Intraoperative Neuromonitoring : Fundamentals, Possibilities, Limitations

• Autore: Zentner Josef
• Pubblicazione: Cham : , : Springer International Publishing AG, , 2024; ©2024
• Edizione: 1st ed.
• Descrizione fisica: 1 online resource (251 pages)
• Disciplina: 617.919
• Altri autori: MacDonaldDavid B WegnerCeline
• Nota di contenuto: Intro -- Preface -- Contents -- Editors and Contributors -- Editors -- Contributors -- Figures and Illustrations -- List of Figures -- List of Tables -- 1: Introduction -- 1.1 Why Neuromonitoring? -- 1.2 Historical Aspects -- 1.3 Monitoring Concept -- 1.4 Monitoring Team -- 2: Anatomical and Physiological Basics -- 2.1 Positional and Directional Designations -- 2.2 The Nervous System -- 2.2.1 The Nerve Cell (Neuron) -- 2.2.2 Signal Conduction and Transmission -- 2.2.2.1 Axon and Synapse -- 2.2.2.2 Action Potential -- 2.2.3 Central Nervous System -- 2.2.3.1 Brain -- 2.2.3.2 Blood Supply and Venous Drainage of the Brain -- 2.2.3.3 Spinal Cord -- 2.2.3.4 Blood Supply and Venous Drainage of the Spinal Cord -- 2.2.4 Peripheral Nervous System -- 2.2.5 Somatic/Voluntary Nervous System -- 2.2.5.1 The Motor System -- 2.2.5.2 The Sensory System -- 2.2.6 Vegetative/Autonomic Nervous System -- 2.2.6.1 The Sympathetic System -- 2.2.6.2 The Parasympathetic System -- 2.3 The Musculoskeletal System -- 2.4 Test Questions -- 3: Technical Basics -- 3.1 Physical Parameters -- 3.1.1 Electrical Current -- 3.1.2 Electrical Voltage -- 3.1.3 Electrical Resistance -- 3.1.4 Electrical Impedance -- 3.1.5 Ohm's Law -- 3.1.6 Electrical Charge -- 3.1.7 Electrical Energy -- 3.1.8 Electrical Current Density -- 3.2 Stimulation -- 3.2.1 Type of Pulses -- 3.2.2 Frequency -- 3.2.3 Stimulators -- 3.3 Signal Acquisition -- 3.3.1 Amplifier Technique -- 3.3.2 Signal Processing -- 3.3.3 Disturbance Variables -- 3.4 Test Questions -- References -- 4: Technical Accessories -- 4.1 Stimulation and Recording Electrodes -- 4.1.1 Stimulation Probes -- 4.1.2 Needle Electrodes -- 4.1.2.1 Insulated Needle Electrodes -- 4.1.2.2 Corkscrew Electrodes -- 4.1.2.3 Double Needle Electrodes -- 4.1.2.4 Hook Electrodes -- 4.1.2.5 Bipolar Needle Electrodes. ; 4.1.2.6 Hookwire Electrodes -- 4.1.3 Surface Electrodes -- 4.1.3.1 Strip and Grid Electrodes -- 4.1.3.2 Adhesive Electrodes -- 4.1.3.3 Rectal Electrodes -- 4.2 Special Accessories -- 4.2.1 Visual Evoked Potentials (VEPs) -- 4.2.2 Auditory Evoked Potentials (AEPs) -- 4.2.3 Spinal Recordings -- 4.2.4 Monitoring of the Vagus Nerve -- 4.2.5 Diagnostics -- References -- 5: Modalities and Methods of Intraoperative Neuromonitoring -- 5.1 Electroencephalography (EEG) -- 5.1.1 The 10-20 Electrode System -- 5.1.2 Cortical Sources -- 5.1.3 Intraoperative EEG Recordings and Analysis -- 5.2 Electromyography (EMG) -- 5.2.1 Continuous (Free-Running) EMG -- 5.2.2 Compound Muscle Action Potential (CMAP) -- 5.3 Electroneurography -- 5.3.1 Motor Neurography -- 5.3.2 Sensory Neurography -- 5.4 Evoked Potentials (EPs) -- 5.4.1 Somatosensory Evoked Potentials (SEPs) -- 5.4.1.1 Median Nerve SEPs -- 5.4.1.2 Tibial Nerve SEPs -- 5.4.1.3 Trigeminal Nerve SEPs -- 5.4.1.4 Pudendal Nerve SEPs -- 5.4.2 Motor Evoked Potentials (MEPs) -- 5.4.2.1 Transcranial Stimulation and Recording -- 5.4.2.2 Corticobulbar MEPs -- 5.4.2.3 Cortical Stimulation and Recording -- 5.4.3 Auditory Evoked Potentials (AEPs) -- 5.4.3.1 Brainstem Auditory Evoked Potentials (BAEPs) -- 5.4.3.2 Electrocochleography (ECochG) -- 5.4.3.3 Compound Nerve Action Potentials (CNAPs) -- 5.4.4 Visual Evoked Potentials (VEPs) -- 5.5 Functional Topographic Mapping -- 5.5.1 Central Sulcus -- 5.5.2 Motor Cortex Mapping -- 5.5.3 Subcortical Corticospinal Tract Mapping -- 5.5.4 Language -- 5.5.5 Spinal Cord Mapping -- 5.5.5.1 Dorsal Column Mapping -- Spinal Cord Recording -- Spinal Cord Stimulation -- Peripheral Nerve Recording -- Scalp Recording -- 5.5.5.2 Corticospinal Tract Mapping -- Combined Transcranial and Spinal Cord Stimulation -- Spinal Cord Stimulation. ; Peripheral Nerve Recording -- Muscle Recording After Single-Train Stimulation -- Muscle Recording After Double-Train Stimulation -- 5.5.5.3 Conclusion -- 5.6 Cranial Nerves -- 5.7 Spinal Nerves -- 5.7.1 Implantation of Pedicle Screws -- 5.8 Reflexes -- 5.8.1 Blink Reflex -- 5.8.2 Bulbocavernosus Reflex -- 5.8.3 Motor Reflexes -- 5.9 Autonomic Nervous System -- 5.10 Test Questions -- References -- 6: Perioperative Management -- 6.1 Patient Preparation -- 6.1.1 Positioning the Electrodes -- 6.1.2 Securing the Electrodes -- 6.1.3 Labeling the Electrodes -- 6.1.4 Connecting the Electrodes -- 6.2 System Preparation -- 6.2.1 Starting the Device -- 6.2.2 Starting the Software -- 6.2.3 Entering the Patient Data -- 6.2.4 Selecting the Program -- 6.2.5 Measuring the Impedance -- 6.2.6 Checking the Parameters -- 6.2.7 Checking and Setting the Artifact Threshold -- 6.3 General Conduct Rules in the Operating Room (OR) -- 6.3.1 Entering the OR -- 6.3.2 Staying in the OR -- 6.3.3 Leaving the OR -- 6.4 Measurement Processes -- 6.4.1 Comparing Results with Preoperative Neurological Status -- 6.4.2 Checking the Current Flow -- 6.4.3 Communicating with the Anesthesia Team -- 6.4.4 Resetting the Baseline -- 6.4.5 Completing the Measurement Process -- 6.4.6 Shutting Down the System -- 6.4.7 Removing the Electrodes -- 6.4.8 Cleaning and Checking the Connection Cables, Adapter Boxes, and Reusable Accessories -- 6.4.9 Documenting the Data -- 7: Anesthesia and IONM -- 7.1 Effect of Anesthetics on the Nervous System -- 7.2 Effects of Anesthetics on Electrophysiology -- 7.2.1 Electroencephalogram -- 7.2.2 Somatosensory Evoked Potentials -- 7.2.3 Motor Evoked Potentials -- 7.2.4 Brainstem Auditory Evoked Potentials -- 7.2.5 Visual Evoked Potentials -- 7.3 Awake Craniotomy -- 7.3.1 Patient Selection and Preparation. ; 7.3.2 Patient Positioning and Monitoring -- 7.3.3 Scalp Nerve Blocks -- 7.3.4 Anesthetic Technique -- 7.3.5 Mapping -- 7.3.6 Evidence, Benefits, and Complications -- 7.3.7 Summary -- 7.4 Test Questions -- References -- 8: Application of Intraoperative Neuromonitoring -- 8.1 Interpretation of the Potential Findings -- 8.2 IONM in Neurosurgery -- 8.2.1 Brain Tumors -- 8.2.2 Vascular Diseases -- 8.2.3 Skull Base Surgery -- 8.2.4 Spinal Neurosurgery -- 8.3 IONM in Orthopedic Surgery -- 8.4 IONM in Vascular Surgery -- 8.5 IONM in General Surgery -- 8.5.1 Thyroid Surgery -- 8.5.2 Colorectal Surgery -- 8.6 IONM in Otolaryngology -- References -- 9: Efficiency and Safety of Intraoperative Neuromonitoring -- 9.1 Introduction -- 9.2 Electrical Safety -- 9.2.1 Electric Shock -- 9.2.1.1 Ventricular Fibrillation -- 9.2.1.2 Leakage Currents -- 9.2.1.3 Means of Protection Against Electric Shock -- 9.2.2 Hazardous Stimulator Output -- 9.2.2.1 Stimulus Parameters -- 9.2.2.2 Strength-Duration and Injury Mechanisms -- 9.2.2.3 Means of Protection Against Thermal Injury -- 9.2.2.4 Means of Protection Against Excitotoxicity -- 9.2.2.5 Means of Protection Against Electrochemical Toxicity -- 9.2.3 Electrode Burns -- 9.2.3.1 Stray Electrosurgery Current Burns -- 9.2.3.2 Means of Protection Against Stray Electrosurgery Current Burns -- 9.2.3.3 Means of Protection Against Magnetic Resonance Imaging Burns -- 9.2.3.4 Means of Protection Against Direct Current Burns -- 9.2.4 Fire -- 9.3 Procedure-Specific Safety -- 9.3.1 Invasive Electrodes -- 9.3.2 Direct Cortical Stimulation -- 9.3.3 Direct Subcortical Stimulation -- 9.3.4 Transcranial Electric Stimulation -- 9.3.5 Other Procedures -- 9.4 Infection Control -- 9.4.1 Standard Precautions -- 9.4.2 Needlestick -- 9.4.3 Additional Precautions -- 9.5 Essential Performance. ; 9.5.1 Neuromonitoring Devices -- 9.5.2 Neuromonitoring Practice -- 9.6 Conclusion -- 9.7 Test Questions -- References -- 10: Troubleshooting -- 10.1 The Impedance of the Electrodes Is Too High -- 10.2 There Is No Current Flow -- 10.3 There Is No Response Signal Recordable -- 10.4 The Response Signal Is Very Noisy -- 10.5 The Response Signal Is Very Small -- 10.6 The Response Signal Is Incompletely Displayed -- 10.7 The Stimulation Cannot Be Triggered in the Software -- Glossary.
• Titolo autorizzato: Intraoperative Neuromonitoring
• ISBN: 3-031-46125-8
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Lingua di pubblicazione: Inglese
• Record Nr.: 9910864183903321
• Lo trovi qui: Univ. Federico II