Prediction and evaluation of brainstem function by auditory brainstem responses in patients with uncal herniation

Nagao, Seigo; Kuyama, Hideyuki; Honma, Yutaka; Momma, Fumiyuki; Nishiura, Tsukasa; Murota, T.; Suga, Masakazu; Tanimoto, Takaho; Kawauchi, Masamitsu; Nishimoto, Akira

doi:10.1016/0090-3019(87)90113-3

Cited by 18 publications

(4 citation statements)

References 14 publications

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“…33 Similarly, studies in patients with hydrocephalus and elevated ICP have also demonstrated absolute latency and interpeak latency ABR abnorm a l i t i e~.~~-~' Again, distortion of wave V and decreased amplitude was a common finding in these patients. Several studies in hydrocephalic patients with increased ICP had shown good correlation with visual evoked potential alterations which tended to normalize after CSF diversion .…”

Section: Suppression Of Wave V and Prolongation Of I-v Ipl Was Observmentioning

confidence: 92%

Modified Auditory Brainstem Responses (MABR) Part 2 - Studies in Patients with Intracranial Lesions

Ghaly

Stone

Subramanian

et al. 1988

Clinical Electroencephalography

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Section: Suppression Of Wave V and Prolongation Of I-v Ipl Was Observmentioning

confidence: 92%

Modified Auditory Brainstem Responses (MABR) Part 2 - Studies in Patients with Intracranial Lesions

Ghaly

Stone

Subramanian

et al. 1988

Clinical Electroencephalography

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“…The addition of this data to other prognostic indicators, none of which by themselves are conclusive, may be helpful in assigning a patient to a poor prognosis category with a high degree of certainty. Nagao et al 47 have'suggested that immediate medical or surgical decompression of ICP should be performed when ICP approaches 30 mm Hg with significant prolongation of wave V latency.…”

Section: Brainstem Auditory Evoked Potentialsmentioning

confidence: 99%

Electrophysiologic Monitoring in the Intensive Care Unit

Hill

Chiappa

1994

Can. J. Neurol. Sci.

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Electroencephalography (EEG) and evoked potential studies are established monitoring tools in the neurological intensive care unit (ICU). These neurophysiologic techniques provide information on physiological state and response to therapy, and may aid diagnosis and prognosis. Serial studies or continuous monitoring may enable changes to be detected prior to irreversible deterioration in the patient's condition. Current computer technology allows simultaneous display and correlation of electrophysiologic parameters, cardiovascular state and intracranial pressure (ICP). Continuous EEG monitoring in the ICU has been shown to have a decisive or contributing impact on medical decision making in more than three-quarters of patients. In addition, continuous EEG monitoring has revealed previously unsuspected non-convulsive seizures in one-third of patients. SEPs and BAEPs can provide useful prognostic information in coma - however, these tests are etiologically nonspecific and must be carefully integrated into the clinical situation. Motor evoked potentials offer a potentially useful tool for evaluating motor system abnormalities in the ICU.

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“…A number of animal studies, in addition to clinical reports and reviews of patients with large supratentorial intracranial lesions or hydrocephalus, demonstrated BAEP wave V changes and correlations, at times reversible between wave V and transtentorial herniation (TH), increased intracranial pressure (ICP), and reduced auditory nerve, cochlear, or brain perfusion. 11 –26 Our previous work in a primate TH model disclosed that attenuation of the V-Vn waveform complex was a better predictor ½ hour before TH than ICP. 27 This led us to modify the BAEP in the hope of increasing the sensitivity of the test, utilizing a rapid binaural stimulation rate and diminishing intensity levels in 106 patients with a symptomatic cerebral lesion.…”

Section: Introductionmentioning

confidence: 99%

Modified Brain Stem Auditory Evoked Potentials in Patients With Intracranial Mass Lesions

et al. 2012

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The authors report their experience utilizing a recently described rapid rate, binaural click and 1000-Hz tone burst modification of the brain stem auditory evoked potentials (BAEP), modified (MBP), in 27 symptomatic patients with non-brain stem compressive space-taking cerebral lesions (22), hydrocephalus (4), and pseudotumor cerebri (1). Many presented with clinical signs suggestive of increased intracranial pressure (ICP) and focal neurological deficits. The cerebral lesions, mostly large tumors with edema, had very substantial radiological signs of mass effect. Fourteen patients were also studied following surgical decompression. A number of significant changes in the wave V and Vn latency/intensity and less so amplitude/intensity function was found in the 27 patients, compared to normal volunteers, as well as those studied pre- and postoperatively. Similar MBP changes had been noted in normal volunteers placed in a dependent head position. Possible mechanisms to explain these findings are discussed. The MBP methodology shows promise and further development could make neuro-intensive care unit monitoring practical.

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Prediction and evaluation of brainstem function by auditory brainstem responses in patients with uncal herniation

Cited by 18 publications

References 14 publications

Modified Auditory Brainstem Responses (MABR) Part 2 - Studies in Patients with Intracranial Lesions

Modified Auditory Brainstem Responses (MABR) Part 2 - Studies in Patients with Intracranial Lesions

Electrophysiologic Monitoring in the Intensive Care Unit

Modified Brain Stem Auditory Evoked Potentials in Patients With Intracranial Mass Lesions

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