Intraoperative neuromonitoring as real-time diagnostic for cerebral ischemia in endovascular treatment of ruptured brain aneurysms

•Significant intraoperative neuromonitoring changes can predict new neurological deficits after endovascular treatment of ruptured aneurysms.•Intraoperative neurophysiological monitoring (IONM) (intraoperative neurophysiological monitoring) changes can detect postprocedural neurological deficits (PP...

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Bibliographic Details
Published in:Clinical neurophysiology 2024-05, Vol.161, p.69-79
Main Authors: Al-Qudah, Abdullah M., Thirumala, Parthasarathy D., Anetakis, Katherine M., Crammond, Donald J., Algarni, Saleh A., AlMajali, Mohammad, Shandal, Varun, Gross, Bradley A., Lang, Michael, Bhatt, Nirav R., Al-Bayati, Alhamza R., Nogueira, Raul G., Balzer, Jeffrey R.
Format: Article
Language:English
Subjects:
EEG
Endovascular surgery
Intracranial
Intraoperative Neurophysiologic monitoring
Ruptured Aneurysm
SSEP
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Summary:•Significant intraoperative neuromonitoring changes can predict new neurological deficits after endovascular treatment of ruptured aneurysms.•Intraoperative neurophysiological monitoring (IONM) (intraoperative neurophysiological monitoring) changes can detect postprocedural neurological deficits (PPND) (postprocedural neurological deficit) with sensitivity up to 47.8% and specificity up to 98.9%.•Periprocedural complications and IONM changes are associated with 6 and 20 folds, respectively, increase in risk of PPND. To evaluate the diagnostic accuracy of intraoperative neurophysiological monitoring (IONM) during endovascular treatment (EVT) of ruptured intracranial aneurysms (rIA). IONM and clinical data from 323 patients who underwent EVT for rIA from 2014-2019 were retrospectively reviewed. Significant IONM changes and outcomes were evaluated based on visual review of data and clinical documentation. Of the 323 patients undergoing EVT, significant IONM changes were noted in 30 patients (9.29%) and 46 (14.24%) experienced postprocedural neurological deficits (PPND). 22 out of 30 (73.33%) patients who had significant IONM changes experienced PPND. Univariable analysis showed changes in somatosensory evoked potential (SSEP) and electroencephalogram (EEG) were associated with PPND (p-values:
ISSN:1388-2457
1872-8952
DOI:10.1016/j.clinph.2024.02.024