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Cerebral arterial flow dynamics during aneurysm haemorrhage.
Acta Neurochirurgica
|January 1, 1978
Summary
Early rupture of an infraclinoid aneurysm during surgery caused rapid pressure changes and altered cerebral arterial flow. This case highlights the self-limiting effects of subarachnoid hemorrhage on blood flow dynamics.
Area of Science:
- Neurosurgery
- Cerebrovascular Medicine
- Medical Physiology
Background:
- Intraoperative aneurysm rupture poses significant surgical risks.
- Understanding cerebral hemodynamics during hemorrhage is crucial for patient outcomes.
Observation:
- A case of early infraclinoid aneurysm rupture during dural opening is presented.
- Cerebral arterial flow and blood pressure were monitored continuously.
- Rupture occurred at mean blood pressure of 160 mmHg and low intracranial pressure (5-6 mmHg).
Findings:
- Rapid increase in parietal epidural pressure to 110 mmHg was observed.
- Initial brief increase in internal carotid artery flow was followed by a marked reduction.
- End-diastolic flow arrest indicated a self-limiting hemorrhage and impaired cerebral perfusion pressure.
- Carotid artery flow demonstrated impaired autoregulation and increased vascular resistance, suggesting a no-reflow phenomenon.
Implications:
- The study discusses the dual role of impaired cerebral perfusion pressure in both potential cerebral damage and hemorrhage control.
- Findings suggest a no-reflow phenomenon following aneurysm rupture, impacting cerebral blood flow.
- This case provides insights into the dynamic physiological responses during intraoperative aneurysm rupture.