Monitoring cerebral ischemia during cerebrovascular surgery

Hong Zhang, Lingzhong Meng, Russ Lyon, Dong-Xin Wang

PDF(98 KB)
PDF(98 KB)
Journal of Biomedical Research ›› 2017, Vol. 31 ›› Issue (4) : 279-282. DOI: 10.7555/JBR.31.20150106
Review Article
Review Article

Monitoring cerebral ischemia during cerebrovascular surgery

Author information +
History +

Abstract

Patients undergoing intracranial cerebrovascular surgery under general anesthesia are at risk of cerebral ischemia due to the nature of the surgery and/or the underlying cerebrovascular occlusive disease. It is thus imperative to reliably and continuously monitor cerebral perfusion during this type of surgery to timely reverse ischemic processes. The aim of this review is to discuss the techniques currently available for monitoring cerebral ischemia during cerebrovascular surgery with a focus on the advantages and disadvantages of each technique.

Keywords

cerebrovascular surgery / cerebral ischemia / intraoperative monitoring

Cite this article

Download citation ▾
Hong Zhang, Lingzhong Meng, Russ Lyon, Dong-Xin Wang. Monitoring cerebral ischemia during cerebrovascular surgery. Journal of Biomedical Research, 2017, 31(4): 279‒282 https://doi.org/10.7555/JBR.31.20150106

References

[1]
Alexandrov AV, Sloan  MA, Wong LK , Practice standards for transcranial Doppler ultrasound: part I-test performance[J]. J Neuroimaging, 2007,17(1):11–18.
[2]
Kincaid MS. Transcranial doppler sonography: A diagnostic tool of increasing utility[J]. Curr Opin Anaesthesiol, 2008,21(5):552–559.
[3]
Claassen J, Hirsch  LJ, Kreiter KT , Quantitative continuous EEG for detecting delayed cerebral ischemia in patients with poor-grade subarachnoid hemorrhage[J]. Clin Neurophysiol, 2004, 115(12):2699–2710.
[4]
Martin CJ, Sinson  G, Patterson T , Sensitivity of scalp EEG, cortical EEG, and somatosensory evoked responses during surgery for intracranial aneurysms[J]. Surg Neurol, 2002,58(5):317–320.
[5]
Vespa PM, Nuwer  MR, Juhasz C , Early detection of vasospasm after acute subarachnoid hemorrhage using continuous EEG ICU monitoring[J]. Electroencephalogr Clin Neurophysiol, 1997,103(6):607–615.
[6]
Sahaya K, Pandey  AS, Thompson BG , Intraoperative monitoring for intracranial aneurysms: the Michigan experience[J]. J Clin Neurophysiol, 2014,31(6):563–567.
[7]
Labar DR, Fisch  BJ, Pedley TA , Quantitative EEG monitoring for patients with subarachnoid hemorrhage[J]. Electroencephalogr Clin Neurophysiol, 1991, 78(5):325–332.
[8]
Claassen J, Mayer  SA, Hirsch LJ . Continuous EEG monitoring in patients with subarachnoid hemorrhage[J]. J Clin Neurophysiol, 2005,22(2):92–98.
[9]
Manninen PH, Patterson  S, Lam AM , Evoked potential monitoring during posterior fossa aneurysm surgery: a comparison of two modalities[J]. Can J Anaesth, 1994,41(2):92–97.
[10]
Chen L. Detection of ischemia in endovascular therapy of cerebral aneurysms: a perspective in the era of neurophysiological monitoring[J]. Asian J Neurosurg, 2010,5(1):60–67.
[11]
Jin SH, Chung  CK, Kim JE , A new measure for monitoring intraoperative somatosensory evoked potentials[J]. J Korean Neurosurg Soc, 2014,56(6):455–462.
[12]
Jameson LC, Janik  DJ, Sloan TB . Electrophysiologic monitoring in neurosurgery[J]. Anesthesiol Clin, 2007,25(3):605–630.
[13]
Jameson LC, Sloan  TB. Monitoring of the brain and spinal cord[J]. Anesthesiol Clin, 2006,24(4):777–791.
[14]
Florence G, Guerit  JM, Gueguen B . Electroencephalography (EEG) and somatosensory evoked potentials (SEP) to prevent cerebral ischaemia in the operating room[J]. Neurophysiol Clin, 2004,34(1):17–32.
[15]
Guo L, Gelb  AW. The use of motor evoked potential monitoring during cerebral aneurysm surgery to predict pure motor deficits due to subcortical ischemia[J]. Clin Neurophysiol,  2011,122(4):648–655.
[16]
Quiñones-Hinojosa A ,  Alam M, Lyon  R, Transcranial motor evoked potentials during basilar artery aneurysm surgery: technique application for 30 consecutive patients[J].  Neurosurgery,  2004,54(4):916–924.
[17]
Motoyama Y, Kawaguchi  M, Yamada S , Evaluation of combined use of transcranial and direct cortical motor evoked potential monitoring during unruptured aneurysm surgery[J]. Neurol Med Chir (Tokyo), 2011,51(1):15–22.
[18]
Macdonald DB. Intraoperative motor evoked potential monitoring: overview and update[J]. J Clin Monit Comput, 2006,20(5):347–377.
[19]
Sasaki T, Kodama  N, Matsumoto M , Blood flow disturbance in perforating arteries attributable to aneurysm surgery[J]. J Neurosurg, 2007,107(1):60–67.
[20]
Yue Q, Zhu  W, Gu Y , Motor evoked potential monitoring during surgery of middle cerebral arteryaneurysms: a cohort study[J]. World Neurosurg, 2014,82(6):1091–1099.
[21]
Neuloh G, Schramm  J. Monitoring of motor evoked potentials compared with somatosensory evoked potentials and microvascular Doppler ultrasonography in cerebral aneurysm surgery[J]. J Neurosurg, 2004,100(3):389–399.
[22]
Friedman WA, Kaplan  BL, Day AL , Evoked potential monitoring during aneurysm operation: observations after fifty cases[J]. Neurosurgery, 1987,20(5):678–687.
[23]
Lopéz JR, Chang  SD, Steinberg GK . The use of electrophysiological monitoring in the intraoperative management of intracranial aneurysms[J]. J Neurol Neurosurg Psychiatry, 1999,66(2):189–196.

Acknowledgments

This work was supported by the Inaugural Anesthesia Department Awards for Seed Funding for Clinically-Oriented Research Projects from the Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California (to Dr. Meng). We thank the International Chinese Academy of Anesthesiology (ICAA) for providing resources for our collaborations.

RIGHTS & PERMISSIONS

2017 2017 by the Journal of Biomedical Research. All rights reserved.
PDF(98 KB)

Accesses

Citations

Detail

Sections
Recommended

/