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2020, Number 2

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Rev Cubana Neurol Neurocir 2020; 10 (2)

Intraoperative neurophysiologic monitoring in a case of benign giant dorsal intraspinal schwannoma

Rojas MYF, Montoya PA, Cruz DUA, Aguilera CAB, Zaldívar SM, Domínguez JPA

Language: Spanish
References: 26
Page: 1-13
PDF size: 240.94 Kb.


ABSTRACT

Objective: To prove the efficacy of intraoperative neurophysiological monitoring to reduce the risk of neurological injury in surgery for benign dorsal intra-spinal schwannoma.
Clinical case: We report a case of a 16 years old female patient, with decreased strength in her lower limbs, as well as fasciculations of one month of evolution. A dorsal spinal tumor was determined. Surgical treatment of the lesion was performed, which was anatomopathological compatible with benign schwannoma. Intraoperative neurophysiological monitoring was used, by somatosensory evoked potentials recording of the posterior tibial nerve bilaterally, and a bilateral pre-surgical evaluation of the P40 component was performed. The tumor excision process was guided by the electrophysiological warning signs. Reversibility was achieved for the changes in the P40 component somatosensory evoked potential record of the bilateral posterior tibial nerve. The postoperative evolutionary records established the normality of the somatosensory evoked potential record values. The patient had a favorable clinical evolution. This is the first patient who underwent neurophysiological monitoring, specifically in pediatric neurosurgery, in Holguín province.
Conclusions: Intraoperative neurophysiological monitoring contributed to the subtotal excision of the intra-spinal tumor at the dorsal level; there were no intraoperative neurological complications. The patient evolved favorably after surgery.


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