Prediction of late ischemic complications after cerebral aneurysm surgery by the intraoperative measurement of cerebral blood flow.
The response of cerebral blood flow (CBF) to drug-induced hypotension was measured in 20 patients who underwent craniotomy for clipping of a cerebral aneurysm following subarachnoid hemorrhage. A modified intravenous xenon-133 injection technique was used to monitor CBF. In 15 patients, CBF increased significantly with hypotension, and only one developed a late neurological deficit. In five patients, CBF fell with halothane-induced hypotension, and four developed delayed neurological deficits. Measurement of the intraoperative CBF response to halothane-induced hypotension may reveal those patients at greatest risk of developing late neurological deficits and who require more intensive postoperative monitoring and early use of the induced hypertension technique.
D001794:Blood Pressure; D002545:Brain Ischemia / Q000175:diagnosis*; D002544:Cerebral Infarction / Q000209:etiology; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000601:surgery