fixed tissues of rabid raccoons from an enzootic area of Pennsylvania. Extensive morphologic lesions of rabies encephalitis were present in the cerebrum and the brain stem regions. Negri bodies were detected by both methods and were present in the brain (cerebral cortex, hippocampus, brain stem, cerebellum, and cervical spinal cord) and in the ganglia of the trigeminal nerves. The viral inclusions were also seen in ganglion cells in the tongue, parotid salivary glands, pancreas, intestines, and adrenal glands. These sites were not associated with any inflammatory cellular infiltrate. The immunoperoxidase method was superior to HE for the detection of Negri bodies. Because lesions of rabies encephalitis were consistently observed in the cerebrum, brain stem, and cervical spinal cord regions, these areas of the brain should be included when raccoons are examined by the fluorescent antibody test for rabies.

scholarly journals False-Negative Rate and Recovery Efficiency Performance of a Validated Sponge Wipe Sampling Method

2011 ◽  
Vol 78 (3) ◽  
pp. 846-854 ◽  
Author(s):  
Paula A. Krauter ◽  
Greg F. Piepel ◽  
Raymond Boucher ◽  
Matt Tezak ◽  
Brett G. Amidan ◽  
...  
Keyword(s):  
Surface Roughness ◽  
Stainless Steel ◽  
Limit Of Detection ◽  
False Negative ◽  
False Negative Rate ◽  
Recovery Efficiency ◽  
Surface Material ◽  
Content Type ◽  
Negative Rate ◽  
Efficiency Performance

ABSTRACTRecovery of spores from environmental surfaces varies due to sampling and analysis methods, spore size and characteristics, surface materials, and environmental conditions. Tests were performed to evaluate a new, validated sponge wipe method usingBacillus atrophaeusspores. Testing evaluated the effects of spore concentration and surface material on recovery efficiency (RE), false-negative rate (FNR), limit of detection (LOD), and their uncertainties. Ceramic tile and stainless steel had the highest mean RE values (48.9 and 48.1%, respectively). Faux leather, vinyl tile, and painted wood had mean RE values of 30.3, 25.6, and 25.5, respectively, while plastic had the lowest mean RE (9.8%). Results show roughly linear dependences of RE and FNR on surface roughness, with smoother surfaces resulting in higher mean REs and lower FNRs. REs were not influenced by the low spore concentrations tested (3.10 × 10−3to 1.86 CFU/cm2). Stainless steel had the lowest mean FNR (0.123), and plastic had the highest mean FNR (0.479). The LOD90(≥1 CFU detected 90% of the time) varied with surface material, from 0.015 CFU/cm2on stainless steel up to 0.039 on plastic. It may be possible to improve sampling results by considering surface roughness in selecting sampling locations and interpreting spore recovery data. Further, FNR values (calculated as a function of concentration and surface material) can be used presampling to calculate the numbers of samples for statistical sampling plans with desired performance and postsampling to calculate the confidence in characterization and clearance decisions.

Somatosensory evoked potential monitoring in anterior thoracic vertebrectomy

2000 ◽  
Vol 92 (2) ◽  
pp. 155-161 ◽  
Author(s):  
Harel Deutsch ◽  
Marc Arginteanu ◽  
Karen Manhart ◽  
Noel Perin ◽  
Martin Camins ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Vertebral Body ◽  
Evoked Potential ◽  
False Negative ◽  
False Negative Rate ◽  
Neurological Deterioration ◽  
Somatosensory Evoked Potential ◽  
Content Type ◽  
Spinal Cord Function ◽  
Fine Print

Object. Spine surgeons have used intraoperative cortical and subcortical somatosensory evoked potential (SSEP) monitoring to detect changes in spinal cord function when intraoperative procedures can be performed to prevent neurological deterioration. However, the reliability of SSEP monitoring as applied to anterior thoracic vertebral body resections has not been rigorously assessed. Methods. The authors retrospectively reviewed hospital charts and operating room records obtained between August 1993 and December 1998 and found that SSEP monitoring was used in 44 surgical procedures involving an anterior approach for thoracic vertebral body resections. There were no patients in whom SSEP changes did not return to baseline during the surgical procedure. Patients in four cases, despite their stable SSEP recordings throughout the procedure, were noted immediately postoperatively to have experienced significant neurological deterioration. The false-negative rate in SSEP monitoring was 9%. Sensitivity was determined to be 0%. Conclusions. It is important to recognize high false-negative rates and low sensitivity of SSEP monitoring when it is used to record spinal cord function during anterior approaches for thoracic vertebrectomies. The insensitivity of SSEPs for motor deterioration during anterior thoracic vertebrectomies is likely due to the limitation of SSEPs, which monitor only posterior column function whereas motor paths are conveyed in the anterior and anterolateral spinal cord. The authors believe that SSEPs can not be relied on to detect reversible spinal damage during anterior thoracic vertebrectomies.

scholarly journals A case of isolated sigmoid sinus dural arteriorvenous fistula showing high intensity areas on T2 weighted image in the brain stem, cerebellum, and cervical spinal cord

2008 ◽  
Vol 2 (3) ◽  
pp. 217-221
Author(s):  
Kousuke OHSHIMA ◽  
Tomoaki TERADA ◽  
Shinji OOKUBO ◽  
Takami HIYAMA ◽  
Hiroo KOBAYASHI ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Brain Stem ◽  
High Intensity ◽  
Cervical Spinal Cord ◽  
Sigmoid Sinus ◽  
Weighted Image ◽  
The Brain

The plated bayonet: a new instrument to facilitate surgery for intra-axial neoplasms of the spinal cord and brain stem

1993 ◽  
Vol 78 (3) ◽  
pp. 505-507 ◽  
Author(s):  
Fred J. Epstein ◽  
Memet Ozek
Keyword(s):  
Spinal Cord ◽  
Brain Stem ◽  
Cranial Nerves ◽  
Neoplastic Tissue ◽  
Content Type ◽  
Small Incision ◽  
New Instrument ◽  
The Brain ◽  
Fine Print

✓ A new instrument for use in surgically treating intra-axial neoplasms of the spinal cord and brain stem is described. The plated bayonet allows neoplastic tissue in the spinal cord to be separated from functioning neural elements without perforating the adjacent spinal cord. In addition, the plated bayonet facilitates exposure through the very small incision necessary to remove tumors of the brain stem without damaging cranial nerves or other vital structures.

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