Intraoperative Neuromonitoring

Intraoperative Neuromonitoring takes you step by step through the proper protocols for measuring and mapping neural function, emphasizing the correct application of intraoperative recordings for improved surgical outcomes. You will learn how to utilize the very latest neuromonitoring tools, and familiarize yourself with the full range of topics pertaining to intraoperative monitoring in neurosurgery. The authors also present both common and lesser-known techniques for neural assessment, resulting in a stand-alone reference that helps you master any type of neuromonitoring for virtually every kind of procedure. The most complete, expert-authored intraoperative neuromonitoring resource, addressing the most current topics, tools, and techniques to enhance your skills. Logical five-part organization clearly explains must-know topics such as neuromonitoring during cerebrovascular surgery, mapping cerebral and brainstem function, neuromonitoring in spinal surgery peripheral nerve procedures, and more.

Intraoperative Neurophysiologic Monitoring, Second Edition, contains chapters related to the monitoring of the spinal motor system and deep brain stimulation have been added. The anatomical and physiological basis for these techniques are described in detail as are the practical aspects of such monitoring. Chapters on monitoring of sensory systems and monitoring in skull base surgery have been re-written as has the chapter on monitoring of peripheral nerves.

The third edition of this classic text again provides practical, comprehensive coverage of the anatomical and physiological basis for intraoperative neurophysiological monitoring. Written by a leading authority in the field, Dr. Aage Moller has updated this important title to again offer all the leading-edge knowledge needed to perform electrophysiological recordings in the operating room, to interpret the results, and to present the results to the surgeon. The field known as "intraoperative monitoring" has expanded rapidly to cover other uses of neurophysiology and electrophysiologic recordings during surgical operations that affect the brain, spinal cord, and other parts of the nervous system. These new areas are covered in this new edition. To better represent the content of the book and the field as it now stands, many of the chapters have been revised and new material has been added. While the general organization of the book is maintained, chapters such as monitoring of motor systems have been revised and extended with new material, including more detailed description of the anatomy and physiology of motor systems and new information about intraoperative monitoring.

Interoperative Monitoring, Volume 186 provides a concise overview of advances in interoperative monitoring targeted for clinical neurologists. It identifies techniques (EEG, ECoG, EMG, etc.), optimal anesthesia for use, safety issues to be considered, and then discusses advances as they relate to intracranial, spinal, peripheral nerve and vascular surgery. Best practices and case studies are included for all chapters as well as surgical microscope views, illustrations, and medical imaging. Identifies the best techniques for specific surgeries with details that include case studies Covers intracranial, spinal, peripheral nerve and vascular surgeries Specifies optimal anesthesia for use Addresses safety issues to be considered Utilizes surgical microscope views, illustrations and medical imaging

Thorough understanding of electricity, electronics, biophysics, neurophysiology, and neuroanatomy renders more tractable otherwise complex electrophysiologically-based targeting. The textbook integrates these subjects in a single resource. Ultimately, electrophysiological monitoring required controlling the movement of electrons in electronic circuits. Thus, the textbook begins with fundamental discussions of electrons, the forces moving electrons, and the electrical circuits controlling these forces. The forces that allow recording and analysis also permeate the environment producing interference, such as noise and artifact. The textbook discusses noise and artifact and the measures to avoid or suppress them. The textbook discusses interpretive principles and methods for translating electrophysiological information collected along a trajectory into an understanding of the trajectory's functional-anatomical location, as well as its optimal location and direction. Forms included allow one to document observations, consult algorithms, and interpret data. Other discussions cover safe brain stimulation, correct interpretation of patient responses, procedures of targeted neurological examinations to assess patients' condition in response to stimulation and any surgical consequences, various aspects and limitations of image-based surgical planning, and principles governing use of electrode-guiding mechanical devices.

Intraoperative neurophysiological monitoring (IONM) has gained increasing interest during the past decades and is now an integral part of various surgical disciplines, especially in neurosurgery, but also in otolaryngology, orthopedics, vascular surgery and general surgery. With expanding applications and evolving techniques, the monitoring team is faced with increasingly complex tasks and responsibilities. Despite its importance and significance in modern surgical medicine and the expectations associated with it, IONM is still not a regular part of the training program of medical professionals. Although knowledge on monitoring is imparted in basic courses offered by a few professional societies, systematic training of medical and non-medical staff according to a standardized curriculum is still lacking.This book aims to contribute to closing this gap. It provides a practical guide to help medical, nursing, and technical personnel get familiar with intraoperative neuromonitoring. The basic tenor is to combine theoretical and practical knowledge and thus to systematically convey essential skills about fundamentals, possibilities, but also limitations of IONM to a broad circle of readers. In order to achieve this goal, the text has been reduced to the absolutely necessary length in favor of numerous illustrations and tables. After an introduction to the tasks, the significance, and the historical development of IONM, the anatomical, physiological and physical basics are presented. This is followed by a presentation of various modalities as well as stimulation and recording techniques. The intraoperative part begins with some information on the organizational processes in the operating room, the presentation of safety aspects, and a description of the influences of anesthesia on monitoring, including the special aspects of awake surgery. This is followed by some basic remarks on the interpretation of monitoring results and a rough overview of the application fields of IONM in various disciplines including representative case examples. The manual concludes with an evaluation of the efficiency of monitoring and practical recommendations for the detection and elimination of intraoperative sources of error. Self-tests in individual chapters are intended to give readers the opportunity to determine their level of knowledge.

Intra-operative neuromonitoring (IONM) refers to a diverse and evolving collection of techniques used to provide real-time assurance of neurological integrity during surgery. Most frequently utilised during neurosurgical procedures, the use of IONM has increased dramatically over recent years, and there is an ongoing need for structured and accessible information in its principles, implementation and interpretation. This dynamic book provides a practical overview of IONM, in simple language and clearly illustrated. Uniquely, it is authored by experienced multidisciplinary clinicians affiliated to Kingâ (TM)s College Hospital NHS Foundation Trust, a regional neurosciences centre in London, UK. Combining the expertise of anaesthetists, physiologists, surgeons and patients themselves, this guide represents an invaluable source of information for all staff and trainees involved in the pre-, intra- and postoperative care of patients undergoing IONM.