Evidence of Redistribution of Cerebral Blood Flow during Treatment for an Intracranial Arteriovenous Malformation
作者:
Hunt Batjer,
Phillip Purdy,
Cole Giller,
Duke Samson,
期刊:
Neurosurgery
(OVID Available online 1989)
卷期:
Volume 25,
issue 4
页码: 599-605
ISSN:0148-396X
年代: 1989
出版商: OVID
关键词: Arteriovenous malformation;Cerebral blood flow;Transcranial Doppler ultrasonography
数据来源: OVID
摘要:
&NA;The presence of an intracranial arteriovenous malformation has a dramatic impact on local circulatory dynamics. Treatment of some arteriovenous malformations can result in disastrous hyperemic states caused by redistribution of previously shunted blood. This report describes serial hemodynamic measurements of both cerebral blood flow and flow velocity in 3 patients during treatment for arteriovenous malformations. Measurements of cerebral blood flow were made by computed tomographic scan employing the stable xenon inhalation technique; flow velocity, including autoregulatory characteristics, was measured by transcranial Doppler ultrasonogram. Substantial hyperemia developed in one patient (Case 1) after resection and in another (Case 3) after embolization. Embolization resulted in restoration of normal regional cerebral blood flow in a patient who demonstrated hypoperfusion before treatment (Case 2). In Patient 1, postoperative hyperemia was associated with persistently elevated flow velocities, and may have been accompanied by hemispheric neurological deficits. Sequential hemodynamic measurements may predict patients at risk of perioperative complications, and may become useful clinical guidelines for the extent and timing of embolization and for the timing of surgery after intracranial hemorrhage or preoperative embolization procedures. (Neurosurgery25:599‐605, 1989)
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