Summary
This chapter describes general observations made and conclusions drawn regarding the prognostic value of intraoperative SSEP monitoring during tumor and brainstem surgery. Detailed analysis of the results of monitoring and neurological status evaluations of 97 patients suffering from tumors (cerebral hemisphere: N = 45; midline: N = 13; posterior fossa: N = 21; base of the skull: N = 6), or from cerebellar hemorrhage and infarction (N = 4), or undergoing functional neurosurgical procedures in the posterior fossa (N = 8) revealed recovery of central conduction time (CCT) at the end of surgery to be the most important prognostic factor for postoperative neurological status. Patients whose neurological status was the same as preoperatively (N = 79) did not show any significant change in CCT at the end of surgery compared with the CCT patterns after anesthesia induction. Patients whose neurological status deteriorated postoperatively (N = 18) showed significant CCT prolongation or even loss of the N20 component at the end of the procedure. When patients were grouped according to whether they had undergone infratentorial surgery, hemisphere tumor removal, or midline tumor removal, to determine if there were differences in CCT that were related to differences in lesion locations, the results were similar. Changes in amplitude of the N20 component also had prognostic value, but such changes were less significant because they were very variable and thus standard deviations were large.
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© 1991 Springer-Verlag Berlin Heidelberg
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Witzmann, A., Beran, H., Huber, A., Fischer, J. (1991). Somatosensory Evoked Potential Monitoring in Tumor and Brainstem Surgery. In: Schramm, J., Møller, A.R. (eds) Intraoperative Neurophysiologic Monitoring in Neurosurgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-75750-1_22
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DOI: https://doi.org/10.1007/978-3-642-75750-1_22
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