Loss of Motor Evoked Potentials Due to Carotid Artery Retraction in an Exoscopic Clipping of a Basilar Tip Aneurysm. (1st October 2020)

• Record Type: Journal Article
• Authors: Silverstein, Justin W.; Ellis, Jason A.; Langer, David J.
• Is Part Of: Neurodiagnostic journal. Volume 60:Number 4(2020)
• Page Start: 289
• Page End: 299
• Publication Date: 2020-10-01
• Subjects: Aneurysm clipping -- craniotomy -- direct cortical stimulation -- evoked potentials -- neuromonitoring, transcranial motor; Neurologic examination -- Periodicals; Nervous system -- Diseases -- Diagnosis -- Periodicals; Diagnostic Techniques, Neurological -- Periodicals; Nervous system -- Diseases -- Diagnosis; Neurologic examination; Periodicals; 616.7407547
• DOI: 10.1080/21646821.2020.1810520
• Languages: English
• ISSNs: 2164-6821

Abstract

ABSTRACT: The internal carotid artery (ICA) may inhibit visualization of a basilar tip aneurysm during an orbitozygomatic craniotomy. Retraction of the ICA may be warranted for better visualization; however, it may lead to impending neurological sequelae. Impending neurological injury due to ICA retraction may be mitigated if multi-modal neuromonitoring techniques are employed. The authors present a case report showing the contemporaneous loss of transcranial motor evoked potentials and direct cortical motor evoked potentials during an exoscopic clipping of a basilar tip aneurysm due to ICA retraction and subsequent loss of perfusion to the vascular territory supplied by ICA. The motor evoked potentials immediately returned after retraction was removed and the patient awoke neurologically intact.