caa a22 4500 606216820 CHVBK 20210128101105.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00701-015-2573-7 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2573-7 Poor diagnostic accuracy of transcranial motor and somatosensory evoked potential monitoring during brainstem cavernoma resection [Elektronische Daten] [Ehab Shiban, Marina Zerr, Thomas Huber, Tobias Boeck-Behrends, Maria Wostrack, Florian Ringel, Bernhard Meyer, Jens Lehmberg] Objective: Microsurgical resection of brainstem cavernomas carries a high risk of new postoperative morbidity such as cranial nerve, motor and sensory deficits as well as functional deterioration. Intraoperative monitoring is used to avoid impending damage to these highly eloquent tracts. However, data on neurophysiological monitoring during resection of brainstem cavernomas are lacking. Methods: Consecutive patients with brainstem cavernomas who underwent surgical removal from June 2007 to December 2014 were retrospectively analysed. Transcranial motor-evoked potential (MEP) and somatosensory-evoked potential (SSEP) monitorings were performed in all cases. The evoked potential (EP) monitoring data were reviewed and related to new postoperative motor and sensory deficits and postoperative imaging. Clinical outcomes were assessed during follow-up. Results: Twenty-six consecutive patients with brainstem cavernoma underwent 27 surgical resections within this study. MEP and SSEP monitoring was technically feasible in 26 and 27 cases, respectively. MEP sensitivity and specificity were 33 and 88%, respectively. MEP positive and negative predictive values were 28 and 78%, respectively. SSEP sensitivity and specificity were 20 and 81%, respectively. SSEP positive and negative predictive values were 20 and 81%, respectively. Conclusion: In continuous MEP and SSEP monitoring during brainstem cavernoma microsurgery, high rates of false-positive and -negative results are encountered, resulting in low positive and relatively high negative predictive values. Careful interpretation of the intraoperative monitoring results is essential in order to avoid potentially unjustified termination of brainstem cavernoma resection. Springer-Verlag Wien, 2015 Intraoperative neuromonitoring nationallicence Brainstem nationallicence Cavernoma nationallicence Predictive value nationallicence Surgery nationallicence Shiban Ehab Department of Neurosurgery, Technische Universität München, Munich, Germany aut Zerr Marina Department of Neurosurgery, Technische Universität München, Munich, Germany aut Huber Thomas Department of Radiology, Division of Neuroradiology, Technische Universität München, Munich, Germany aut Boeck-Behrends Tobias Department of Radiology, Division of Neuroradiology, Technische Universität München, Munich, Germany aut Wostrack Maria Department of Neurosurgery, Technische Universität München, Munich, Germany aut Ringel Florian Department of Neurosurgery, Technische Universität München, Munich, Germany aut Meyer Bernhard Department of Neurosurgery, Technische Universität München, Munich, Germany aut Lehmberg Jens Department of Neurosurgery, Technische Universität München, Munich, Germany aut Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 1963-1969 0001-6268 157:11<1963 2015 157 701 https://doi.org/10.1007/s00701-015-2573-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2573-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shiban Ehab Department of Neurosurgery, Technische Universität München, Munich, Germany aut NATIONALLICENCE 700 1- Zerr Marina Department of Neurosurgery, Technische Universität München, Munich, Germany aut NATIONALLICENCE 700 1- Huber Thomas Department of Radiology, Division of Neuroradiology, Technische Universität München, Munich, Germany aut NATIONALLICENCE 700 1- Boeck-Behrends Tobias Department of Radiology, Division of Neuroradiology, Technische Universität München, Munich, Germany aut NATIONALLICENCE 700 1- Wostrack Maria Department of Neurosurgery, Technische Universität München, Munich, Germany aut NATIONALLICENCE 700 1- Ringel Florian Department of Neurosurgery, Technische Universität München, Munich, Germany aut NATIONALLICENCE 700 1- Meyer Bernhard Department of Neurosurgery, Technische Universität München, Munich, Germany aut NATIONALLICENCE 700 1- Lehmberg Jens Department of Neurosurgery, Technische Universität München, Munich, Germany aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 1963-1969 0001-6268 157:11<1963 2015 157 701