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  • Title: [Cortical mapping and neurophysiological monitoring during resection of an arteriovenous malformation in the rolandic region].
    Author: Vega-Zelaya L, Pedrosa-Sánchez M, Pastor J.
    Journal: Rev Neurol; 2014 Jul 01; 59(1):20-4. PubMed ID: 24965927.
    Abstract:
    INTRODUCTION. Surgery of arteriovenous malformations of eloquent areas has a significant risk of causing severe neurological deficits. CASE REPORT. A 39 years old woman having a headache, showed an arteriovenous malformation in right rolandic region. During resection, performed under general anesthesia, a neurophysiological mapping and subsequently intraoperative neurophysiological monitoring of motor and somatosensory functions was performed. The temporary closure of an artery resulted in a severe motor impairment, reversible after remove the clipping, so that artery had to be respected during the intervention. After resection, the motor and sensory responses were normal. The patient was discharged without any neurological deficits. CONCLUSION. Functional mapping and intraoperative neurophysiological monitoring were very helpful for the identification and protection of eloquent areas. The use of these techniques for resection of arteriovenous malformations located in functionally relevant areas, allows a safely surgery in patients under general anesthesia. TITLE: Mapeo cortical y monitorizacion neurofisiologica durante la reseccion de una malformacion arteriovenosa en la region rolandica. UNLABELLED: Introduccion. La cirugia de las malformaciones arteriovenosas de zonas elocuentes tiene un riesgo importante de producir deficits neurologicos graves. Caso clinico. Mujer de 39 años con cefalea que presentaba una malformacion arteriovenosa en la region rolandica derecha. Durante la reseccion, realizada bajo anestesia general, se realizo un mapeo neurofisiologico y, posteriormente, monitorizacion neurofisiologica intraoperatoria de las funciones motora y somatosensorial. El cierre transitorio de una arteria daba lugar a una alteracion motora grave, reversible al quitar el clipaje, por lo que hubo de respetarse durante la intervencion. Tras la reseccion, las respuestas motora y sensorial fueron normales. La paciente fue dada de alta sin ningun deficit neurologico. Conclusion. El mapeo funcional y la monitorizacion neurofisiologica intraoperatoria resultaron de gran ayuda para la identificacion y proteccion de las areas elocuentes. Debe tenerse en cuenta la utilizacion de estas tecnicas durante la reseccion de malformaciones arteriovenosas situadas en areas funcionalmente relevantes, que pueden ser realizadas con seguridad en pacientes con anestesia general.
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