Neuroapraxia of Trigeminal Nerve Controlled by Neuromonitoring During Microvascular Decompression in Multiple Sclerosis Patients Affected by Drug-Resistant Trigeminal Neuralgia Recurrent After Previous Operations.

Background And Importance: Trigeminal neuralgia (TN) can complicate the clinical course of multiple sclerosis (MS) and can be very difficult to treat. Usually, these patients experience multiple recurrences after surgical procedures with a poor overall outcome. To the best of our knowledge, we report the first 3 cases of drug-resistant MS-related TN recurrent after previous operations in which intraoperative neuromonitoring controlled neuroapraxia of trigeminal nerve was performed.

Dural and cranial reconstruction techniques in retrosigmoid craniotomy: key factors associated with CSF leaks in 225 patients.

Objective: This study evaluated the effectiveness of various dural closure and bone reconstruction techniques in preventing CSF leakage following retrosigmoid craniotomy for cerebellopontine angle (CPA) tumors. The goal was to identify whether newer combinations of reconstructive materials offer any advantage in reducing CSF leaks and improving surgical outcomes.

Methods: The authors conducted a retrospective review of 225 patients who underwent a retrosigmoid craniotomy for CPA neoplasms between January 2018 and August 2024.

Abnormal electromyographical trigeminal activation through stimulation of the offending artery (Z-L response): An intraoperative tool during microvascular decompression for trigeminal neuralgia.

Background: There are currently no intraoperative neurophysiological tools to assess the effectiveness of trigeminal nerve decompression during microvascular decompression surgery for drug-resistant trigeminal neuralgia. In microvascular decompression surgery for hemifacial spasm, an abnormal electromyographic activation of facial muscles after stimulation of the offending vessel was identified and named 'Z-L response'.

Methods: We adapted a neurophysiological protocol to elicit a Z-L response during microvascular decompression surgery for trigeminal neuralgia and applied it to a prospective series of 18 surgical patients.

Optimizing surgical technique in microvascular decompression for hemifacial spasm - Results from a surgical series with contemporary use of neuronavigation and intraoperative neuromonitoring.

Background: Microvascular decompression (MVD) through a retrosigmoid approach is considered the treatment of choice in cases of hemifacial spasm (HFS) due to neurovascular conflict (NVC). Despite the widespread of neuronavigation and intraoperative neuromonitoring (IONM) techniques in neurosurgery, their contemporary application in MVD for HFS has been only anecdotally reported.

Methods: Here, we report the results of MVD performed with a combination of neuronavigation and IONM, including lateral spread response (LSR) in 20 HFS patients.

Unsatisfactory Neurological Outcome in an Intramedullary Thoracic Intermediate-Grade Melanocytoma-Systematic Review and Illustrative Case.

Background: Intramedullary melanocytomas are exceedingly rare, with only twenty-four cases reported up to now. They present as local invasive tumors despite their benign biological behavior. Attempting a complete safe resection often results in severe post-operative neurological deficits, as in our case presented here.

Stereoscopic Monitoring Technique for Motor Area Tumors.

Background: The balance between comprehensive intraoperative neurophysiological monitoring (IONM) for both upper and lower limbs while ensuring the reliability of motor evoked potentials (MEPs) is paramount in motor area surgery. It is commonly difficult to obtain good simultaneous stimulation of both upper and lower limbs. A series of factors can bias MEP accuracy, and inappropriate stimulation intensity can result in unreliable monitoring.

Embodimetrics: A Principal Component Analysis Study of the Combined Assessment of Cardiac, Cognitive and Mobility Parameters.

There is a growing body of literature investigating the relationship between the frequency domain analysis of heart rate variability (HRV) and cognitive Stroop task performance. We proposed a combined assessment integrating trunk mobility in 72 healthy women to investigate the relationship between cognitive, cardiac, and motor variables using principal component analysis (PCA). Additionally, we assessed changes in the relationships among these variables after a two-month intervention aimed at improving the perception-action link.

Methods and Principles of the Intraoperative Neurophysiologic Monitoring in Neurosurgery.

Intraoperative neurophysiologic monitoring (IONM) is an innovation introduced in neurosurgery in the past decades. It aims to support and guide the neurosurgeon to obtain the best surgical result possible, preventing the occurrence of neurological deficits. The somatosensory evoked potentials (SSEP) assess the integrity of the sensory pathways monitoring the dorsal column-medial lemniscus pathway during spine and cerebral surgery.

Predictive value of intraoperative vagus nerve corticobulbar motor evoked potentials to assess the risk of dysphagia in fourth ventricle surgery.

Objective: Dysphagia is a significant complication in fourth ventricle surgery. Corticobulbar motor evoked potentials (CB-MEPs) of the lower cranial nerves may provide real-time information possibly correlating with postoperative swallowing dysfunction, and the vagus nerves may prove ideal for this purpose. However, the literature is heterogeneous, non-systematic, and inconclusive on this topic.

Reliability of intraoperative visual evoked potentials (iVEPs) in monitoring visual function during endoscopic transsphenoidal surgery.

Objective: To refine a reliable and reproducible intraoperative visual evoked potentials (iVEPs) monitoring protocol during endoscopic transsphenoidal surgery. To assess the reliability of baseline iVEPs in predicting preoperative visual status and perioperative iVEP variation in predicting postoperative visual outcome.

Methods: Sixty-four patients harboring tumors of the pituitary region were included.

Has intraoperative neuromonitoring changed the surgery for unruptured middle cerebral artery aneurysms? A retrospective comparative study.

Intraoperative neurophysiological monitoring (IONM) represents one of the available technologies able to assess ischemia and aimed to improve surgical outcome reducing the treatment related morbidity in surgery for intracranial aneurysms. Many studies analyzing the impact of IONM are poised by the heterogeneity bias affecting the cohorts. We report our experience with IONM for surgery of unruptured middle cerebral artery (MCA) aneurysm in order to highlight its influence on functional and radiological outcome and surgical strategy.

A Study on the Role of Intraoperative Corticobulbar Motor Evoked Potentials for Improving Safety of Cerebellopontine Angle Surgery in Elderly Patients.

Preservation of facial nerve function (FNF) during neurosurgery for cerebellopontine angle (CPA) tumors is paramount in elderly patients. Corticobulbar facial motor evoked potentials (FMEPs) allow assessment intraoperatively of the functional integrity of facial motor pathways, thus improving safety. We aimed to evaluate the significance of intraoperative FMEPs in patients 65 years and older.

Tailored Approach and Multimodal Intraoperative Neuromonitoring in Cerebellopontine Angle Surgery.

The cerebellopontine angle (CPA) is a highly complex anatomical compartment consisting of numerous nervous and vascular structures that present mutual and intricate spatial relationships. CPA surgery represents, therefore, a constant challenge for neurosurgeons. Over the years, neurosurgeons have developed and refined several solutions with the aim of maximizing the surgical treatment effects while minimizing the invasiveness and risks for the patient.

Intraoperative Corticobulbar Motor Evoked Potential in Cerebellopontine Angle Surgery: A Clinically Meaningful Tool to Predict Early and Late Facial Nerve Recovery.

Background: Intraoperative neuromonitoring is crucial for facial nerve preservation in cerebellopontine angle (CPA) surgery. Among the available techniques, the role of intraoperative corticobulbar facial motor evoked potentials (FMEPs) is unclear.

Objective: To evaluate the significance of intraoperative FMEPs as indicators for early and late postoperative facial nerve function (FNF) in CPA tumor resection and the feasibility of their integration with standard monitoring techniques.

Bio-syngas production from agro-industrial biomass residues by steam gasification.

This study evaluated the steam gasification potential of three residues from Brazilian agro-industry by assessing their reaction kinetics and syngas production at temperatures from 650 to 850°C and a steam partial pressure range of 0.05 to 0.3bar.