scholarly journals Papaverine is a confounding factor in neurological assessment after cerebral aneurysm clipping: Report of three cases and review of the literature

2016 ◽  
Vol 03 (01) ◽  
pp. 040-042 ◽  
Author(s):  
Veena Sheshadri ◽  
Rohini Surve ◽  
B. Chandramouli
Keyword(s):  
Cerebral Aneurysm ◽  
Evoked Potential ◽  
Confounding Factor ◽  
Neurological Deficits ◽  
Neurological Assessment ◽  
Transient Phenomenon ◽  
Pupillary Dilatation ◽  
Aneurysm Clipping ◽  
Evoked Potential Monitoring ◽  
New Onset

AbstractIntracisternal papaverine instillation is being used across many centers after cerebral aneurysm clipping to prevent and treat cerebral vasospasm. Pupillary dilatation secondary to papaverine can interfere with the neurological assessment postoperatively. This report describes pupillary changes in three patients following the papaverine application after craniotomy and aneurysm clipping, with one patient developing contralateral pupillary dilatation and the other two having bilateral pupillary dilatation. The pupillary changes resolved over 30 min to 4 h postoperatively. We conclude that pupillary changes following papaverine instillation could be a transient phenomenon and should not be considered ominous in absence of new onset neurological deficits. Intraoperative somatosensory evoked potential monitoring also helped in postoperative decision making in all our cases.

Diagnostic Value of Somatosensory-Evoked Potential Monitoring During Cerebral Aneurysm Clipping: A Systematic Review

2016 ◽  
Vol 89 ◽  
pp. 672-680 ◽  
Author(s):  
Parthasarathy D. Thirumala ◽  
Reshmi Udesh ◽  
Aditya Muralidharan ◽  
Karthy Thiagarajan ◽  
Donald J. Crammond ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cerebral Aneurysm ◽  
Evoked Potential ◽  
Diagnostic Value ◽  
Somatosensory Evoked Potential ◽  
Aneurysm Clipping ◽  
Evoked Potential Monitoring ◽  
Potential Monitoring

scholarly journals Motor-Evoked Potential Monitoring during Cerebral Aneurysm Surgery

2005 ◽  
Vol 25 (1) ◽  
pp. 51-59
Author(s):  
Kyouichi SUZUKI ◽  
Masato MATSUMOTO ◽  
Tatsuya SASAKI ◽  
Namio KODAMA ◽  
Masaki NAKANE ◽  
...  
Keyword(s):  
Cerebral Aneurysm ◽  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Aneurysm Surgery ◽  
Evoked Potential Monitoring ◽  
Potential Monitoring

S170. Optimal baseline selection approach for somatosensory evoked potential monitoring during cerebral aneurysm surgery

2018 ◽  
Vol 129 ◽  
pp. e205
Author(s):  
Mahmoud Salhab ◽  
Parthasarathy Thirumala ◽  
Eyad Saca ◽  
Donald Crammond ◽  
Ahmad Kashkoush ◽  
...  
Keyword(s):  
Cerebral Aneurysm ◽  
Evoked Potential ◽  
Somatosensory Evoked Potential ◽  
Aneurysm Surgery ◽  
Selection Approach ◽  
Evoked Potential Monitoring ◽  
Potential Monitoring

scholarly journals Awake craniotomy for clipping of unruptured aneurysm: anesthesia concerns, management and challenges

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Wan Mohd Nazaruddin Wan Hassan ◽  
Sanihah Che Omar ◽  
Wong Teck Fui ◽  
Zamzuri Idris ◽  
Regunath Kandasamy
Keyword(s):  
Cerebral Aneurysm ◽  
Unruptured Aneurysm ◽  
Awake Craniotomy ◽  
Neurological Assessment ◽  
Aneurysm Clipping ◽  
Unruptured Cerebral Aneurysm ◽  
Neurosurgical Technique ◽  
Scalp Block ◽  
Eloquent Cortex ◽  
Deep Brain Stimulation Surgery

Awake craniotomy is a neurosurgical technique performed either as an asleep-awake-asleep technique or a monitored anesthesia care technique, in combination with a scalp block. The surgery indication has been well documented for brain tumor excision at the eloquent cortex, epilepsy and deep brain stimulation surgery. However, this technique’s use during unruptured cerebral aneurysm clipping has only been recently reported. The main goal of awake craniotomy for unruptured cerebral aneurysm clipping is to prevent the risk of ischemia during temporary and permanent clipping by immediate awake neurological assessment during surgery. There have been limited reports on this surgery’s anesthesia issues. The aim of our case report is to discuss the anesthesia concerns, management and challenges during our first successful experience of this surgery. Key words: Awake craniotomy; Clipping; Cerebral aneurysm; Scalp block Citation: Hassan WMNW, Omar SC, Fui WT, Idris Z, Kandasamy R. Awake craniotomy for clipping of unruptured aneurysm: anesthesia concerns, management and challenges. Anaesth. pain intensive care 2021;25(1):96-101; DOI: 10.35975/apic.v25i1.1436 Received: 2 July 2020, Reviewed: 10 August 2020, Accepted: 3 September 2020

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.

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