Multilobar electrocorticography monitoring during intracranial aneurysm surgery

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Serval ID
serval:BIB_9BF2B6C660CA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Multilobar electrocorticography monitoring during intracranial aneurysm surgery
Journal
Neurocritical Care
Author(s)
Dehdashti  A. R., Pralong  E., Debatisse  D., Regli  L.
ISSN
1541-6933 (Print)
Publication state
Published
Issued date
2006
Volume
4
Number
3
Pages
215-22
Notes
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Abstract
INTRODUCTION: To detect a neuronal threshold of tolerance to ischemia, the usefulness of multilobar electrocorticography (mEcoG) during intracranial aneurysm surgery was compared to the scalp EEG and correlated with the postoperative neurological status and the radiological findings. METHODS: Twenty-one patients harboring intracranial aneurysms were monitored by simultaneous scalp EEG and lobe-dependent mEcoG during surgical clipping. The patients were divided into group A (6 patients with no temporary clipping) and group B (15 patients with temporary clipping). RESULTS: New focal modifications of the mEcoG signal with high frequency (HF)-beta3 and delta waves were observed in none of the patients in group A and all of the patients in group B. These anomalies were followed by focal burst suppression pattern in eight cases (53%) in group B. These changes were detected in only two cases (9%) on the scalp EEG. New corticographic changes resolved in eight patients (53%) in group B. Among the seven patients in group B who had persistent focal burst pattern after clip removal, six (85%) presented with new neurological deficit or new hypodensity on CT. The Glasgow Outcome Scale was good (IV or V) in 85% of cases. CONCLUSION: mEcoG is more sensitive than scalp EEG. The appearance and persistence of the focal burst suppression pattern shown on mEcoG, was associated with a new neurological deficit or new hypodensity, whereas HF-beta3 or delta waves per se were not associated with new changes. A better comprehension of these EEG anomalies could determine the duration of temporary clipping and consequently influence the surgical strategy.
Keywords
Adult Aged Electroencephalography/*methods Feasibility Studies Female Follow-Up Studies Humans Intracranial Aneurysm/*physiopathology/radiography/*surgery Male Middle Aged Monitoring, Intraoperative Neurologic Examination Sensitivity and Specificity Tomography, X-Ray Computed Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2008 14:10
Last modification date
01/10/2019 7:18
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