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The Research of Cerebral Ischemia and the Tolerance in Evoked Potential Monitoring of Intracranial Aneurysm Surgery

Author: YaoPeiSen
Tutor: KangDeZhi
School: Fujian Medical
Course: Surgery
Keywords: Evoked potentials Intracranial aneurysms Ischemic tolerance ratio Wear -vessel Cerebral vasospasm
CLC: R743.3
Type: Master's thesis
Year: 2010
Downloads: 45
Quote: 0
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Abstract


Objective To explore the relationship between potential signal changes with cerebral ischemia and its tolerance of induced intracranial aneurysm surgery. 47 cases of intracranial aneurysm clipping in patients undergoing somatosensory evoked potential (SEP) and / or motor evoked potential (MEP) monitoring, intraoperative temporary occlusion of the parent artery wear vessel mistakenly folder or cerebrovascular the spasm evoked potentials to achieve early warning standard time and its reach warning standards continuing to lift caused by the time of the operation evoked potential changes, lifting related evoked potential recovery time, based on whether the new motor function of patients after damage determine whether the corresponding parts of (muscle strength decline) and / or CT examination after the emergence of fresh infarct caused new cerebral ischemic injury, and both correlation analysis. The results of surgery in 35 cases of SEP and MEP monitoring success, SEP monitoring a separate line in 10 cases, two cases MEP monitoring a separate line, after a total of 10 cases of fresh infarct and / or motor function impairment. Seven cases of ischemic changes within 24 hours, which CT 3 cases, six cases of ischemic changes, impaired motor function 24 hours after three cases of ischemic changes, including CT ischemic changes those two cases, impaired motor function. Significant SEP change surgery there are a total of 13 cases, including five cases of postoperative ischemic changes, the parent artery occlusion to induce ischemic tolerance than somatosensory evoked potentials (temporary occlusion reach warning criteria continued to temporary blocking the release time / temporary blocking to somatosensory evoked potentials to achieve early warning standards × 100%) more than 80% of all postoperative ischemic changes (4 cases), while less than 50% of patients (8 cases ischemic changes) were not, and one cases caused by perforating branches of vascular occlusion. Intraoperative MEP change eight cases of postoperative ischemic changes in four cases (including intraoperative SEP normal postoperative ischemic changes in 3 patients). Conclusion Intraoperative evoked potential changes in the degree of postoperative cerebral ischemia has a good correlation does not exist, due to individual differences, the safety of the blocking time limit, but in the somatosensory evoked potential monitoring of ischemic tolerance than has objective predictive value, the ischemic tolerance ratio remained below 50% can prevent postoperative brain ischemia incidence of ischemic tolerance ratio exceeds 80% will inevitably postoperative cerebral ischemia, while in monitoring due to wear vessel ischemic changes, MEP monitoring has a better advantage, the United SEP and MEP in intracranial aneurysms process is very important.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke)
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