Search Our Scientific Publications & Authors

Clin Exp Emerg Med 2019 Feb 12. Epub 2019 Feb 12.

Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

A 34-year-old male was brought to the hospital with a chest gunshot wound. Pulseless upon arrival, blood pressure was absent for 10 minutes. A thoracotomy resulted in return of spontaneous circulation. Read More

J Neurol Surg B Skull Base 2019 Feb 3;80(1):40-45. Epub 2018 Jul 3.

Department of Neurosurgery, Brüder Krankenhaus Trier, Trier, Germany.

 Facial nerve (FN) weakness as a presenting feature in vestibular schwannoma (VS) is extremely rare. We are presenting two different cases of VS with significant facial weakness and reviewed the literature for similar cases.  We are presenting two cases of VS with significant facial weakness. Read More

J Clin Neurophysiol 2019 Jan 28. Epub 2019 Jan 28.

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.

Purpose: Intraoperative neurophysiological monitoring using somatosensory evoked potentials has been linked to a reduction in the incidence of neurological deficits during corrective surgery. Nonetheless, quantitative assessments of somatosensory evoked potential waveforms are often difficult to evaluate, because they are affected by anesthesia, injury, and noise. Here, we discuss a novel method that integrates somatosensory evoked potential signals into a single metric by calculating the area under the curve (AUC). Read More

J Neurosurg 2019 Jan 25:1-9. Epub 2019 Jan 25.

1Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland.

OBJECTIVECurrent management of gliomas involves a multidisciplinary approach, including a combination of maximal safe resection, radiotherapy, and chemotherapy. The use of intraoperative MRI (iMRI) helps to maximize extent of resection (EOR), and use of awake functional mapping supports preservation of eloquent areas of the brain. This study reports on the combined use of these surgical adjuncts. Read More

World Neurosurg 2019 Jan 11. Epub 2019 Jan 11.

Orthopedic department, University Hospital Jena, Campus Eisenberg, Germany.

Background: Both progression of scoliosis following completion of growth, and the combination of low mental retardationand the conspicuous sagittal clinical and radiographic abnormalities suggest a secondary genesis of the scoliosis according to a genetic aberration.

Case Discription: In the outpatient department, an 18-year-old girl presents with scoliosis and mild mental retardation. Radiography findings demonstrate a sacral agenesis and the consecutively performed MRI a conus depression. Read More

Childs Nerv Syst 2019 Mar 8;35(3):529-533. Epub 2019 Jan 8.

Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

Purpose: It is well known that the preoperative enlarged sac in occult spinal dysraphism, in which the spinal cord is attached to its dome, can be associated with neurological deficits by aggravation of spinal cord traction. We experienced a similar phenomenon during the early stage of untethering surgery for "lipomyelomeningocele in a strict sense (LMMC)."

Clinical Presentation: We report a case of a 3-month-old girl with LMMC, which showed decreased motor evoked potentials (MEPs) in the lower extremities during the early stage of untethering surgery. Read More

Acta Neurochir Suppl 2019 ;125:369-380

Institute of Neurosurgery, University Hospital, Verona, Italy.

Craniovertebral junction (CVJ) surgery encompasses a wide spectrum of neurosurgical procedures ranging from transoral approaches for CVJ bone anomalies to surgery for intramedullary tumours. Intraoperative neurophysiological monitoring (IONM) has been increasingly used in recent years because of its ability to prevent neurological complications during surgery. In CVJ surgery the risk of neurological injuries is related first to the positioning of the patient and then to the surgical procedure. Read More

Clin Spine Surg 2019 Jan 2. Epub 2019 Jan 2.

Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

Study Design: A retrospective analysis of prospectively collected data of 179 consecutive patients who underwent intraoperative neurophysiological monitoring during posterior cervical spine surgery for compression myelopathy.

Objective: To evaluate preoperative factors in patients with deteriorating spinal cord function due to flexion of the neck during posterior cervical spine surgery by observing changes in waveforms on intraoperative monitoring.

Summary Of Background Data: We encountered several cases of intraoperative monitoring warning alerts because of neck flexion during posterior cervical spine surgery. Read More

Laryngoscope 2018 Dec 25. Epub 2018 Dec 25.

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.

Objective: Loss of signal (LOS) during intraoperative neuromonitoring (IONM) of robotic or endoscopic thyroidectomy via a retroauricular approach (RAT) and during conventional open thyroidectomy (COT) was investigated to compare the risk of recurrent laryngeal nerve (RLN) injury between the two groups.

Study Design: Original article.

Methods: This is a retrospective case series study performed between May 2014 and September 2016. Read More

Cir Esp 2019 Feb 20;97(2):103-107. Epub 2018 Dec 20.

Unidad de Neurofisiología, Hospital Universitario General de Albacete, Albacete, España.

In surgical procedures of the supraclavicular and lateral cervical regions, as well as in cardiac and mediastinal surgeries, diaphragm function can be compromised by the risk of injury to the phrenic nerve and/or the C4 root. There are few publications that treat the intraoperative stimulation of these nerve structures to evaluate their functionality and, to our knowledge, until now it has not been hypothesized about whether it is possible to reduce the injury rates, which reach 26% in some cardiac surgery studies. We describe the technique used for the neurophysiological monitoring of the phrenic nerve. Read More

Medicine (Baltimore) 2018 Dec;97(51):e13816

Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University.

Background: Medical researchers have been reluctant to use neuromuscular blocking drugs (NMBD) during the use of intraoperative motor evoked potential (MEP) monitoring despite the possibility of patient movement. In this study, we compared the effects of no NMBD and continuous rocuronium infusion on the incidence of patient involuntary movement and MEP monitoring.

Methods: In this study, 80 patients who underwent neuro intervention with MEP monitoring were randomly assigned into 2 groups. Read More

Eur Spine J 2018 Dec 17. Epub 2018 Dec 17.

Spine Unit, Department of Neurology, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland.

Purpose: We compared the value of different uni- and multimodal intraoperative neurophysiological monitoring (IONM) methods on the detection of neurological complications during spine surgery.

Methods: IONM data derived from sensory spinal and cortical evoked potentials combined with continuous electromyography monitoring, motor evoked potentials and spinal recording were evaluated in relation to subsequent post-operative neurological changes. Patients were categorised based on their true-positive or true-negative post-operative neurological status. Read More

Clin Exp Otorhinolaryngol 2018 Dec 11. Epub 2018 Dec 11.

Department of Otolaryngology, Head and Neck Surgery and Medical Research Institute, Pusan National University College of Medicine, Busan, Korea.

Objectives: False-negative or false-positive responses in intraoperative neuromonitoring (IONM) using electromyography (EMG) in thyroid surgery pose a challenge. Therefore, we developed a novel IONM system that uses a surface pressure sensor instead of EMG to detect muscle twitching. This study aimed to investigate the feasibility and safety of a new IONM system using a piezo-electric surface pressure sensor in an experimental animal model. Read More

J Neurosurg Spine 2018 Nov 1:1-9. Epub 2018 Nov 1.

4Department of Neurosurgery, Humanitas Research Hospital and University, Milan, Italy.

OBJECTIVEThe purpose of this study was to evaluate the technical feasibility, accuracy, and relevance on surgical outcome of D-wave monitoring combined with somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) during resection of intradural extramedullary (IDEM) spinal tumors.METHODSClinical and intraoperative neurophysiological monitoring (IONM) data obtained in 108 consecutive patients who underwent surgery for IDEM tumors at the Institute for Scientific and Care Research "ASMN" of Reggio Emilia, Italy, were prospectively entered into a database and retrospectively analyzed. The IONM included SSEPs, MEPs, and-whenever possible-D-waves. Read More

Acta Neurochir (Wien) 2019 Jan 27;161(1):69-78. Epub 2018 Nov 27.

Department of Surgical Specialties, Division of Neurosurgery and Unit of Neurophysiopathology, San Filippo Neri Hospital/ASLRoma1, Via Reno 14, 00198, Rome, Italy.

Background And Objective: Goals of small vestibular schwannoma (VS) microneurosurgery are as follows: radical resection, facial nerve (FN) preservation, and hearing preservation (HP). Microsurgical advances make HP possible in many patients with preoperative socially useful hearing (SUH). We evaluated postoperative HP in VS with maximum diameter < 2 cm monitored with two different auditory brainstem response (ABR) techniques. Read More

Cureus 2018 Sep 22;10(9):e3346. Epub 2018 Sep 22.

Neurophysiology, Axis Neuromonitoring, Richardson, USA.

Arthroscopic hip surgery is performed routinely for the treatment of various hip disorders. Leg traction during labral tear repair, femoroplasty, and acetabuloplasty for hip stabilization can stretch the peripheral nerves. This may cause temporary or permanent nerve injury. Read More

Front Pediatr 2018 1;6:309. Epub 2018 Nov 1.

Department of Neurosurgery, Alder Hey NHS Foundation Trust, Liverpool, United Kingdom.

Pediatric neuro-oncology surgery continues to progress in sophistication, largely driven by advances in technology used to aid the following aspects of surgery: operative planning (advanced MRI techniques including fMRI and DTI), intraoperative navigation [preoperative MRI, intra-operative MRI (ioMRI) and intra-operative ultrasound (ioUS)], tumor visualization (microscopy, endoscopy, fluorescence), tumor resection techniques (ultrasonic aspirator, micro-instruments, micro-endoscopic instruments), delineation of the resection extent (ioMRI, ioUS, and fluorescence), and intraoperative safety (neurophysiological monitoring, ioMRI). This article discusses the aforementioned technological advances, and their multimodal use to optimize safe pediatric neuro-oncology surgery. Read More

Conf Proc IEEE Eng Med Biol Soc 2018 Jul;2018:3894-3897

The purpose of this study was to develop a user-friendly presentation of surface-EMG data in near-time for intraoperative nerve-monitoring. We have built a novel surface-EMG probe as a diagnostic device to investigate innervation patterns of sphincter muscles in further clinical diagnostic studies. S-EMG data were recorded from 20 healthy volunteers from the orbicularis oris muscles. Read More

BMC Anesthesiol 2018 Nov 7;18(1):161. Epub 2018 Nov 7.

Department of Paediatric Anaesthesia, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.

Background: The Auditory brainstem implant (ABI) is a new surgical option for hearing impaired children. Intraoperative neurophysiology monitoring includes brainstem mapping of cranial nerve (CN) IX, X, XI, XII and their motor nuclei, and corticobulbar tract motor-evoked potential. These require laryngeal electrodes and intra-oral pins, posing a challenge to airway management especially in the pediatric airway, where specialized electromyogram (EMG) tracheal tubes are not available. Read More

World Neurosurg 2019 Feb 2;122:129-132. Epub 2018 Nov 2.

Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.

Background: There is still a controversy for low-flow extracranial-intracranial or high-flow extracranial-intracranial bypass with proximal occlusion in the treatment of unclippable giant internal carotid artery aneurysms.

Case Description: A 61-year-old woman presented with a 1-month history of double vision. Neuroimages revealed an unclippable giant internal carotid artery aneurysm located from the cavernous sinus to proximal site of the posterior communicating artery. Read More

Neurodiagn J 2018 2;58(4):218-225. Epub 2018 Nov 2.

a Division of Surgical Neurophysiology Keck Hospital of University of Southern California , Los Angeles , California.

Transcranial electrical motor evoked potential (TcMEP) is a modality utilized in intraoperative neurophysiological monitoring to assess the integrity of the corticospinal tract. Traditionally, TcMEPs are obtained by anodal stimulation of the scalp over the motor cortex of the selected hemisphere and referenced to the contralateral hemisphere. Subsequent compound motor action potential responses (CMAPs) are recorded at various muscles. Read More

Brain Tumor Res Treat 2018 Oct;6(2):60-67

Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Background: Recently, modern technology such as diffusion tensor imaging (DTI), neuro-navigation and intraoperative neurophysiological monitoring (IOM) have been actively adopted for the treatment of thalamic tumors. We evaluated surgical outcomes and efficacy of the aforementioned technologies for the treatment of pediatric thalamic tumors.

Methods: We retrospectively reviewed clinical data from 37 children with thalamic tumors between 2004 and 2017. Read More

J Clin Monit Comput 2018 Oct 30. Epub 2018 Oct 30.

Golden Gate Neuromonitoring, San Francisco, CA, USA.

The American Society of Neurophysiological Monitoring (ASNM) was founded in 1989 as the American Society of Evoked Potential Monitoring. From the beginning, the Society has been made up of physicians, doctoral degree holders, Technologists, and all those interested in furthering the profession. The Society changed its name to the ASNM and held its first Annual Meeting in 1990. Read More

Neurosurg Rev 2018 Oct 26. Epub 2018 Oct 26.

Department of Neurosurgery, Inselspital, Bern University Hospital, 3010, Bern, Switzerland.

In vestibular schwannoma (VS) surgery postoperative facial nerve (CN VII) palsy is reducing quality of life. Recently, we have introduced a surgical suction device for continuous dynamic mapping to provide feedback during tumor resection without switching to a separate stimulation probe. The objective was to evaluate the reliability of this method to avoid CN VII injury. Read More

Neuroradiology 2019 Feb 17;61(2):207-215. Epub 2018 Oct 17.

Department of Neurosurgery, Inje University Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan, 48108, Republic of Korea.

Purpose: Forms of intraoperative neurophysiologic monitoring (IONM), including somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs), have been widely used in the field of neurosurgery. This study aimed to evaluate the diagnostic efficacy of IONM in identifying intraoperative events and predicting postoperative neurologic deficits in neurovascular intervention.

Methods: From January 2013 to December 2016, we retrospectively reviewed patients who underwent neurovascular intervention under general anesthesia with the use of IONM. Read More

World Neurosurg 2019 Jan 13;121:205-210. Epub 2018 Oct 13.

Department of Neurosurgery, Nara Medical University, Kashihara, Japan.

Background: To avoid permanent neurologic deficits and preserve brain function in and near the eloquent area, intraoperative electrical stimulation mapping (IESM) is necessary. However, little is known about how these subcortical regions are involved in calculation processing function in patients with glioma.

Case Description: We report the case of a 56-year-old, right-handed woman working at a primary school as a teacher who had recurrent left parietal glioma. Read More

J Clin Neurophysiol 2018 Nov;35(6):463-467

Clinical Neurophysiology Department, Hospital Ramón y Cajal, Madrid, Spain.

Purpose: The occurrence of urinary incontinence and erectile dysfunction after surgical treatment for prostate cancer is a significant and lingering problem. The aim of this study is to revise and improve older techniques of intraoperative cavernous nerve mapping already in use to improve accuracy and reliability.

Methods: We prospectively studied this technique in 12 patients suffering from prostate cancer. Read More

Asian J Neurosurg 2018 Jul-Sep;13(3):595-606

Department of Neurosurgery-Neurotraumatology, A.O.U. Parma, Parma, Italy.

Objective And Background: Data on intraoperative neurophysiological monitoring (IOM) during surgery of spinal dural arteriovenous fistulas (SDAVFs) are lacking. The purpose of this study was to evaluate the role of IOM during microsurgery for SDAVFs.

Materials And Methods: From March 2007 to March 2013, 12 patients had microsurgery with IOM for SDAVFs. Read More

Neuroimage Clin 2018 27;20:868-874. Epub 2018 Sep 27.

Department of Neurosurgery, Inselspital, University Hospital Bern, and University of Bern, Bern, Switzerland.

Background: Accurate interindividual comparability of deep brain stimulation (DBS) lead locations in relation to the surrounding anatomical structures is of eminent importance to define and understand effective stimulation areas. The objective of the current work is to compare the accuracy of the DBS lead localisation relative to the STN in native space with four recently developed three-dimensional subcortical brain atlases in the MNI template space. Accuracy is reviewed by anatomical and volumetric analysis as well as intraoperative electrophysiological data. Read More

Neurosurg Focus 2018 Oct;45(VideoSuppl2):V7

1Department of Neurological Surgery, University of Wisconsin-Madison School of Medicine and Public Health; and.

Although the surgical treatment of thalamic tumors remains challenging due to the proximity to the internal capsule, safe resection of gliomas or metastatic tumors of the thalamus are possible in some selected cases due to a better understanding of microsurgical anatomy and due to advances in neurophysiological mapping and monitoring. In this video, the authors demonstrate the use of mapping of the internal capsule with direct subcortical stimulation for the resection of a metastatic tumor. The patient is a 58-year-old man with a history of renal cell carcinoma and metastasis in the left thalamus and parieto-occipital region. Read More

Eur Arch Otorhinolaryngol 2018 Nov 28;275(11):2615-2626. Epub 2018 Sep 28.

Coordinator of the International Head and Neck Scientific Group, Padua, Italy.

Purpose: Management of the facial nerve is instrumental in the surgical treatment of parotid cancer.

Methods: A literature search was conducted using PubMed and ScienceDirect database. A total of 195 articles were finally included into the analysis, based on relevance, scientific evidence and actuality. Read More

Curr Oncol Rep 2018 Sep 26;20(11):89. Epub 2018 Sep 26.

Department of Neurosurgery, Stanford University, 300 Pasteur Dr, Stanford, CA, 94305, USA.

Purpose Of Review: Surgical treatment of brain tumors remains an integral part of a comprehensive treatment plan. Here, we review technological advances that have enhanced what surgeons are capable of doing within and outside the traditional operating room.

Recent Findings: Extent of surgical resection has improved with the use of MRI and fluorescent dyes intraoperatively. Read More

Neurodiagn J 2018 ;58(3):174-181

b Department of Neurology , Duke University Medical Center , Durham , North Carolina.

Somatosensory evoked potentials (SEPs) using tibial nerve stimulation are used during neurophysiologic intraoperative monitoring (NIOM). These SEPs produce a P37 waveform that is recorded from scalp electrodes. In this study, we attempted to determine the best derivation for recording the P37 waveform. Read More

Eur Arch Otorhinolaryngol 2018 Nov 19;275(11):2861-2868. Epub 2018 Sep 19.

Department of Otorhinolaryngology-Head and Neck Surgery, University of Campinas, Rua Tessália Vieira de Camargo, 126, Campinas, SP, CEP 13083-970, Brazil.

Purpose: There are no randomized trials comparing the incidence or severity of facial nerve dysfunction after superficial parotidectomy with or without continuous intraoperative electromyographic neuromonitoring. This pilot study aimed to assess the variability in outcomes to help determine the needs and possible ethical issues in a full-scale study.

Methods: Prospective randomized pilot study comparing the incidence and grade of facial nerve dysfunction among 106 patients subjected to superficial parotidectomy with or without continuous four channels electromyographic neuromonitoring (52 monitored patients and 54 controls). Read More

Surg Neurol Int 2018 3;9:177. Epub 2018 Sep 3.

Federal Centre of Treatment and Rehabilitation of Ministry of Healthcare of Russian Federation, 125367 Moscow, Russia.

Background: The use of awake craniotomy for surgical treatment of epilepsy was applied in surgery of convexital tumors, arteriovenous malformations, some superficial aneurysms, and stereotactic neurosurgery. The aim of this study was to show the advantages of awake craniotomy without sedation, accompanied by intraoperative neurophysiological monitoring in patients with symptomatic epilepsy.

Methods: This article describes the results of surgical treatment in 41 patients with various pathologies; 31 among them suffered from epilepsy. Read More

Clin Neurophysiol 2018 Nov 22;129(11):2276-2283. Epub 2018 Aug 22.

Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address:

Objective: To identify factors associated with the failure to generate baseline muscle motor evoked potentials (mMEPs) during spinal surgery, and to determine the association between baseline mMEP generation and postoperative outcomes.

Methods: A total of 345 patients who underwent spine surgery with intraoperative mMEP monitoring were included, and we retrospectively reviewed their demographic/clinical parameters, and mMEP recording results according to lesion locations.

Results: Multivariable logistic regression analysis revealed that preoperative Medical Research Council grade of the weakest muscle <3 was significantly associated with failure of baseline mMEP generation in both cervical and thoracic lesions. Read More

BMC Neurol 2018 Sep 14;18(1):142. Epub 2018 Sep 14.

Department of Neurosurgery, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, China.

Background: Patients with ischemic cerebrovascular diseases are more likely to suffer from intracranial aneurysms, and their surgical treatment has a growing controversy in this condition. The current case series was aimed at exploring surgical treatment and perioperative management of intracranial aneurysms in Chinese patients with ischemic cerebrovascular diseases.

Methods: Minimally invasive surgical approach through small pterion or inferolateral forehead was applied in 31 patients. Read More

Clin Neurophysiol 2018 Nov 29;129(11):2245-2251. Epub 2018 Aug 29.

Graduate School of Business and Law School, Stanford University, USA; Hoover Institution, Stanford University, USA.

Objectives: Well-designed longitudinal studies assessing effectiveness of intraoperative neurophysiologic monitoring (IONM) are lacking. We investigate IONM effects on cost and administrative markers for health outcomes in the year after cervical spine surgery.

Methods: We identified single-level cervical spine surgeries in commercial claims. Read More

World Neurosurg 2018 Oct 2;118:e304-e315. Epub 2018 Jul 2.

Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Whitefield, Bangalore, India.

Objective: To evaluate the safety and accuracy of anatomic- and lateral fluoroscopic-guided placement of C2 pars/pedicle, C1 lateral mass screws, and freehand placement of C2 laminar screws.

Methods: All the patients who underwent posterior cervical/occipitocervical fixation that involved the placement of C1/C2 screws during a 5-year period (2011-2015) at our institute were included in this study.

Results: C1/C2 screws were placed in a total of 94 patients during this period. Read More

J Korean Neurosurg Soc 2018 Sep 31;61(5):625-632. Epub 2018 Aug 31.

Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.

Objective: Because the anatomical structure of the brachial plexus is very complex, surgical treatment of tumors in this region is challenging. Therefore, a lot of clinical and surgical experience is required for successful treatment; however, many neurosurgeons have difficulty accumulating this experience owing to the rarity of brachial plexus tumors. The purpose of this report is to share our surgical experience with brachial plexus tumor with other neurosurgeons. Read More

Neuroimage Clin 2018 14;20:580-593. Epub 2018 Aug 14.

Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Germany; Medical Faculty, Freiburg University, Freiburg, Germany; Philips GmbH DACH, Hamburg, Germany.

Background: Deep brain stimulation (DBS) of the superolateral branch of the medial forebrain bundle (slMFB) emerges as a - yet experimental - treatment for major depressive disorder (MDD) and other treatment refractory psychiatric diseases. First experiences have been reported from two open label pilot trials in major depression (MDD) and long-term effectiveness for MDD (50 months) has been reported.

Objective: To give a detailed description of the surgical technique for DBS of the superolateral branch of the medial forebrain bundle (slMFB) in MDD. Read More

Acta Neurochir Suppl 2018;129:43-52

Division of Neurosurgery, Padua City Hospital, Padova, Italy.

Intraoperative flowmetry (IF) has been recently introduced during cerebral aneurysm surgery in order to obtain a safer surgical exclusion of the aneurysm. This study evaluates the usefulness of IF during surgery for cerebral aneurysms and compares the results obtained in the joined surgical series of Verona and Padua to the more recent results obtained at the neurosurgical department of Verona.In the first surgical series, between 2001 and 2010, a total of 312 patients were submitted to IF during surgery for cerebral aneurysm at the neurosurgical departments of Verona and Padua: 162 patients presented with subarachnoid hemorrhage (SAH) whereas 150 patients harbored unruptured aneurysms. Read More

J Neurosurg Sci 2018 Aug 28. Epub 2018 Aug 28.

Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico "C. Besta", Milan, Italy.

Background: Decompression and, when necessary, neurolysis in entrapment neuropathies of upper limbs are effective and safe procedures, but their correlation with the variation of compound muscle action potentials (CMAPs) is still unclear, based in particular on experimental models. In addition, there are few data regarding the efficacy of intraoperative neurophysiologic monitoring (IOM) to predict clinical early and late outcome after surgery in term of pain control and sensitive/motor recovery. We report about the association between the intraoperative anatomical and neurophysiological findings and the mid- and long-term postoperative clinical course in a surgical series. Read More

World Neurosurg 2018 Dec 21;120:e259-e268. Epub 2018 Aug 21.

Neurosurgical Services, Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India; Homi Bhabha National University, Mumbai, India.

Background: Subcortical motor mapping is crucial to ensure preservation of motor tracts during resections of tumors. Continuous dynamic mapping using a modified monopolar suction probe is a novel and effective way of achieving this goal. We describe our experience using this technique. Read More

Curr Opin Anaesthesiol 2018 Dec;31(6):667-672

Department of Anesthesiology.

Purpose Of Review: Various neurologically focused monitoring modalities such as processed electroencephalography (pEEG), tissue/brain oxygenation monitors (SbO2), and even somatosensory evoked responses have been suggested as having the potential to improve the well tolerated and effective delivery of care in the setting of outpatient surgery. The present article will discuss the pros and cons of such monitors in this environment.

Recent Findings: There is a paucity of evidence from rigorous, well designed clinical trials demonstrating that the routine use of any neuromonitoring technique in an ambulatory surgery setting leads to meaningful cost savings or a reduction in morbidity or mortality. Read More

Spine Deform 2018 Sep - Oct;6(5):627-630

Department of Orthopedic Surgery, The Spine Hospital, Columbia University Medical Center, New York, NY, USA.

Background: Transcranial motor evoked potential (TcMEP) is widely used intraoperatively to monitor spinal cord and nerve root function. To our knowledge, there is no report regarding TcMEP signal loss purely caused by patient positioning during the spinal procedure.

Purpose: The objective of this article is to report an intraoperative TcMEP signal loss of a patient with fixed sagittal imbalance posture along with mild hip contractures. Read More

World Neurosurg 2018 Nov 16;119:e1052-e1059. Epub 2018 Aug 16.

Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan.

Objective: We investigated the relationship between the reliability of the transcranial or transcortical motor evoked potential (MEP) response and age in pediatric patients aged ≤15 years with brain tumor.

Methods: We retrospectively analyzed the data from 60 consecutive patients aged ≤15 years who had undergone brain tumor surgery that involved intraoperative MEP monitoring from October 2009 to May 2016.

Results: A total of 41 patients with reliable signals (MEP response group) and 19 patients without reliable signals (MEP nonresponse group) were included in the present study. Read More

J Shoulder Elbow Surg 2018 Oct 13;27(10):1845-1851. Epub 2018 Aug 13.

New England Baptist Hospital, Boston, MA, USA; Boston Sports and Shoulder Center, Waltham, MA, USA. Electronic address:

Hypothesis: Grammont-style reverse shoulder arthroplasty (RSA) has an increased risk of nerve injury compared with anatomic total shoulder arthroplasty (TSA) due to arm lengthening. We hypothesized that an RSA with a lateralized glenosphere and 135° neck-shaft angle would reduce humeral lengthening and decrease the risk of nerve injury to the level of a TSA.

Methods: The study prospectively enrolled 50 consecutive patients undergoing RSA (n = 30) or TSA (n = 20) as determined by a power analysis based on previous research for our institution. Read More

Spine (Phila Pa 1976) 2018 09;43(17):1231-1237

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Study Design: Retrospective study.

Objective: The goal of the study was to investigate the significance of a change in latency in monitoring of transcranial muscle-action potential (Tc-MsEP) waveforms.

Summary Of Background Data: Tc-MsEP has become a common approach in spine surgery due to its sensitivity and importance in motor function. Read More

World Neurosurg 2018 Dec 8;120:e169-e180. Epub 2018 Aug 8.

Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Objective: To evaluate the validity of intraoperative somatosensory-evoked potential (SSEP) and motor-evoked potential (MEP) monitoring according to 2 different warning criteria during 6 months from intramedullary spinal ependymoma surgery.

Methods: Twenty-six patients who underwent intramedullary spinal ependymoma surgery with intraoperative monitoring from January 2010 to June 2017 were retrospectively analyzed. We examined the sensitivity, specificity, positive predictable value, negative predictable value, and diagnostic odds ratio of SSEP and MEP monitoring for each extremity according to 2 warning criteria: 50% decline and all-or-none. Read More