[Perioperative monitoring of cerebral circulation in a patient with Takayasu disease].
Transcranial Doppler (TCD) and fiberoptic oximetry for continuous measurement of jugular venous oxygen saturation (SjO2) were used as perioperative monitoring of cerebral circulation in a patient with Takayasu disease who received bilateral aorto-carotid bypass. Following revascularization of the left carotid artery, mean velocity in the middle cerebral artery (MV) increased (lt 300%, rt 200% of control values) and SjO2 also increased. Following revascularization of right carotid artery, MV increased (lt 500%, rt 400% of control values) but SjO2 was unchanged. After bilateral revascularization, high velocity continued for about 10 days, and convulsion with headache occurred. Therefore hyperperfusion syndrome was suspected. By perioperative monitoring of MV and SjO2, it might be possible to evaluate intracranial hemodynamics, necessity of shunt operation as well as bilateral bypass, and postoperative hyperperfusion syndrome.
Department of Anesthesiology, Nara Medical University, Kashihara.
M
M
Yamada
M
M
Kawaguchi
H
H
Furuya
K
K
Kurehara
J
J
Shimoyama
T
T
Inoue
K
K
Kawachi
S
S
Kitamura
T
T
Okuda
D000328:Adult; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*; D013625:Takayasu Arteritis / Q000601:surgery*