Intraoperative neuromonitoring as real-time diagnostic for cerebral ischemia in endovascular treatment of ruptured brain aneurysms.
Clin Neurophysiol
; 161: 69-79, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38452426
ABSTRACT
OBJECTIVE:
To evaluate the diagnostic accuracy of intraoperative neurophysiological monitoring (IONM) during endovascular treatment (EVT) of ruptured intracranial aneurysms (rIA).METHODS:
IONM and clinical data from 323 patients who underwent EVT for rIA from 2014-2019 were retrospectively reviewed. Significant IONM changes and outcomes were evaluated based on visual review of data and clinical documentation.RESULTS:
Of the 323 patients undergoing EVT, significant IONM changes were noted in 30 patients (9.29%) and 46 (14.24%) experienced postprocedural neurological deficits (PPND). 22 out of 30 (73.33%) patients who had significant IONM changes experienced PPND. Univariable analysis showed changes in somatosensory evoked potential (SSEP) and electroencephalogram (EEG) were associated with PPND (p-values <0.001 and <0.001, retrospectively). Multivariable analysis showed that IONM changes were significantly associated with PPND (Odd ratio (OR) 20.18 (95%CI7.40-55.03, p-value <0.001)). Simultaneous changes in both IONM modalities had specificity of 98.9% (95% CI 97.1%-99.7%). While sensitivity when either modality had a change was 47.8% (95% CI 33.9%-62.0%) to predict PPND.CONCLUSIONS:
Significant IONM changes during EVT for rIA are associated with an increased risk of PPND.SIGNIFICANCE:
IONM can be used confidently as a real time neurophysiological diagnostic guide for impending neurological deficits during EVT treatment of rIA.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Aneurisma Intracraniano
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Isquemia Encefálica
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Aneurisma Roto
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Eletroencefalografia
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Potenciais Somatossensoriais Evocados
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Procedimentos Endovasculares
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Monitorização Neurofisiológica Intraoperatória
Limite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Clin Neurophysiol
Assunto da revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos