Skip to main content

Neurological Monitoring with Evoked Potentials

  • Chapter
Thoraco-Abdominal Aorta

Abstract

The aim of perioperative neurological monitoring is to assess spinal cord function during aortic cross-clamping, allowing corrective measures in case of jeopardized spinal cord perfusion. The technique of motor evoked potentials is a reliable and highly sensitive method to evaluate spinal cord integrity during thoraco-abdominal aortic repair. Using this technique, critical spinal cord function can be determined and improved by surgical and hemodynamic interactions in order to prevent neurological deficits.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Nijenhuis RJ, Jacobs MJ, Schurink GW et al. Magnetic resonance angiography and neuromonitoring to assess spinal cord blood supply in thoracic and thoracoabdominal aortic aneurysm surgery. J Vasc Surg 2007;45:71–77

    Article  PubMed  Google Scholar 

  2. Nijenhuis RJ, Jacobs MJ, Jaspers K et al. Comparison of magnetic resonance with computed tomography angiography for preoperative localization of the Adamkiewicz artery in thoracoabdominal aortic aneurysm patients. J Vasc Surg 2007;45:677–685

    Article  PubMed  Google Scholar 

  3. Yamada N, Takamiya M, Kuribayashi S et al. MRA of the Adamkiewicz artery: a preoperative study for thoracic aortic aneurysm. J Comput Assist Tomogr 2000;24:362–368

    Article  PubMed  CAS  Google Scholar 

  4. Yoshioka K, Niinuma H, Ohira A et al. MR angiography and CT angiography of the artery of Adamkiewicz: noninvasive preoperative assessment of thoracoabdominal aortic aneurysm. Radiographies 2003;23:1215–1225

    Article  Google Scholar 

  5. Jacobs MJ, de Mol BA, Elenbaas T et al. Spinal cord blood supply in patients with thoracoabdominal aortic aneurysms. J Vasc Surg 2002;35:30–37

    PubMed  Google Scholar 

  6. Rothwell J, Burke D, Hicks R et al. Transcranial electrical stimulation of the motor cortex in man: further evidence for the site of activation. J Physiol 1994;481:243–250

    PubMed  CAS  Google Scholar 

  7. Ubags LH, Kalkman CJ, Been HD. Influence of isoflurane on myogenic motor evoked potentials to single and multiple transcranial stimuli during nitrous oxide/opioid anesthesia. Neurosurgery 1998; 43:90–95

    Article  PubMed  CAS  Google Scholar 

  8. Ubags LH, Kalkman CJ, Been HD et al. A Comparison of myogenic motor evoked responses to electrical and magnetic transcranial stimulation during nitrous oxide/opioid anesthesia. Anesth Analg 1999;88:568–572

    Article  PubMed  CAS  Google Scholar 

  9. Achouh PE, Estrera AL, Miller III CC et al. Role of somatosensory evoked potentials in predicting outcome during thoracoabdominal aortic repair. Ann Thorac Surg 2007;84:782–788

    Article  PubMed  Google Scholar 

  10. Shahin GM, Hamerlijnck RP, Schepens MA et al. Upper and lower extremity somatosensory evoked potential recording during surgery for aneurysms of the descending thoracic aorta. Eur J Cardio-thorac Surg 1996;10:299–304

    Article  CAS  Google Scholar 

  11. Marsala M. Spinal cord blood flow and metabolism in transient spinal ischemia. In Stålberg E, Sharma HS, Olsson Y (eds) Spinal cord monitoring. Springer, Wien, 1998, pp 3–25

    Google Scholar 

  12. Sloan TB, Jameson LC. Electrophysiologic monitoring during surgery to repair the thoraco-abdominal aorta. J Clin Neurophysiol 2007;24:316–327

    PubMed  Google Scholar 

  13. Krauss WE. Vascular anatomy of the spinal cord. Neurosurg Clin N Am 1999;10:9–15

    PubMed  CAS  Google Scholar 

  14. Meylaerts SA, Jacobs MJ, van Iterson V et al. Comparison of transcranial motor evoked potentials and somatosensory evoked potentials during thoracoabdominal aortic arch repair. Ann Surg 1999; 6:742–749

    Article  Google Scholar 

  15. van Dongen EP, Schepens MA, Morshuis WJ et al. Thoracic and thoracoabdominal aortic aneurysm repair: use of evoked potential monitoring in 118 patients. J Vasc Surg 2001;34:1035–1040

    Article  PubMed  Google Scholar 

  16. Dong CCJ, MacDonald DB, Janusz MT. Intraoperative spinal cord monitoring during descending thoracic and thoracoabdominal aneurysm surgery. Ann Thorac Surg 2002;74:S1873–S1876

    Article  PubMed  Google Scholar 

  17. Keyhani K, Miller CC 3rd, Estrera Al et al. Analysis of motor and somatosensory evoked potentials during thoracic and thoracoabdominal aortic aneurysm repair. J Vasc Surg 2009;49:36–41

    Article  PubMed  Google Scholar 

  18. Schurink GWH, Hijenhuis RJ, Backes WH et al. Assessment of spinal cord circulation and function in endovascular treatment of thoracic aortic aneurysms. Ann Thorac Surg 2007;83:S877–S881

    Article  PubMed  Google Scholar 

  19. Coselli JS, LeMaire SA, Conklin LD et al. Left heart bypass during descending thoracic aortic aneurysm repair does not reduce the incidence of paraplegia. Ann Thorac Surg 2004;77:1298–1303

    Article  PubMed  Google Scholar 

  20. Kouchoukos NT, Masetti P, Murphy SF. Hypothermic cardiopulmonary bypass and circulatory arrest in the management of extensive thoracic and thoracoabdominal aortic aneurysms. Semin Thorac Cardiovasc Surg 2003;15:333–339

    Article  PubMed  Google Scholar 

  21. Etz CD, Luehr M, Kari FA et al. Paraplegia after extensive thoracic and thoracoabdominal aortic aneurysm repair: does critical spinal cord ischemia occur postoperatively? J Thorac Cardiovasc Surg 2008;135:324–330

    Article  PubMed  Google Scholar 

  22. Conrad MF, Crawford RS, Davison JK et al. Thoracoabdominal aneurysm repair: a 20-year perspective. Ann Thorac Surg 2007;83:S856–S861

    Article  PubMed  Google Scholar 

  23. Coselli JS, Bozinovski J, LeMaire SA. Open surgical repair of 2286 thoracoabdominal aortic aneurysms. Ann Thorac Surg 2007;83:S862–S864

    Article  PubMed  Google Scholar 

  24. Wong DR, Coselli JS, Amerman K et al. Delayed spinal cord deficits after thoracoabdominal aortic aneurysm repair. Ann Thorac Surg 2007;83:1345–1355

    Article  PubMed  Google Scholar 

  25. Dardik A, Perler BA, Roseborough GS et al. Subdural hematoma after thoracoabdominal aortic aneurysm repair: an underreported complication of spinal fluid drainage? J Vasc Surg 2002;36:47–50

    Article  PubMed  Google Scholar 

  26. Weaver KD, Wiseman DB, Farber M et al. Complications of lumbar drainage after thoracoabdominal aortic aneurysm repair. J Vasc Surg 2001;34:623–527

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag Italia

About this chapter

Cite this chapter

Jacobs, M.J., Mess, W.H. (2011). Neurological Monitoring with Evoked Potentials. In: Chiesa, R., Melissano, G., Zangrillo, A. (eds) Thoraco-Abdominal Aorta. Springer, Milano. https://doi.org/10.1007/978-88-470-1857-0_32

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-1857-0_32

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1856-3

  • Online ISBN: 978-88-470-1857-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics