1/22/2015 1 Anesthesia and Intraoperative Neurological Monitoring David Ferson, M.D. Department of Anesthesiology Department of Neurosurgery M. D. Anderson Cancer Center Lecture Outline Neuroanatomy and neurophysiology Modern imaging and navigation techniques Anesthetic agents and their effects on neurological monitoring Future directions
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Anesthesia and Intraoperative Neurological Monitoring Part I/Ferson... · Neurological Monitoring David Ferson, M.D. Department of Anesthesiology Department of Neurosurgery M. D.
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1/22/2015
1
Anesthesia and Intraoperative
Neurological MonitoringDavid Ferson, M.D.
Department of AnesthesiologyDepartment of NeurosurgeryM. D. Anderson Cancer Center
Lecture Outline
� Neuroanatomy and neurophysiology
� Modern imaging and navigation techniques
� Anesthetic agents and their effects on neurological monitoring
� Future directions
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Modern Imaging - Tractography
Modern Imaging - Tractography
Preoperative Surgical Planning
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Constant current generator producing a train of square wave, biphasic pulses of 1 ms phase duration at frequency of 60 Hz.
Ojemann stimulator (bipolar electrode with 5mm spacing).
SSEPs and CMEPs
Upper extremity
Lower extremity
Intraoperative EP Monitoring Gold Standard for Functional Mapping
Childs Nerv Syst. 2002 Jul;18(6-7):264-87. Epub 2002 Jun 13.Intraoperative neurophysiological monitoring in pediatric neurosurgery: why, when, how?Sala F, Krzan MJ, Deletis V.
sensory
motor
Cortical Mapping
motor sensory
TIBIAL SSEP – KNEE STIMULATION
contact 1 contact 5
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motor sensory
TIBIAL SSEP – ANKLE STIMULATION
Childs Nerv Syst. 2002 Jul;18(6-7):264-87. Epub 2002 Jun 13.Intraoperative neurophysiological monitoring in pediatric neurosurgery: why, when, how?Sala F, Krzan MJ, Deletis V.