2019-04-122019-04-122017MOREIRA, Diego Góes. Monitorização multimodal sob estimulação cortical nas cirurgias para clipagem de aneurismas intracranianos. Orientador: Eric Homero Albuquerque Paschoal. 2017. 64 f.Trabalho de Curso (Bacharelado em Medicina) - Faculdade de Medicina, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, 2017. Disponível em: http://bdm.ufpa.br/jspui/handle/prefix/1283. Acesso em:.http://bdm.ufpa.br/jspui/handle/prefix/1283The use of intraoperative neurophysiology monitoring (MNIO) in neurosurgery represents an advance in the surgical treatment of intracranial aneurysms. The aim of this work was to demonstrate the importance of the tool in the microsurgery for clipping middle cerebral artery aneurysms in order to prevent and reduce morbidity for patients. We evaluated 23 patients (Group I with MNIO) and 15 patients (Group II without MNIO), who had intracranial aneurysms at the Hospital do Coração do Pará from January to December 2016. The female gender was predominant in the series. In the series of patients, there was a greater inference to Amerindian ancestry, and the most frequent modifiable risk factor was systemic arterial hypertension (SAH) and the most frequent clinical complaint was headache in 87% in group I and 80% in group II. All the measured variables showed statistical relevance for the evaluation of the results (p <0.0001) for the prediction of deficits. Among the aspects of angioarchitecture the right side was the most common, as well as the morphology of the middle cerebral artery with bifurcation in the M2 segment was more evident, just as among the size most of the aneurysms presented with the largest diameter of 5 mm in 42% of patients and irregular domus in 50%. Approximately 45% of the patients in group I were distributed with Phases score 3.5% and in group II 66% presented the same score. This was one of the criteria used to assess the risk of bleeding to the aneurysm. Magnetic resonance imaging of encephalon demonstrated the inflammatory signal with significance in group I (p 0.0365). The MNIO evaluation showed that the potential drop was the parameter of greatest relevance (p <0.01), in which 1/4 of the patients presented motor deficit in the postoperative period. As a result, more than 90% of the patients presented favorable results on the modified Rankin scale and the Glasgow outcome scale. It is concluded that the use of MNIO in clipping of middle cerebral artery aneurysms is a useful method for the prevention of permanent damage. Keywords: aneurysm; clipping; monitoring.Acesso AbertoAneurismaClipagemMonitoraçãoMicrocirurgiaCNPQ::CIENCIAS DA SAUDE::MEDICINA::CIRURGIA::NEUROCIRURGIATrabalho de Curso - Graduação - Monografia