• Riccardo Carrai, Cristiana Martinelli, Fabrizio Baldanzi, Simonetta Gabbanini, Benedetta Gori, Giulia Masi, Simone Troiano, Camilla Bonaudo, Alice Esposito, Giovanni Muscas, Serena Tola, Riccardo Caramelli, Maddalena Spalletti, Francesco Lolli, Antonello Grippo, Luca Bucciardini, Andrea Amadori, and Alessandro Della Puppa.
• SODc Neurophysiopathology, Department Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi University Hospital, Florence, Italy. Electronic address: riccardo.carrai@unifi.it.
• World Neurosurg. 2023 Mar 1; 171: 175180.e0175-180.e0.

ObjectiveThe role of visual evoked potentials (VEPs) monitoring during neurosurgical procedure in patient remains unclear. The purpose of our study was to determine the feasibility of intraoperative VEP recording using a strip cortical electrode during surgical resection of intracranial lesions.MethodsIn this prospective, monocentric, observational study, we enrolled consecutive patients undergoing neurosurgical procedure for intracranial lesions. After dural opening, a cortical strip was positioned on the lateral occipital surface. Flash VEPs were continuously recorded using both subdermal corkscrew electrodes and strip electrodes. An electroretinogram was also recorded to guarantee delivery of adequate flash stimuli to the retina.ResultsWe included 10 patients affected by different intracranial lesions. Flash VEPs were recorded using subdermal corkscrew electrodes in all patients except 1 in whom they were never identified during the recording. Flash VEPs were recorded using strip electrodes in all patients and showed a polyphasic morphology with a significantly larger amplitude compared with that of flash VEPs measured using subdermal corkscrew electrodes. No patient reported worsened postoperative vision and a >50% decrease in the VEPs amplitude was never registered.ConclusionsWe have reported for the first time in the literature that VEP monitoring during a neurosurgical procedure is feasible via a cortical strip located on the occipital surface. The technique demonstrated greater stability and a larger amplitude compared with recordings with scalp electrodes, facilitating identification of any changes. Studies with more patients are needed to assess the clinical reliability of the technique.Copyright © 2022 Elsevier Inc. All rights reserved.

13 keywords...

hide…