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Updated: Apr 14, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
BAER suppression during posterior fossa dural opening.
Christopher B Shields1, Lisa B E Shields1, Yi Dan Jiang2
1Norton Neuroscience Institute, Norton Healthcare, 210 East Gray Street, Suite 1102, Louisville, KY 40202, USA.
Brainstem auditory evoked responses (BAER) can be suppressed by posterior fossa tumor surgery due to tissue shift after dural opening. Understanding this mechanism aids neurosurgeons during operations.
Area of Science:
- Neurosurgery
- Neurophysiology
Background:
- Brainstem auditory evoked responses (BAER) monitor neurological integrity during surgery.
- Sudden BAER loss can create surgical dilemmas.
Purpose of the Study:
- To document a unique cause of BAER suppression during posterior fossa meningioma resection.
- To elucidate the mechanism of intraoperative BAER changes.
Main Methods:
- Case study of two patients undergoing posterior fossa meningioma resection.
- Monitoring of BAER signals during surgical procedures.
Main Results:
- Deterioration of BAER signals occurred shortly after dural opening, before tumor manipulation.
- Posterior shift of intracranial structures was observed following durotomy.
- BAER suppression was attributed to cochlear nerve compression/stretching from tissue shift.
Conclusions:
- Dural opening in posterior fossa surgery can induce BAER suppression via tissue shift.
- Understanding this mechanism can reduce neurosurgeon anxiety.
- BAER partially recovered after decompression and repair.
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