Somatosensory Evoked Potential Monitoring During Carotid Endarterectomy in Patients with a Stroke

Manninen, Pirjo; Tan, Tong; Sarjeant, Roger

doi:10.1097/00000539-200107000-00010

Cited by 48 publications

(17 citation statements)

References 14 publications

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“…4,20,21 It is worthy to emphasize that in the acute phase of stroke (within the first 3 days), different pathophysiological processes apart from direct tissue damage may interfere with some SSEPs parameters such as decreased levels of consciousness, drug effects, and cortical hyperexcitability. 20,22 Our patients were followed up for 3 months, which may be disputed as too short a time by some authors, 4,23-25 who used follow-up periods of 6 months and up to 1 year. We believe it is enough time because the physiologic recovery of the injured tissue is generally completed within 3 months.…”

Section: Discussionmentioning

confidence: 99%

Somatosensory Evoked Potentials as a Predictor for Functional Recovery of the Upper Limb in Patients with Stroke

Al-Rawi

Hamdan

Abdul-Muttalib

2009

Journal of Stroke and Cerebrovascular Diseases

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Section: Discussionmentioning

confidence: 99%

Somatosensory Evoked Potentials as a Predictor for Functional Recovery of the Upper Limb in Patients with Stroke

Al-Rawi

Hamdan

Abdul-Muttalib

2009

Journal of Stroke and Cerebrovascular Diseases

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“…However, all intracranial arteries are not easily explored, flow velocity and cerebral blood flow may be poorly correlated, and observations are not necessarily related to late neurologic outcome. 2 A persistent decrease in the amplitude of somatosensory evoked potentials is a good predictor of intraoperative cerebral ischemia, 3 but this type of recording can be altered by general anesthesia and requires good expertise. Near infrared spectroscopy monitoring is currently under investigation in that respect, 4 but it measures only frontal territories underneath the sensors and thresholds for ischemia still need to be defined.…”

mentioning

confidence: 99%

Bispectral Index Profile During Carotid Cross Clamping

Bonhomme¹,

Désiron

Lemineur³

et al. 2007

Journal of Neurosurgical Anesthesiology

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This study aimed at investigating the Bispectral Index (BIS) profile during carotid cross clamping (CXC). The study involved a pilot group of 10 patients undergoing routine carotid endarterectomy with shunt insertion under total intravenous anesthesia, and a study group of 26 additional patients. In all patients, rates of propofol and remifentanil providing a steady-state level of hypnosis (BIS: 40-60) were maintained constant throughout a recording period ranging from 3 minutes before CXC to shunt insertion. BIS was recorded throughout this period and the internal carotid backflow observed at the time of shunt insertion was graded as good, moderate, or poor. In addition, A-Line Autoregressive Index (AAI) and processed electroencephalogram (EEG) parameters were recorded in patients of the study group. All parameters were averaged over 1 minute before CXC, at CXC, 1, 2, and 3 minutes after CXC, and at shunt insertion. Statistical analysis was performed using chi2, Friedman, and Spearman correlation tests. For technical reasons, reliable AAI, BIS monitor-derived, and other processed EEG data were obtained in 24, 25, and 18 patients of the study group, respectively. During the first 3 minutes after CXC, BIS increased over 60 [68.8 (6.1)] in 47%, decreased below 40 [34.9 (4.4)] in 25%, and remained in the 40 to 60 range in 28% of all recruited patients. A BIS increase was more frequently observed in patients with moderate or poor than in those with good internal carotid backflow (78, 67, and 29%, respectively). It was significantly correlated to an increase in AAI and EEG amplitude, a decrease in EEG suppression ratio, and a shorter time between induction of anesthesia and CXC. A BIS decrease was significantly correlated to an increase in suppression ratio and a longer time between induction and CXC. In conclusion, during CXC under a constant level of intravenous anesthesia, BIS may increase, decrease, or remain unchanged. The paradoxical BIS increase could be related to borderline ischemia, a change in brain anesthetic agent concentration, or a change in the nociceptive-antinociceptive balance associated with a CXC-elicited painful stimulation. Caution should be used when interpreting BIS value during CXC.

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“…In this way, SEP monitoring based on the usual criteria can be used for reliable detection of cerebral ischemia after clamp application with no significant difference. 11 …”

Section: Discussionmentioning

confidence: 99%

Cerebral Monitoring of Somatosensory Evoked Potentials during Carotid Surgery: A Review of 100 Cases

Baton¹,

Szym²,

Hoffmann³

et al. 2007

Annals of Vascular Surgery

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Somatosensory Evoked Potential Monitoring During Carotid Endarterectomy in Patients with a Stroke

Abstract: Patients who have had a preoperative stroke may show asymmetry of their cortical baseline somatosensory evoked potential waveforms; however, this does not interfere with the ability to use somatosensory evoked potential as a monitor during surgery.

Cited by 48 publications

References 14 publications

Somatosensory Evoked Potentials as a Predictor for Functional Recovery of the Upper Limb in Patients with Stroke

Somatosensory Evoked Potentials as a Predictor for Functional Recovery of the Upper Limb in Patients with Stroke

Bispectral Index Profile During Carotid Cross Clamping

Cerebral Monitoring of Somatosensory Evoked Potentials during Carotid Surgery: A Review of 100 Cases

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