Intraoperative Study On The Identification And Protection Of Lenticulostriate Artery Under Different Pathological Conditions By IONM

Objective: Benefit from the application of intraoperative neurop hysiological monitoring,this paper studies how to effectively identify and protect the lenticulostriate arteries in different pathological conditions,so as to avoid arterial injury and preserve the structural and functional integrity of nerve tissue,and reduce the occurrence of adverse complications.Methods: The clinical data of 49 patients who underwent surgery from December 2017 to January 2019 were included.Intraoperative neuro physiological monitoring,including MEP/SEP/EEG and other monito ring methods,were routinely used during the operation.According to the types of diseases,brain tumors,brain arteriovenous malformations and cerebrovascular diseases were analyzed.According to the preoperative imaging methods,the relationship between lenticulostriate artery and space occupying was preliminarily determined.Based on the anatomical basis of lenticulostriate artery,combined with the results of intraoperative electrophysiological monitoring,the intraoperative conditions and intervention measures under different pathological conditions were analyzed,summarized and evaluated.Results: During the treatment of 49 patients,abnormal electrop hysiological monitoring occurred in 22 cases,accounting for about 44.8%.Among them,15 cases reported abnormal MEP,the incidencerate was 68.1%,10 cases reported abnormal SEP,the incidence rate was 45.4%,9 cases reported abnormal SEP,the incidence rate was 40.1%.In the cases of abnormal changes in the results of electrophysiological monitoring,after intraoperative intervention and treat ment,a total of 12 patients with abnormal changes were reversed,the proportion was 45.5%.Among them,9 cases recovered after abn ormal MEP alarm,accounting for 69.2%,7 cases recovered after abnormal SEP alarm,accounting for 70%,8 cases recovered after abnormal EEG alarm,accounting for 88.9%.Among the 27 cases in which no electrophysiological abnormal alarm was found,there were 2 patients with new neurological dysfunction,with an incidence of about 7.4%.Conclusion: The microanatomy and imaging anatomy of lenticulostriate artery is still an unremitting field to be explored in cerebral neuroscience.The goal of neurosurgeons is to protect the integrity of blood vessels and avoid ischemic injury of brain tissue.In neurosurgery,the auxiliary application of electrophysiological monitoring technology combined with MEP/SEP/EEG has a certain clinical significance for effectively identifying and protecting lenticulostriate arteries in different pathological states.