4.4 Article

Prediction of postoperative motor deficits using intraoperative motor-evoked potentials in middle cerebral artery aneurysm

Journal

NEUROSURGICAL REVIEW
Volume 44, Issue 1, Pages 495-501

Publisher

SPRINGER
DOI: 10.1007/s10143-020-01235-0

Keywords

Intraoperative neurophysiological monitoring; Middle cerebral artery aneurysm; Motor-evoked potentials; Postoperative motor deficits

Funding

  1. Capital Foundation of Medical Development [2018-2-1075] Funding Source: Medline

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This study revealed a significant association between the duration of MEP changes and postoperative motor dysfunction in patients with middle cerebral artery aneurysms. It also proposed a critical cutoff value of 8.5 minutes for predicting the risk of postoperative motor dysfunction.
To explore the relationship between postoperative motor deficits and the duration of reduced motor-evoked potentials (MEPs) in patients with middle cerebral artery (MCA) aneurysm. This study included 285 cases of MCA aneurysm treated with clipping surgery with MEP monitoring. The effects of MEP changes on postoperative motor function were assessed, and the key time point for minimizing the incidence of postoperative motor dysfunction was found through receiver operating characteristic (ROC) curve analysis. Motor dysfunction was significantly associated with the occurrence of MEP changes, and patients with irreversible changes were more likely to suffer motor dysfunction than were those with reversible changes. The critical duration of MEP changes that minimized the risk of postoperative motor dysfunction was 8.5 min. This study revealed that MEP monitoring is an effective method for preventing ischemic brain injury during surgical treatment of MCA aneurysm and proposes a critical cutoff for the duration of MEP deterioration of 8.5 min for predicting postoperative motor dysfunction.

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