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Latency-shift of intra-operative visual evoked potential predicts reversible homonymous hemianopia after intra-ventricular meningioma surgery

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  • Erisela Qerama
  • Anders R Korshoej
  • ,
  • Mikkel V Petersen
  • Richard Brandmeier, Richards Brandmeier, Electroneurophysiology Consultant, Biomedical Engineer, Lausanne, Switzerland.
  • ,
  • Gorm von Oettingen

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.

Original languageEnglish
JournalClinical Neurophysiology Practice
Pages (from-to)224-229
Number of pages6
Publication statusPublished - 14 Nov 2019

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