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KMID : 0359819950240060660
Journal of Korean Neurosurgical Society
1995 Volume.24 No. 6 p.660 ~ p.666
Somatosensory Evoked Potentials Bdfore and During Surgery in Patient with Cerebral Aneurysm
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Abstract
It has been known that the electrical activity of the brain is related to regional cerebral blood flow. and cerebral ischemia developed during the management of aneurysmal subarachnoid hemorrhage (SAH) is one of the major causes of morbidity and
mortality.
Somatosensory evoked potentials (SEPs) in response to median nerve stimulation at wrist have been recorded before and during surgery in 31 patients with aneurysmal SAH and 30 normal control subjects. The central conduction time (CCT). the time
between
the N14 peak recorded from the second cervical spine and the N20 peak recorded from the sensory cortex. were observed as an indicator of cortical activity.
@ES The results were as follows.
@EN 1) In patients with aneurysmal SAH. CCT recorded before surgery were not different from that of controls.
2) In patients with aneurysmal SAH. CCT recorded during surgery were found to be significantly increased by administration of anesthetics.
3) During surgery in aneurysmal SAH. CCT tended to be increased by brain retraction.
4) During surgery in aneurysmal SAH, CCT changes relative to the temporary occlusion of the parent artery were quite variable, ranging from rapid disappearance of N20 by only 2 minutes of temporary occlusion to no significant change after 20
minutes of
occlusion. The rapid disappearance of N20 within 2 minutes after temporary occlusion was highly likely to be associated with appreciable neurologic deficit after surgery.
These results suggest that somatosensory evoked potentials during the management of patients with aneurysmal SAH is considered to be a valuble indicator of cortical function, especially when temporary occlusion was performed to prevent premature
rupture
of cerebral aneurysm during surgery.
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