Objective To explore the value of motor evoked potentials(MEP)as an early judgment of prognosis after thrombectomy.Methods The clinical data of 10 patients underwent emergency mechanical thrombectomy at Department of Neurosurgery,Shanghai Donglei Brain Hospital from August 2020 to October 2021 were analyzed retrospectively.All patients were admitted to hospital with acute large vessel occlusion,aged 36-81 years old(with an average of 62.3±16.41 years old).Among them,3 cases of acute embolism occurred in the middle cerebral artery,whilst 7 cases were occurred in the internal carotid artery.All patients met the indications for thrombectomy.The MEP amplitudes of bilateral limbs were recorded before thrombectomy and after vascular opening.Six months after surgery,the recovery of muscle strength,changes in the modified Rankin scale(mRS),and changes in MEP amplitude before and after vascular opening were analyzed.Results When the MEP amplitude of the affected limb increased by more than 50％compared with the baseline after the blood vessel was opened,the patients had the good postoperative prognosis.However,when the MEP amplitude of the affected limb increases by less than 10％compared with the baseline after vascular opening,even if the brain perfusion was good on imaging,it still had the poor final prognosis.Conclusions MEP alone can reflect the damage of the motor conduction pathway when the brain tissue is restored to perfusion.After the blood vessels are opened,when the MEP amplitude average increases by more than 50％compared with the baseline,the recovery of muscle strength and prognosis after half a year are generally good.Intraoperative MEP monitoring can reflect the prognosis after thrombectomy early and accurately,with high safety and feasibility.
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