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Brain and Spinal Cord Monitoring by Multispatial and Multimodal Evoked Potentials during Aortic Surgery

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Neurophysiology and Standards of Spinal Cord Monitoring

Summary

The most serious complications of aortic surgery are ischemic spinal cord and/or brain dysfunctions caused by an aortic clamp or emboli (15). As neurological signs and symptoms of ischemic lesions by aortic clamping are masked during anesthesia, an alternative measure should be undertaken for monitoring the brain and spinal cord functions. Although several neurophysiological techniques have been successfully used to detect early signs of CNS dysfunction due to carotid surgery (10, 17, 31, 34), there are some difficulties in monitoring CNS functions in aortic surgery. First, it is hard to define the anticipated sites of ischemia preoperatively, since there are considerable anatomical variations of arterial outflows to the spinal cord (7). Second, although the skin surface recording of spinal cord potential (SCP) has been attempted (32), it is often hard to reproduce the potential and also takes a considerable amount of time to average the response.

Therefore, we have developed a new method of monitoring the spinal cord and brain functions during aortic surgery. We report herein that multimodal and/or multispatial recordings of evoked potentials, using a specially designed epidural catheter electrode, might be of value for this purpose. A preliminary account has been made elsewhere (18,30).

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Authors and Affiliations

  1. Department of Anesthesiology, Niigata University School of Medicine, 1-757 Asahi-Machi, 951, Niigata, Japan

    Y. Maruyama

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  1. Y. Maruyama
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  2. K. Shimoji
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  3. H. Fujioka
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  4. T. Takada
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  5. H. Endoh
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Editors and Affiliations

  1. University of Maryland, Baltimore, MD, USA

    Thomas B. Ducker M.D., F.A.C.S. (Clinical Professor, Associate Professor) (Clinical Professor, Associate Professor)

  2. Johns Hopkins University, Baltimore, MD, USA

    Thomas B. Ducker M.D., F.A.C.S. (Clinical Professor, Associate Professor) (Clinical Professor, Associate Professor)

  3. Division of Surgical Research, St. Luke’s Spine Center, Cleveland, OH, USA

    Richard H. Brown Ph.D (Director, Research Director) (Director, Research Director)

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© 1988 Springer-Verlag New York Inc.

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Maruyama, Y., Shimoji, K., Fujioka, H., Takada, T., Endoh, H. (1988). Brain and Spinal Cord Monitoring by Multispatial and Multimodal Evoked Potentials during Aortic Surgery. In: Ducker, T.B., Brown, R.H. (eds) Neurophysiology and Standards of Spinal Cord Monitoring. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3804-1_22

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  • DOI: https://doi.org/10.1007/978-1-4612-3804-1_22

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-8359-1

  • Online ISBN: 978-1-4612-3804-1

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