Intraoperative Neurophysiological Monitoring in Ruptured-Unruptured Multiple Aneurysm Surgery: A Case Report

Ibnu Siena  Samdani; Iwan  Fuadi; Iwan Abdul  Rachman

doi:10.18502/aacc.v11i5.19943

Ibnu Siena Samdani Department of Anesthesiology and Intensive Care, Padjadjaran University, Bandung, Indonesia.
Iwan Fuadi Department of Anesthesiology and Intensive Care, Padjadjaran University, Bandung, Indonesia.
Iwan Abdul Rachman Department of Anesthesiology and Intensive Care, Padjadjaran University, Bandung, Indonesia.

DOI: https://doi.org/10.18502/aacc.v11i5.19943

Keywords: Aneurysm; Anesthesia; Clipping; Intraoperative monitoring

Abstract

Intraoperative Neurophysiological Monitoring (IONM) refers to the use of various electrophysiological methods to monitor the function of the brain, spinal cord, and related nerves during surgical procedures. IONM involves the use of neurophysiological recordings to detect changes in nervous system function during surgery, allowing doctors to identify potential nerve damage before it occurs. Reported is a 65-year-old male patient with a diagnosis of unruptured aneurysm of the Posterior Communicating Artery (PcomA) and left ophthalmic segment of C5 whose aneurysm was planned to be clipped. The patient was planned to have the aneurysm clipped under general anesthesia. The challenge in the anesthesia process for aneurysm cases is maintaining the pressure in the aneurysm and cerebral perfusion pressure (CPP), protecting the brain during periods of ischemia, and providing as wide an operating field as possible. Post-operatively, the patient showed stable neurological function with no new deficits, highlighting the importance of intraoperative neurophysiological monitoring in achieving a favorable outcome.