Neuromonitoring employs various electrophysiologic modalities, such as extracellular single unit and local field recordings, SSEP, transcranial electrical motor evoked potentials (TCeMEP), EEG, EMG, and auditory brainstem response (ABR). For a given surgery, the set of modalities used depends in part on which neural structures are at risk. Transcranial Doppler imaging (TCDI) is also becoming more widely used to detect vascular emboli. TCDI can be used in tandem with EEG during vascular surgery.<unk>  techniques have significantly reduced the rates of morbidity and mortality without introducing additional risks. By doing so,<unk>  techniques reduce health care costs. To accomplish these objectives, a member of the surgical team with special training in neurophysiology obtains and co-interprets triggered and spontaneous electrophysiologic signals from the patient periodically or continuously throughout the course of the operation. Patients who benefit from neuromonitoring are those undergoing operations involving the nervous system or which pose risk to its anatomic or physiologic integrity. In general, a trained neurophysiologist attaches a computer system to the patient using stimulating and recording electrodes. Interactive software running on the system carries out two tasks: # selective activation of stimulating electrodes with appropriate timing, and # processing and displaying of the electrophysiologic signals as they are picked up by the recording electrodes. The neurophysiologist can thus observe and document the electrophysiologic signals in realtime in the operating area during the surgery. The signals change according to various factors, including anesthesia, tissue temperature, surgical stage, and tissue stresses. Various factors exert their influence on the signals with various tissue-dependent timecourses. Differentiating the signal changes along these lineswith particular attention paid to stressesis the joint task of the surgical triad: surgeon, anesthesiologist, and neurophysiologist.
Intraoperative neurophysiological monitoring
Non-invasive measurement of intracranial pressure
Neuromuscular monitoring
Cortical stimulation mapping
Microcurrent electrical neuromuscular stimulator
Intracranial pressure monitoring
Stent-electrode recording array
Clinical neurophysiology