Median nerve somatosensory evoked potential alarm related to head and neck positioning for carotid surgery.
Carotid pseudoaneurysm
Carotid surgery
Neck rotation
SEP
Somatosensory evoked potentials
Journal
Journal of clinical monitoring and computing
ISSN: 1573-2614
Titre abrégé: J Clin Monit Comput
Pays: Netherlands
ID NLM: 9806357
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
received:
09
03
2022
accepted:
27
07
2022
medline:
4
4
2023
pubmed:
13
8
2022
entrez:
12
8
2022
Statut:
ppublish
Résumé
Head positioning in carotid surgery represents an often overlooked but sensitive period in the surgical plan. A 53-year-old male presented a significant decrement in median nerve somatosensory evoked potential (mSEP) following head and neck positioning for carotid pseudoaneurysm repair before skin incision.Neurophysiological monitoring was performed with mSEP and electroencephalography early during the patient's preparation and surgery. Within five minutes after rotation and extension of the head to properly expose the surgical field, the contralateral m-SEP significantly decreased in both cortical (N20/P25) and subcortical (P14/N18) components. Partial neck correction led to m-SEP improvement, allowing to proceed with the carotid repair. We discuss possible underlying pathophysiological mechanisms responsible for these changes and highlight the relevance of an early start on monitoring to avoid neurological deficits.
Identifiants
pubmed: 35960492
doi: 10.1007/s10877-022-00904-3
pii: 10.1007/s10877-022-00904-3
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
699-704Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature B.V.
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