处理后的脑电图在前循环动脉瘤手术中的临时夹应用中可以用作脑缺血监测仪吗?

IF 0.2 Q4 ANESTHESIOLOGY
R. Mariappan, S. Krothapalli, Bijesh Nair, Benjamin F. Alexander
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引用次数: 0

摘要

接受脑动脉瘤夹闭术的患者有发生脑缺血的风险。缺血耐受性因个体而异。因此,多模式术中神经监测(IONM)是必不可少的。IONM在许多中心都不可用。本病例报告强调了在临时剪辑应用过程中使用处理脑电图(EEG)作为脑缺血监测仪。我们的病人接受了前交通动脉瘤破裂的夹闭术。在右侧和左侧的临时夹敷后,A1动脉段导致体感诱发电位(SSEP)的短暂下降。同时,经额叶四通道处理的脑电呈现突发抑制(BS)模式。血压升高和移除临时夹有助于将SSEP恢复到基线,并使处理后的EEG中的BS模式消失。在麻醉稳定状态下,在排除了BS的其他潜在原因后,处理后的脑电图中突然出现BS模式可归因于剪辑诱导的脑缺血。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can the Processed EEG Be Utilized as a Cerebral Ischemia Monitor during the Temporary Clip Application in Anterior Circulation Aneurysm Surgery?
Patients undergoing cerebral aneurysm clipping are at risk for cerebral ischemia. Ischemic tolerance varies among individuals. Hence, multimodal intraoperative neuromonitoring (IONM) is essential. IONM is not available in many centers. This case report highlights the utilization of processed electroencephalography (EEG) as a cerebral ischemia monitor during temporary clip application. Our patient underwent clipping of a ruptured anterior-communicating artery aneurysm. After the temporary clip applications on the right and left, A1 arterial segments led to a transient drop of somatosensory evoked potentials (SSEPs). At the same time, the frontal four-channel processed EEG showed a burst suppression (BS) pattern. Blood pressure augmentation and the removal of temporary clips helped restore the SSEP back to baseline and the disappearance of the BS pattern in processed EEG. During the steady state of anesthesia, the sudden appearance of the BS pattern in processed EEG can be attributed to clip-induced cerebral ischemia after ruling out other potential causes for BS.
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来源期刊
Journal of Neuroanaesthesiology and Critical Care
Journal of Neuroanaesthesiology and Critical Care Medicine-Critical Care and Intensive Care Medicine
CiteScore
0.50
自引率
0.00%
发文量
29
审稿时长
15 weeks
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