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Subcortical infarcts are most commonly the consequence of perforating artery occlusion and pure motor deficit is the most frequent syndrome resulting from an interruption of the corticospinal tract at the level of the corona radiate, the internal capsule or the brainstem. Motor evoked potential (MEP) monitoring is used as an adjunct to surgery as(More)
OBJECTIVE Hemifacial spasm caused by a cerebellopontine angle lipoma is extremely rare. We describe a patient with left-sided hemifacial spasm caused by vascular compression of the facial and vestibulocochlear cranial nerves by the anteroinferior cerebellar artery embedded within a cerebellopontine angle lipoma. CLINICAL PRESENTATION A 77-year-old man(More)
OBJECTIVE Spinal cord function is now routinely monitored with somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) during surgery for intraspinal cervical dumbbell and foraminal tumors. However, upper extremity nerve roots are also at risk during these procedures. Anatomic relations are frequently difficult to interpret because the(More)
BACKGROUND Surgical trapping or endovascular deconstruction commonly is used for the treatment of giant or complex intracranial aneurysms. Preoperative balloon test occlusion and cerebral blood flow studies and intraoperative neurophysiologic monitoring can indicate whether sufficient collateralization exists or whether revascularization is needed.(More)
OBJECTIVE To analyze optimal placement of recording-needle electrodes surrounding the eye and lip for facial nerve monitoring by identifying the maximum compound muscle action potential (CMAP) recorded by electrode pairs of different spatial configurations. STUDY DESIGN Prospective clinical trial. SETTING Ambulatory surgery at a tertiary care center. (More)
BACKGROUND/AIMS A major goal of intracranial surgery is to maximize resection while minimizing neurological morbidity, particularly motor dysfunction. Direct cortical stimulation (DCS) is a common intraoperative adjunct used to identify functional motor cortex. In this study, we report on the safety/efficacy of short pulse train DCS (direct cortical(More)
BACKGROUND We hypothesized that the addition of dexmedetomidine in a clinically relevant dose to propofol-remifentanil anesthesia regimen does not exert an adverse effect on motor-evoked potentials (MEP) and somatosensory-evoked potentials (SSEP) in adult patients undergoing thoracic spinal cord tumor resection. METHODS Seventy-one adult patients were(More)
OBJECTIVE MEPs are used as surrogate endpoints to predict the effectiveness of interventions, made in response to MEP deterioration, in avoiding new postoperative deficits. MEP performance in capturing intervention effects on these outcomes was investigated. METHODS A meta-analysis of studies using MEPs during intracranial vascular surgeries between 2003(More)
BACKGROUND Motor evoked potentials (MEPs) are commonly used during surgery for spinal cord tumor resection. However, it can be difficult to record reliable MEPs from the muscles of the lower extremities during surgery in patients with preoperative weakness due to spinal cord compression. In this study, motor function of patients' lower extremities and their(More)
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