Table 2.
Profiles of 19 patients with intraoperative changes in MMEPs and postoperative motor deficits
| Age(yrs)/Sex | Side | Aneurysm location size (mm), shape | Operative method | Duration of MMEP loss | Cause of MMEP change | Postoperative paresis (MMT) | Ischemia on postoperative MRI | |
|---|---|---|---|---|---|---|---|---|
| 1. | 40/M | L | IC (C1) (32 mm, thrombosed) | Neck clipping after intra-aneurysmal thrombectomy with STA–MCA and ECA-RA graft-M2 bypass | Transient loss (33 min) | Temporary occlusion of ICA (30 min) | None | No lesion |
| 2. | 55/F | L | IC (C1) (40 mm, thrombosed) | Ttrapping after intra-aneurysmal transient losstemporary occlusion thrombectomy with STA–MCA and ECA-RA graft-M2 bypass | Transient loss (42 min) | Temporary occlusion of ICA (33 min) | None | No lesion |
| 3. | 58/F | L | IC (C2) (28 mm, saccular) | Neck clipping with STA–MCA bypass and suction decompression method and Dolenc's approach | Transient loss (15 min) | Temporary occlusion of ICA (9 min) | None | No lesion |
| 4. | 71/F | R | IC (C2) (28 mm, saccular) | Neck clipping with STA–MCA bypass and suction decompression method and Dolenc's approach | Transient loss (18 min) | Temporary occlusion of ICA (8 min) | None | No lesion |
| 5. | 64/F | L | IC (C2) (25 mm, saccular) | Neck clipping with STA–MCA bypass and suction decompression method (Dolenc's approach) | Transient loss (13 min) | Temporary occlusion of ICA (10 min) | None | No lesion |
| 6. | 77/F | L | IC (C2) (25 mm, saccular) | Neck clipping with STA–MCA bypass and suction decompression method (Dolenc's approach) | Transient loss (18 min) | Temporary occlusion of ICA (12 min) | Transient paresis (2/5) | Internal capsule (AchA) |
| 7. | 71/M | L | IC top (15 mm, saccular) | Neck clipping | Transient loss (12 min) | Temporary occlusion of ICA (7 min) | Transient paresis (3/5) | Basal ganglia (LSA) |
| 8. | 68/M | R | IC (C1) (16 mm, saccular) | Neck clipping with STA–MCA bypass and suction decompression | Transient loss (11 min) | Temporary occlusion of ICA (8 min) | Transient paresis (2/5) | Internal capsule (AchA) |
| 9. | 48/M | R | IC (C1) (30 mm, saccular) | Neck clipping | Permanent loss | Clipping | Permanent paresis (2/5) | Internal capsule (AchA) |
| 10 | 75/F | R | IC (C2) (28 mm, saccular) | Neck clipping with STA–MCA, ECA-RA-M2 bypass and suction decompression method | Transient loss (11 min) | Temporary occlusion of ICA (8 min) | None | No lesion |
| 11. | 64/F | R | IC (C1) (30 mm, thrombosed) | Removal of the aneurysm (trapping) with STA–MCA, ECA-RA-M2, STA–STA graft-AchA, and A1-sup.thyroid A graft-M1 bypass | Permanent loss | Trapping of aneurysm | Permanent paresis (1/5) | Basal ganglia (LSA) |
| 12. | 69/M | R | IC-PC (C1) (15 mm, saccular) | Neck clipping | Permanent loss | Temporary occlusion for a long time (38 min) during management of aneurysmal rupture | Permanent paresis (2/5) | Internal capsule (AchA) |
| 13. | 74/F | L | MCA (16 mm, saccular) | Neck clipping | Transient loss (5 min) | Temporary occlusion of MCA (4.5 min) | None | No lesion |
| 14. | 37/M | L | MCA (40 mm, thrombosed) | Removal of the aneurysm with STA-M2 double bypass | Transient loss (35 min) | temporary occlusion (30 mins) | Transient paresis (2/5) | Basal ganglia (LSA) |
| 15. | 14/M | R | MCA (30 mm, thrombosed) | Removal of the aneurysm with complex vascular reconstruction | Transient loss (40 min) | thrombus formation inside the reconstructed vessel (32 min) | Transient paresis (3/5) | Basal ganglia (LSA) |
| 16. | 48/F | R | MCA (50 mm, thrombosed) | Removal of the aneurysm with M1–M2 reanastomosis | Transient loss (18 min) | Temporary occlusion of MCA (8 min) | None | No lesion |
| 17. | 15/F | R | MCA (35 mm, thrombosed) | Removal of the aneurysm with complex vascular reconstruction including a perforator | Permanent loss | Temporary occlusion of MCA (30 min) | Permanent paresis (2/5) | Basal ganglia (LSA) |
| 18. | 70/F | L | MCA (19 mm, saccular) | Neck clipping with STA–MCA bypass | Transient loss (33 min) | Temporary occlusion of MCA (25 min) | Transient paresis (4/5) | Basal ganglia (LSA) |
| 19. | 30/M | R | MCA (15 mm, saccular) | Removal of the aneurysm (trapping) with STA-M2 bypass | Transient loss (30 min) | Temporary occlusion (15 min) | None | No lesion |
AchA: anterior choroidal artery, ECA: external cerebral artery, IC: internal carotid, ICA: internal carotid artery, LSA: lenticulostriate artery, MCA: middle cerebral artery, MMEP: muscle motor evoked potential, MMT: manual muscle testing, MRI: magnetic resonance imaging, PC/PcomA: posterior communicating artery, RA: radial artery, STA: superficial temporal artery, sup.thyroid A: superior thyroid artery.