ABSTRACT
Se realiza una revisión y actualización de la monitorización intraoperatoria del nervio facial (MINF). Su utilización aconsejable, en aquellos procesos quirúrgicos que puedan originar riesgo de lesión el nervio facial. La MINF es una técnica fácil de usar y que no solo ayuda a disminuir el riesgo de lesionar el nervio, sino que además evita responsabilidades legales. Evidentemente debe de ir asociada al buen conocimiento anatómico del nervio facial junto a un buen juicio clínico y quirúrgico del cirujano. El personal que controla la monitorización es preciso que mantenga una estrecha colaboración con el cirujano y anestesista y tenga una buena formación neurofisiológica (AU)
Subject(s)
Adolescent , Adult , Female , Male , Middle Aged , Humans , Facial Nerve/surgery , Facial Nerve/pathology , Monitoring, Intraoperative/methods , Monitoring, Intraoperative , Therapeutic Irrigation/methods , Facial Paralysis/complications , Facial Paralysis/diagnosis , Neuromuscular Depolarizing Agents/therapeutic use , Ear, Middle/surgery , Ear, Middle/pathology , Skull Base/surgery , Skull Base/pathology , Monitoring, Intraoperative/classification , Monitoring, Intraoperative/instrumentationABSTRACT
Patients harboring intracranial aneurysms may experience secondary brain injury around the time of aneurysm repair, either from the repair process itself or secondary to altered cerebral vascular physiology following subarachnoid hemorrhage. Management of patients with aneurysms includes strategies to avoid or minimize secondary brain injury. Various technologies have been employed to monitor patients undergoing treatment for cerebral aneurysms to detect and treat causes of secondary ischemic damage. These methods include monitoring for cerebral ischemia and monitoring of electrophysiologic function of the brain. This article discusses noninvasive techniques which have been employed to monitor cerebral function in aneurysm patients.
Subject(s)
Brain , Intracranial Aneurysm/diagnosis , Monitoring, Intraoperative/methods , Subarachnoid Hemorrhage/diagnosis , Brain/blood supply , Brain/diagnostic imaging , Brain/physiopathology , Cerebrovascular Circulation/physiology , Electroencephalography/methods , Evoked Potentials/physiology , Humans , Intracranial Aneurysm/physiopathology , Intracranial Aneurysm/surgery , Intracranial Embolism and Thrombosis/diagnosis , Intracranial Embolism and Thrombosis/physiopathology , Ischemic Attack, Transient/diagnosis , Ischemic Attack, Transient/etiology , Ischemic Attack, Transient/physiopathology , Monitoring, Intraoperative/classification , Oximetry/methods , Point-of-Care Systems , Spectroscopy, Near-Infrared/methods , Subarachnoid Hemorrhage/complications , Subarachnoid Hemorrhage/physiopathology , Subarachnoid Hemorrhage/surgery , Tomography, Emission-Computed , Tomography, Emission-Computed, Single-Photon/methods , Tomography, X-Ray Computed/methods , Ultrasonography, Doppler, Transcranial/methods , Xenon , Xenon RadioisotopesABSTRACT
Progress in quantifying states of cerebral function and in the further development of automated EEG processing demands the application of suitable methods for the reduction of neurophysiological multi-channel data as well as their automatic classification. The method used here for reducing multi-channel data was to gain distributions of parametric descriptors from EEG data from computer-aided topographic electroencephalometry (CATEEM), for example the relative and absolute band power in the frequency bands delta, theta, alpha 1, alpha 2, beta 1, beta 2, total power, median and mode frequency, and other parameters. These values were subjected to cluster analysis. The classification of EEG parameters was carried out by means of discrimination analysis and neural networks. The practicability of both procedures was demonstrated in the reduction and classification of EEG data in the context of a normed study involving 104 healthy adults. These data have been used as the basis for a new evaluation study of 60 additional intraoperative EEG recordings obtained with CATEEM. In that newly started study, the effects of sedative and anaesthetic drugs on EEG behavior and psychophysiologic behavior remain to be investigated.
Subject(s)
Brain/physiology , Electroencephalography/classification , Signal Processing, Computer-Assisted , Adult , Aged , Alpha Rhythm/classification , Alpha Rhythm/drug effects , Alpha Rhythm/statistics & numerical data , Anesthetics/administration & dosage , Beta Rhythm/classification , Beta Rhythm/drug effects , Beta Rhythm/statistics & numerical data , Brain/anatomy & histology , Brain/drug effects , Cluster Analysis , Delta Rhythm/classification , Delta Rhythm/drug effects , Delta Rhythm/statistics & numerical data , Discriminant Analysis , Electroencephalography/drug effects , Electroencephalography/statistics & numerical data , Evaluation Studies as Topic , Humans , Hypnotics and Sedatives/administration & dosage , Middle Aged , Monitoring, Intraoperative/classification , Monitoring, Intraoperative/statistics & numerical data , Neural Networks, Computer , Neurophysiology , Psychophysiology , Theta Rhythm/classification , Theta Rhythm/drug effects , Theta Rhythm/statistics & numerical dataABSTRACT
Over the past decade the application of neurophysiologic monitoring techniques has been a major factor in decreasing the incidence of neurologic dysfunction following orthopedic, vascular, and neurosurgical operations. This article focuses on the common neurophysiologic monitoring modalities and their basic intraoperative applications.
