Neuromonitoring From Neurosurgical Point Of View, A Case Series

Abstract

Background: Intraoperative neurophysiological monitoring (IONM) involves the use of various techniques to monitor the functional integrity of the eloquent cortex, cranial nerves, and spinal cord during surgery. The primary goal is to reduce the risk of neurological deficits post-surgery by providing real-time feedback to the surgical team. The aim of this case series is to ensure that all young neurosurgeons understand the principles of neuromonitoring. This will enable them to effectively collaborate with neurophysiologists and maximize the benefits of IONM. Case Presentation: 1: 53-year-old male with a left temporal lesion where the left was the dominant hemisphere, so the awake craniotomy technique was operated. IONM was used to identify the speech area intraoperatively, safe resection was achieved, and postoperatively the patient was Fc and intact. 2: 58-year-old male with CPA left vestibular schwannoma diagnosed, operated on for resection by retrosigmoid approach with the use of IONM to identify the cranial nerves and preserve them; postoperatively, the tumor was resected safely with preservation of the integrity of the cranial nerves. 3: A 42-year-old female with a right high parietal lesion found compressing the motor area; resection with usage of IONM direct cortical stimulation and subcortical stimulation and by strip to know the site of the central gyrus; postoperatively, the patient clinically improved, and radiologically, there was no residual tumor. 4: 12-year-old male with scoliosis, correction done with MEP, SEP, and pedicle proximity modalities used postoperatively; the patient was intact. 5: 32-year-old male with epileptic focus; intraoperative EEG helped us to identify the active focus. In the follow-up for this patient, he was seizure-free. Conclusion: IONM will be highly effective and efficient when utilized with knowledge of its proper use and when to use it. This proficiency will substantially improve patient outcomes and prevent undesirable complications.