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Related Experiment Videos

Regional cortical blood flow at craniotomy

L P Carter, W L White, J R Atkinson

    Neurosurgery
    |May 1, 1978
    PubMed
    Summary

    Directly measuring regional cerebral blood flow during surgery helps assess risks. This technique can identify dangerous flow reductions from hypotension or clip placement, improving patient safety.

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    Area of Science:

    • Neurosurgery
    • Cerebrovascular Physiology
    • Medical Instrumentation

    Background:

    • Surgical interventions for brain conditions require careful monitoring of cerebral blood flow (CBF).
    • Understanding how surgical manipulations affect CBF is crucial for patient safety.
    • Previous methods for assessing intraoperative CBF have limitations.

    Purpose of the Study:

    • To evaluate the utility of a thermal diffusion flow probe for real-time monitoring of regional cortical blood flow during neurosurgery.
    • To assess the impact of various surgical conditions, including vascular manipulation, retraction, hypotension, and hyperventilation, on CBF.
    • To determine if direct CBF measurement can aid in managing temporary clips and hypotension during aneurysm surgery.

    Main Methods:

    • Regional cortical blood flow was monitored using a thermal diffusion flow probe in 32 patients undergoing craniotomy.
    • Intermittent CBF measurements were performed in 11 patients with supratentorial tumors.
    • Continuous CBF monitoring was conducted in 14 patients with aneurysms.

    Main Results:

    • Surgical manipulations such as vascular manipulation, retraction, hypotension, and hyperventilation caused readily apparent changes in regional cortical blood flow.
    • In patients with aneurysms, hypotension led to reduced CBF, with two cases experiencing critically low levels.
    • Aneurysm clip occlusion of a cerebral artery branch was identified and corrected by adjusting clip placement, restoring flow.

    Conclusions:

    • Direct measurement of regional cortical blood flow provides valuable real-time data during neurosurgical procedures.
    • This technique can help estimate the safety of temporary clip application and the tolerance to induced hypotension.
    • Intraoperative CBF monitoring can potentially prevent catastrophic events related to compromised blood supply.

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