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Latency-shift of intra-operative visual evoked potential predicts reversible homonymous hemianopia after intra-ventricular meningioma surgery.
Clin Neurophysiol Pract 2019; 4:224-229CN

Abstract

Objectives

Intraoperative visual evoked potentials (VEPs) are used to monitor the function of optic radiation during neurosurgery with the P100 amplitude decrement as a predictor of post-operative visual deficit. However, there is currently no evidence of early VEP changes indicating reversible visual field affection.

Methods

In this case report, we used VEPs during surgery for a benign meningioma located in the atrium of the right lateral ventricle. The tumor was accessed through a transcortical approach via a two-centimeter corticotomy in the lateral aspect of the superior parietal lobule. We performed flash VEPs and simultaneous recordings of electroretinography alongside with multimodal intraoperative monitoring.

Results

We observed a significant and sustained unilateral latency shift of the P100 component of VEPs, while amplitudes temporarily dropped to 80% of baseline but recovered entirely at the end of surgery. After the operation, the patient had a left-sided lower-quadrant anopia, which recovered completely during the following three months. Diagnostic VEP with pattern reversal monocular full field stimulation at one month postoperatively showed normal latencies bilaterally.

Conclusion

Our case indicates that the VEP (P100) latency may be a new and valuable indicator (in addition to VEP amplitude) of the visual pathways.

Significance

Monitoring VEPs may be useful to detect an imminent injury and a potentially reversible functional deficit.

Authors+Show Affiliations

Aarhus University Hospital, Department of Neurophysiology, Aarhus, Denmark. Aarhus University, Department of Clinical Medicine, Aarhus, Denmark.Aarhus University Hospital, Department of Neurosurgery, Aarhus, Denmark. Aarhus University, Department of Clinical Medicine, Aarhus, Denmark.Aarhus University, Center for Functional and Integrative Neuroscience, Aarhus, Denmark.Richards Brandmeier, Electroneurophysiology Consultant, Biomedical Engineer, Lausanne, Switzerland.Aarhus University Hospital, Department of Neurosurgery, Aarhus, Denmark. Aarhus University, Department of Clinical Medicine, Aarhus, Denmark.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31886448

Citation

Qerama, Erisela, et al. "Latency-shift of Intra-operative Visual Evoked Potential Predicts Reversible Homonymous Hemianopia After Intra-ventricular Meningioma Surgery." Clinical Neurophysiology Practice, vol. 4, 2019, pp. 224-229.
Qerama E, Korshoej AR, Petersen MV, et al. Latency-shift of intra-operative visual evoked potential predicts reversible homonymous hemianopia after intra-ventricular meningioma surgery. Clin Neurophysiol Pract. 2019;4:224-229.
Qerama, E., Korshoej, A. R., Petersen, M. V., Brandmeier, R., & von Oettingen, G. (2019). Latency-shift of intra-operative visual evoked potential predicts reversible homonymous hemianopia after intra-ventricular meningioma surgery. Clinical Neurophysiology Practice, 4, pp. 224-229. doi:10.1016/j.cnp.2019.10.004.
Qerama E, et al. Latency-shift of Intra-operative Visual Evoked Potential Predicts Reversible Homonymous Hemianopia After Intra-ventricular Meningioma Surgery. Clin Neurophysiol Pract. 2019;4:224-229. PubMed PMID: 31886448.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Latency-shift of intra-operative visual evoked potential predicts reversible homonymous hemianopia after intra-ventricular meningioma surgery. AU - Qerama,Erisela, AU - Korshoej,Anders R, AU - Petersen,Mikkel V, AU - Brandmeier,Richard, AU - von Oettingen,Gorm, Y1 - 2019/11/14/ PY - 2019/04/17/received PY - 2019/10/18/revised PY - 2019/10/31/accepted PY - 2019/12/31/entrez PY - 2019/12/31/pubmed PY - 2019/12/31/medline KW - Hemianopia KW - Intra-ventricular meningioma KW - Latency KW - Optic radiation KW - Visual evoked potentials SP - 224 EP - 229 JF - Clinical neurophysiology practice JO - Clin Neurophysiol Pract VL - 4 N2 - Objectives: Intraoperative visual evoked potentials (VEPs) are used to monitor the function of optic radiation during neurosurgery with the P100 amplitude decrement as a predictor of post-operative visual deficit. However, there is currently no evidence of early VEP changes indicating reversible visual field affection. Methods: In this case report, we used VEPs during surgery for a benign meningioma located in the atrium of the right lateral ventricle. The tumor was accessed through a transcortical approach via a two-centimeter corticotomy in the lateral aspect of the superior parietal lobule. We performed flash VEPs and simultaneous recordings of electroretinography alongside with multimodal intraoperative monitoring. Results: We observed a significant and sustained unilateral latency shift of the P100 component of VEPs, while amplitudes temporarily dropped to 80% of baseline but recovered entirely at the end of surgery. After the operation, the patient had a left-sided lower-quadrant anopia, which recovered completely during the following three months. Diagnostic VEP with pattern reversal monocular full field stimulation at one month postoperatively showed normal latencies bilaterally. Conclusion: Our case indicates that the VEP (P100) latency may be a new and valuable indicator (in addition to VEP amplitude) of the visual pathways. Significance: Monitoring VEPs may be useful to detect an imminent injury and a potentially reversible functional deficit. SN - 2467-981X UR - https://www.unboundmedicine.com/medline/citation/31886448/Latency-shift_of_intra-operative_visual_evoked_potential_predicts_reversible_homonymous_hemianopia_after_intra-ventricular_meningioma_surgery L2 - https://linkinghub.elsevier.com/retrieve/pii/S2467-981X(19)30037-X DB - PRIME DP - Unbound Medicine ER -