title: Intraoperative Transcranial Motor-Evoked Potentials Predict Motor Function Outcome in Intracerebral Hemorrhage Surgery.
abstract: OBJECTIVE
  Prediction of motor function after intracerebral hemorrhage (ICH) often poses a diagnostic challenge. This study was performed to investigate whether intraoperative monitoring of motor-evoked potentials (MEPs) could predict postoperative motor function recovery.
  
  
  METHODS
  We reviewed 16 consecutive patients undergoing evacuation of supratentorial ICH with hemiplegia between June 2011 and October 2014. Patients were categorized according to the results of MEPs before and after evacuation of hematoma. The correlation between detection of MEPs and prognosis of motor function was analyzed.
  
  
  RESULTS
  In 10 of 16 cases (62%), stable MEPs were detected before and after evacuation of hematoma, and postoperative motor function was improved in all cases, including 3 cases with severe preoperative motor impairment on manual muscle test (1-2). In 3 cases (19%) in which MEPs were not detected throughout the procedure, motor function was not improved. In the other 3 cases (19%), MEPs were not measured before evacuation of ICH but were detected after evacuation despite poor prognosis of motor function. The results of postevacuation MEPs were considered false-negative results. Predictions using pre-evacuation MEP results were completely consistent with prognosis for recovery, whereas MEPs obtained during and after evaluation were useful for monitoring.
  
  
  CONCLUSIONS
  Intraoperative MEPs may indicate preservation of pyramidal tracts, and pre-evacuation MEPs can predict motor function outcome after ICH surgery.
authors.affiliation: Department of Neurosurgery, Suisyoukai Murata Hospital, Osaka City, Osaka, Japan; Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto, Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Ikedo
authors.affiliation: Department of Neurosurgery, Suisyoukai Murata Hospital, Osaka City, Osaka, Japan. Electronic address: nakamura.ikedo@gmail.com.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Neurosurgery, Suisyoukai Murata Hospital, Osaka City, Osaka, Japan; Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto, Japan.
authors.forename: Noritaka
authors.initials: N
authors.lastname: Sano
authors.affiliation: Department of Neurosurgery, Suisyoukai Murata Hospital, Osaka City, Osaka, Japan; Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Nagata
authors.affiliation: Department of Neurosurgery, Suisyoukai Murata Hospital, Osaka City, Osaka, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Okada
authors.affiliation: Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Terakawa
authors.affiliation: Department of Neurosurgery, Suisyoukai Murata Hospital, Osaka City, Osaka, Japan.
authors.forename: Takaho
authors.initials: T
authors.lastname: Murata
mesh_terms: D000368:Aged; D001931:Brain Mapping / Q000379:methods; D002543:Cerebral Hemorrhage / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D019054:Evoked Potentials, Motor; D005260:Female; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods*; D008297:Male; D009069:Movement Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D019635:Neurosurgical Procedures / Q000009:adverse effects; D017063:Outcome Assessment, Health Care / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
keywords: Hemiparesis; Intracerebral hemorrhage; Motor function; Motor-evoked potential; Prediction; Prognosis