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Neurosurgery

  • Situation

    In nearly all neurological procedures, such as at the base of the skull or in the brainstem neural structures are at risk. Motor and sensory nerves, but also cerebral structures of the brain can be injured during neurosurgery. In order to enable the best possible observation of the endangered structures multimodal neuromonitoring methods are preferred and often used.

     

  • EMG

    Motor nerves can be monitored using EMG techniques. Electrical stimulation is done with hand-held stimulation probes directly in the surgical site. The emerging motor unit action potentials (MUAP) are recorded in the innervated target muscles and processed by the neuromonitor.

     

  • ABR

    During operations on the ear and at the acoustic nerve the ABR measurement (auditory brainstem response) helps the surgeon in detecting malfunctions. Thereby, defined "click" sounds are applied to the patients through earphones. The emerging action potentials can be recorded on from the skull with needle electrodes. ABR measurements allow a conclusion about the functionality of both the auditory nerve (nervus acusticus) and the brainstem.

     

  • SEP

    An important method that can be used to monitor the brainstem, is the recording of somatosensory evoked potentials (SEP) from the scalp after transcutaneous electrical stimulation of median (upper extremity) or tibial nerve (lower extremity).

     

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