Neurophysiology in neurosurgery : a modern approach

645 Pages·2020·28.556 MB·English

by  Vedran Deletis (editor), Jay L. Shils (editor), Kathleen Seidel (editor), Francesco Sala (editor)

NEUROPHYSIOLOGY IN NEUROSURGERY
SECOND EDITION
https://www.elsevier.com/books-and-journals/book-companion/9780128150009/
Neurophysiology in Neurosurgery
Vedran Deletis, Jay L. Shils, Francesco Sala, Kathleen Seidel, Editors
Resources available:
Chapter 2 - Intraoperative neurophysiology and methodologies used to monitor the functional integrity of the motor system (Video 2.1)
Chapter 9 - Cortical and subcortical brain mapping (Videos 9.1, 9.2)
Chapter 12 - Neurophysiological identification of long sensory and motor tracts within the spinal cord (Videos 12.1, 12.2, 12.3)
Chapter 15 - Intraoperative monitoring of the vagus and laryngeal nerves with the laryngeal adductor reflex (Videos 15.1, 15,2)
Chapter 16 - Bringing the masseter reflex into the operating room (Video 16.1)
Chapter 24 - Surgery of the face (Video 24.1)
Chapter 29 - Neurophysiological monitoring during endovascular procedures on the spine and the spinal cord (Video 29.1)
Chapter 34 - Neurophysiological monitoring during neurosurgery for movement disorders (Video 34.1)
Chapter 36 - Deep brain stimulation for treatment patients in vegetative state and minimally conscious state (Videos 36.1, 36.2, 36.3,
36.4, 36.5)
Chapter 37 - Neuromonitoring for spinal cord stimulation placement under general anesthesia (Videos 37.1, 37.2)
NEUROPHYSIOLOGY IN
NEUROSURGERY
A Modern Approach
SECOND EDITION
Edited by
V D
EDRAN ELETIS
DepartmentofNeurosurgery,UniversityHospitalDubrava,Zagreb,Croatia
AlbertEinsteinCollegeofMedicine,NewYork,NY,UnitedStates
J L. S
AY HILS
DepartmentofAnesthesiology,RushUniversityMedicalCenter,Chicago,IL,UnitedStates
F S
RANCESCO ALA
SectionofNeurosurgery,DepartmentofNeurosciences,BiomedicineandMovementSciences,UniversityHospital,Verona,Italy
K S
ATHLEEN EIDEL
DepartmentofNeurosurgery,InselspitalBernUniversityHospital,Bern,Switzerland
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Dedication
This book is dedicated to two extraordinary men, Vahe Amassian and Fred Epstein. Both of these extraordi-
nary individuals changed our professional lives and made a significant impact on the fields of intraoperative
neurophysiology and neurosurgery.
Vahe was French-born neurophysiologist, from Armenian parents, educated in the United Kingdom, where he
made part of his professional carrier as a neurophysiologist, and later on moved to the United States where he
continued to work with great success and achievement. Vahe’s work on the physiology of the nervous system
describing D and I waves of corticospinal neurons [1] was the basis for the development of present methodolo-
gies for intraoperative monitoring of motor-evoked potentials. Vahe was actively involved throughout the devel-
opment of this methodology. Vahe generously shared his enormous intellectual talent and his vast knowledge.
Vahe was always an inspiration for us and our colleagues. Vahe was the quintessential great teacher and mentor
youremember for life.
Fred was larger than life. Growing up he battled with circumstances that made every academic achievement a
hard-earned victory. He beat that, and went on to reach further. Having become an accomplished and leading
pediatric neurosurgeon, he developed pioneering surgeries in the brainstem and spinal cord. In doing this he
realized the potential of intraoperative neurophysiology. Thus he was a very early advocate of the utilization of
intraoperative neurophysiologic techniques to make complex operations in critical areas safer, better, and possi-
bleat all. Asa world-renowned neurosurgeon he said, “Monitoring is themostinteresting thing we do here!”
Fred had an amazing ability to see forest, when most of us only saw trees. And that applied to his vision of
intraoperative neurophysiology. Following this vision he was instrumental in many of intraoperative neurophy-
siology’sdevelopments and this bookis testament to thefact that he was right.
Vedran Deletis and Karl Kothbauer
Reference
[1] Patton HD, Amassian VE. Single and multiple unit analysis of the cortical state of pyramidal tract activation. J Neurophysiol
1954;17:345(cid:1)63.
Contents
List of contributors xiii 3.2 History 35
Preface xvii 3.3 Methodology 35
3.4 Warningcriteria 45
Intraoperative neurophysiological
3.5 Corticalsomatosensoryevokedpotentialmapping 47
monitoring—why we need it and a personal
3.6 Futuredirections 48
perspective of its development xix
3.7 Conclusion 48
JOHANNESSCHRAMMANDAZIZEBOSTRO¨M References 49
I
4. Neurophysiology of the visual system: basics
INTRODUCTION TO and intraoperative neurophysiology techniques 53
INTRAOPERATIVE KUNIHIKOKODAMAANDTETSUYAGOTO
NEUROPHYSIOLOGY 4.1 Introduction 53
4.2 Historicalreview 53
4.3 Neurophysiologyofthevisualpathway 54
1. Animal and human motor system 4.4 Recordingofintraoperativeflashvisualevokedpotentials 55
4.5 Results 58
neurophysiology related to intraoperative
4.6 Opticnerveactionpotentialsandevokedpotentials 62
monitoring 3
4.7 Monitoringandmappingtheposteriorvisualpathway 63
VAHEE.AMASSIAN 4.8 Conclusion 64
References 64
1.1 Introduction 3
1.2 Corticospinalresponses 4
1.3 Muscleresponses 12 5. Neurophysiology of the auditory system:
References 14 basics and ION techniques 65
AAGER.MØLLER
2. Intraoperative neurophysiology and
methodologies used to monitor the functional 5.1 Theauditorynerve 65
5.2 Historyofrecordingsoftheauditorybrainstemresponse 65
integrity of the motor system 17
5.3 Generationoffar-field-evokedpotentials 67
VEDRANDELETIS 5.4 Intraoperativeneurophysiologicalmonitoringofthe
auditorybrainstemresponse 67
2.1 Intraoperativemonitoringofthemotorsystem:abrief
5.5 Detectionofsignsofhearinglossfrommanipulations
history 17
oftheauditorynerve 72
2.2 Newmethodologies 19
5.6 Recordingdirectlyfromtheexposedauditorynerve 72
2.3 Methodologicalaspectsoftranscranialelectrical
5.7 Recordingoftheresponsefromthecochlearnucleus 73
stimulationduringgeneralanesthesia 19
5.8 Whattoreporttothesurgeon? 75
2.4 RecordingofMEPsoverthespinalcord(epiduraland
5.9 Theneuralgeneratorsoftheauditorybrainstemresponse 77
subduralspaces)usingsingle-pulsestimulation
5.10 Useofauditorybrainstemresponseinmonitoringto
technique 22
detectchangesinthefunctionofthebrainstem 82
2.5 Recordingofmotor-evokedpotentialsinlimbmuscles
References 84
elicitedbyamultipulsestimulatingtechnique 27
2.6 Conclusion 32
References 33 6. Intraoperative neurophysiological monitoring
of the sacral nervous system 87
3. Monitoring somatosensory evoked potentials 35
DAVIDB.VODUSˇEKANDVEDRANDELETIS
DAVIDB.MACDONALD
6.1 Introduction 87
3.1 Introduction 35 6.2 Functionalanatomy 88
vii
viii
Contents
6.3 Clinicalneurophysiologicaltestsindiagnostics 89 10. Corticobulbar motor evoked potentials in
6.4 Intraoperativeclinicalneurophysiology 90 skull base surgery 137
6.5 DiscussionandConclusion 96
ISABELFERNA´NDEZ-CONEJERO
References 98
Furtherreading 99
10.1 Introduction 137
10.2 Methodology 139
7. Neurophysiology of language and cognitive 10.3 Anesthesiaregime 141
10.4 Facialcorticobulbarmotorevokedpotentials 141
mapping 101
10.5 Vagalcorticobulbarmotorevokedpotentials 144
LORENZOBELLO,MARCOROSSI,MARCOCONTINIBALI, 10.6 Limitationsofcorticobulbarmotorevokedpotentials 147
TOMMASOSCIORTINO,GUGLIELMOPUGLISI,ANTONELLALEONETTI, 10.7 Conclusion 148
LUCAFORNIA,LORENZOGAYANDMARCORIVA
References 148
7.1 Introduction 101
7.2 Languagemapping 102
11. Brain stem mapping 151
7.3 Advancedmapping:cognitivemapping 109
7.4 Conclusion 109 NOBUHITOMOROTA,VEDRANDELETISANDFREDEPSTEIN
References 110
11.1 Introduction 151
11.2 Methodologyofbrainstemmapping 154
8. Effects of subthreshold stimuli on the 11.3 Resultsofbrainstemmapping 155
excitability of axonal membrane 113 11.4 Surgicalimplicationsofbrainstemmapping 158
11.5 Clinicallimitationsofbrainstemmapping 158
JAVIERURRIZA 11.6 Representativecaseofbrainstemmapping 158
11.7 Clinicalapplicationofbrainstemmapping 159
8.1 Introduction 113
11.8 Conclusion 161
8.2 Methodology 113
References 161
8.3 Results 115
8.4 Discussion 115
8.5 Conclusion 116 12. Neurophysiological identification of long
References 117
sensory and motor tracts within the spinal cord 163
II VEDRANDELETISANDKATHLEENSEIDEL
12.1 Introduction 163
INTRAOPERATIVE
12.2 Dorsalcolumnmapping 163
NEUROPHYSIOLOGY: 12.3 Corticospinaltractmapping 167
NEUROPHYSIOLOGIC 12.4 Conclusion 174
References 174
PERSPECTIVE
13. Electromyographic monitoring for pedicle
screw placements 177
9. Cortical and subcortical brain mapping 121
RICHARDJ.TOLEIKIS
KATHLEENSEIDELANDANDREASRAABE
13.1 Introduction 177
9.1 Introduction 121
13.2 Monitoringpediclescrewplacements 178
9.2 Brainmappingandanesthesia 121
13.3 Conclusion 189
9.3 Recordinganddocumentation 122
References 190
9.4 Physicalbackground 124
9.5 Choiceofstimulationparadigm 124
9.6 Choiceofstimulationprobe 126 14. Clinical and neurophysiologic features of the pure
9.7 Subcorticalmappinganddistancetothecorticospinal
motor deficit syndrome caused by selective upper
tract 126
motor neuron lesion: contribution to a new
9.8 Continuoussubcorticalmapping 128
9.9 Possiblepitfalls 130 neurological entity 195
9.10 Caseillustrations 131
BEATRIZARRANZARRANZ
9.11 Summaryandconclusion 131
Acknowledgment 132 14.1 Introduction 195
References 132 14.2 Underlyingpathologyofpuremotordeficit 195
ix
Contents
14.3 Diagnosis 196 18.5 Physiologyandelectromyographiccharacteristicsof
14.4 Methodologies 199 posteriorroot-musclereflexes 242
14.5 Topographyofthecorticospinaltractand 18.6 Examplesofintraoperativemonitoringapplications 247
corticobulbartractlesionsproducingpuremotordeficit 199 18.7 Conclusion 250
14.6 Prognosis 203 References 251
14.7 Conclusion 204
IV
References 204
Furtherreading 204
INTRAOPERATIVE
III NEUROPHYSIOLOGY: SURGICAL
PERSPECTIVE
NEUROPHYSIOLOGY OF BRAINSTEM
AND SPINAL CORD REFLEXES
19. Functional approach to brain tumor surgery:
awake setting 257
15. Intraoperative monitoring of the vagus and
LORENZOBELLO,MARCOROSSI,MARCOCONTINIBALI,
laryngeal nerves with the laryngeal adductor
TOMMASOSCIORTINO,MARCORIVAANDFEDERICOPESSINA
reflex 209
19.1 Introduction 257
MARIAJ.TE´LLEZ,SEDATULKATANANDCATHERINEF.SINCLAIR 19.2 Rationaleofsurgicaltreatment 257
19.3 Theconceptoffunctionalneuro-oncology:resection
15.1 Introduction 209
accordingtofunctionalboundaries 257
15.2 History 210
19.4 Preoperativeworkup 258
15.3 Methodology 212
19.5 Decisionforsurgery 261
15.4 Examples 218
19.6 Intraoperativesetup 261
15.5 Conclusion 220
19.7 Surgicaltime 263
References 220
19.8 Howtomanageintraoperativecomplications 265
19.9 Functionalresultsofsurgery 266
16. Bringing the masseter reflex into the
19.10 Conclusion 266
operating room 223
References 266
MARIAJ.TE´LLEZANDSEDATULKATAN Furtherreading 269
16.1 Introduction 223
20. Surgery of brain tumors asleep 271
16.2 History 223
16.3 Methodology 224 DAVIDEGIAMPICCOLO,CRISTIANOPARISI,
16.4 Examples 227 VINCENZOTRAMONTANOANDFRANCESCOSALA
16.5 Conclusion 227
20.1 Introduction 271
References 227
20.2 Corticalmapping 272
20.3 Monitoring 275
17. Blink reflex 229
20.4 Subcorticalmapping 276
ISABELFERNA´NDEZ-CONEJEROANDVEDRANDELETIS 20.5 Conclusion 280
References 280
17.1 Introduction 229
17.2 Methodology 230
17.3 Anestheticconsiderations 231 21. Surgery and intraoperative neurophysiological
17.4 Clinicalassessment/results 231 monitoring for aneurysm clipping 283
17.5 Practicalapplications 231
ANDREASZELE´NYIANDGEORGNEULOH
17.6 Summary 236
References 237 21.1 Introduction 283
21.2 Somatosensory-evokedpotentials 283
18. The posterior root-muscle reflex 239 21.3 Motor-evokedpotentials 284
21.4 Earlyauditory-evokedpotentials 285
KARENMINASSIAN,BRIGITTAFREUNDLAND
21.5 Visual-evokedpotentials 286
URSULAS.HOFSTOETTER
21.6 Generalremarksforsafetyconsiderationsand
18.1 Introduction 239 anesthesia 287
18.2 History 239 21.7 IntraoperativeNeuromonitoring(ION)andsurgical
18.3 Anatomyoftheposteriorroots 240 workflow 287
18.4 Methodologiesforevokingposteriorroot-muscle 21.8 Surgicalaspectsincerebrovascularsurgery 288
reflexes 241 21.9 Vascularterritoriesandrecommendedrecordings 288