神经电生理监测颅内动脉瘤介入治疗

目的 探讨神经电生理技术在颅内动脉瘤介入治疗中的应用价值.方法 对22例颅内动脉瘤患者在介入治疗过程中实施术中神经电生理监测,在术中按动脉瘤部位监测体感诱发电位(SSEP)、脑干听觉诱发电位(BAEP)、视觉诱发电位(VEP),观察术中监测的变化对颅内动脉瘤介入治疗的指导作用.结果 术后恢复良好20例,短暂性偏瘫1例,永久性偏瘫1例,其中SSEP变化8例,BAEP变化1例,VEP变化1例.其中8例在神经电生理监测下发现不同原因导致的脑组织缺血,及时采取相应措施,避免严重医源性神经功能损伤;2例在神经电生理监测指导下改变治疗方案,降低原治疗方案风险;1例通过术中神经电生理监测对患者条件进行重新评估,避免了放弃介入治疗方案,使介入治疗取得成功.结论 神经电生理监测对颅内动脉瘤介入治疗有显著的指导意义,具有重要的应用价值.可最大限度地减少动脉瘤介入治疗过程中的缺血性并发症,提高手术的安全性.

Abstract：

Objective To study the application of neuroelectrophysiological monitoring for interventional therapy of intracranial aneurysms. Methods 22 patients with intracranial aneurysm were received neuroelectrophysiological monitoring during interventional therapy. Somatosensory evoked potential(SSEP) 、brainstem auditory evoked potential (BAEP) and visual evoked potential(VEP) were monitored during operation according to the position of intracranial aneurysm. Results 20 patients recovered well after operation. Temporary and hemiplegia were observed in 1 patient respectively. SSEP changes were observed in 8 patients, BAEP change in 1, and VEP change in 1. Cerebral ischemia was detected in 8 patients by neuroelectrophysiological monitoring and patients were given adequate management immediately. The therapeutic schedule of 2 patients were changed during neuroelectrophysiological monitoring in order to decrease the risk. 1 patient was evaluated again during neuroelectrophysiological monitoring so that the original interventional therapy schedule was not given up. Conclusion Neuroelectrophysiological monitoring is significantly important during interventional therapy of intracranial aneurysm, which could reduce the risk of cerebral ischemia and enhance treatment security.

Interventional therapy for intracranial aneurysms under neuroelectrophysiological monitoring

Objective To study the application of neuroelectrophysiological monitoring for interventional therapy of intracranial aneurysms. Methods 22 patients with intracranial aneurysm were received neuroelectrophysiological monitoring during interventional therapy. Somatosensory evoked potential(SSEP) 、brainstem auditory evoked potential (BAEP) and visual evoked potential(VEP) were monitored during operation according to the position of intracranial aneurysm. Results 20 patients recovered well after operation. Temporary and hemiplegia were observed in 1 patient respectively. SSEP changes were observed in 8 patients, BAEP change in 1, and VEP change in 1. Cerebral ischemia was detected in 8 patients by neuroelectrophysiological monitoring and patients were given adequate management immediately. The therapeutic schedule of 2 patients were changed during neuroelectrophysiological monitoring in order to decrease the risk. 1 patient was evaluated again during neuroelectrophysiological monitoring so that the original interventional therapy schedule was not given up. Conclusion Neuroelectrophysiological monitoring is significantly important during interventional therapy of intracranial aneurysm, which could reduce the risk of cerebral ischemia and enhance treatment security.