Intraoperative Monitoring of the Corticospinal Motor Evoked Potential (D-wave): Clinical Index for Postoperative Motor Function and Functional Recovery
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- YAMAMOTO Takamitsu
- Department of Neurological Surgery, Nihon University School of Medicine Division of Applied System Neuroscience, Nihon University School of Medicine
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- KATAYAMA Yoichi
- Department of Neurological Surgery, Nihon University School of Medicine Division of Applied System Neuroscience, Nihon University School of Medicine
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- NAGAOKA Takafumi
- Department of Neurological Surgery, Nihon University School of Medicine
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- KOBAYASHI Kazutaka
- Department of Neurological Surgery, Nihon University School of Medicine Division of Applied System Neuroscience, Nihon University School of Medicine
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- FUKAYA Chikashi
- Department of Neurological Surgery, Nihon University School of Medicine Division of Applied System Neuroscience, Nihon University School of Medicine
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Abstract
The corticospinal motor evoked potential was investigated as a monitoring index of motor function to perform maximal resection of brain tumors located around the motor cortex in 37 patients with glioma. Tumor resections were performed under general anesthesia with muscle relaxant and completely controlled ventilation. No special arrangements for anesthesia were required. Direct cortical stimulation revealed that if one electrode was placed on the posterior half of the precentral gyrus, the D-wave could be recorded even when using an electrode separation of 10 mm, and the amplitude was larger with anodic rather than cathodic stimulation. Monitoring of the D-wave enabled the function of the corticospinal tract to be evaluated selectively. Postoperative persistent motor disturbance remained in six patients who had a decrease of over 30% in amplitude of the D-wave during tumor resection. A decrease of less than 30% may indicate postoperative preservation of motor function, including transient motor disturbance with subsequent complete recovery. Intraoperative monitoring of the D-wave is suitable for open cranial surgery with general anesthesia, can detect the primary motor cortex, and allow maximal resection of brain tumors located around the motor cortex.<br>
Journal
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- Neurologia medico-chirurgica
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Neurologia medico-chirurgica 44 (4), 170-182, 2004
The Japan Neurosurgical Society
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Details 詳細情報について
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- CRID
- 1390282680026795520
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- NII Article ID
- 110002277193
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- NII Book ID
- AN00358613
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- COI
- 1:STN:280:DC%2BD2c3osFeqsw%3D%3D
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- ISSN
- 13498029
- 04708105
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- PubMed
- 15185755
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- Text Lang
- en
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- Data Source
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- JaLC
- Crossref
- PubMed
- CiNii Articles
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- Abstract License Flag
- Disallowed