Efficacy of intraoperative neurophysiological monitoring in detecting and preventing injury during high-risk brain aneurysm surgeries

Intraoperative neurophysiological monitoring (INM) is utilized during high-risk brain surgeries to provide the surgeon with insight into neurological status of the patient at various stages of the surgery. Presently, the two most successful methods to treat aneurysms are: (1) placement of detachable coil inside the aneurysm, and (2) clipping of aneurysm by craniotomy. We have clinically collected data of 28 patients undergoing the coiling procedure and data of additional 62 patients undergoing Craniotomies with the both groups under multi-modality INM. Our results showed that there was no significant change in the signals for 89.3% and 79% of patients undergoing coiling of aneurysm and craniotomies respectively. The surgeon was made aware of the neurological status throughout the surgery without the need for wake-up test. We conclude that multi-modality INM is extremely valuable in detecting neurological status of the patient and reduces the risk of intraoperative neurological injury and postoperative deficits. (Abstract shortened by UMI.)...