12/19/2023 0 Comments Brainlab airo ucla![]() ![]() The neurophysiologist locates and monitors SSEPs in the brain to help the surgeon avoid the sensory processing regions.ĭuring surgery, MEPs are monitored to protect the brain regions that control a patient’s ability to move (motor function).Īn MEP is the electrical activity in muscles that results from applying small electrical currents to motor regions of the brain. Like a touch stimulus, this initiates subsequent electrical activity in the corresponding areas of the patient’s brain. Throughout the surgery, the neurophysiologist applies small electrical pulses to specific sensory nerves that carry information from the body to the brain. Neurophysiologists can identify critical brain regions based on the precise pattern of electrical activity recorded. ![]() For example, a touch stimulus (like from a pin prick or puff of air on the finger) will evoke measurable voltage peaks at precise times in the brain regions responsible for body sensation, including a voltage peak in the somatosensory cortex at 60 milliseconds after the stimuli, and another voltage peak in the parietal cortex at 100 milliseconds after the stimuli. ![]() SSEPs have a characteristic electrical pattern that is reliably identified across different parts of the brain. Somatosensory Evoked Potentials (SEPs or SSEPs)ĭuring surgery, SSEPs are monitored to protect the brain regions that control a patient’s sense of touch.Īn SSEP is the electrical activity in the brain that results from sensory stimulation on the body. Depending on the location of the tumor and the specific brain regions at risk, different combinations of the following techniques may be used: This helps the surgeon remove as much of the tumor as possible, while protecting important function in the neighboring tissue. Intraoperative neuromonitoring uses a variety of methods to locate and monitor specific brain regions and nerves. This process is called intraoperative neuromonitoring (also called intraoperative neurophysiological monitoring, or IONM). With all these advantages, neuronavigation systems are used for most neurosurgical procedures.ĭuring an operation, a neurophysiologist monitors electrical signals in the patient’s brain, cranial nerves, and spinal cord to make the tumor removal as safe as possible. Specifically, it allows for accurate localization of the tumor, and enhances the extent of tumor removal this both improves safety for the patient and improves their outcomes with greater tumor resection. This process, called “functional neuro-navigation”, reduces the risk of postoperative neurologic deficits and improves assessment of risk beforehand. Surgeons combine “functional” and anatomic information obtained from preoperative imaging with neuronavigation to help find the safest route. In addition, the shortest and safest route can be selected that avoids important neural and vascular structures. As a result, mistakes in trajectory and depth during tumor resection are prevented. Using neuronavigation systems, surgeries can be simulated and planned ahead of time, allowing for maximum accuracy. During the operation, the surgeon knows where the surgical instrument (magenta) is relative to the corticospinal tracts, and can more easily avoid the region to preserve motor function. Diffusion tensor imaging, taken prior to the surgery, allows identification of the corticospinal tracts (orange outlines), which is merged into the live neuronavigation image. By overlaying these images, neuronavigation provides a more detailed, live map for surgeons to make visually guided movements.Īn example of a neuronavigation image, taken during a biopsy procedure for brainstem glioma. Intraoperative imaging during the surgery shows where the surgeon’s instruments or probes are within the patient’s brain, in addition to certain neural and vascular structures. The preoperative scans are useful for visualizing anatomical landmarks in the brain, as well as the location and extent of the tumor. To create a custom “map” for each patient’s brain, these systems use scans collected from the patient before surgery (like high resolution MRI). It is like having a GPS or Google Maps for a neurosurgeon to navigate their patient’s brain. ![]() Neuronavigation systems are computer-assisted technologies that provide neurosurgeons with better visual feedback during surgery. ![]()
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