Remote effect of brain retraction on regional cerebral blood flow and cerebrovascular reserve on single photon emission computed tomography.
BACKGROUND
The purpose of this study is to evaluate the effect of brain retraction 1 year or more after intracranial aneurysm clipping, demonstrated by a regional cerebral blood flow (rCBF) imaging technique.


RESULTS
rCBF and cerebrovascular reserve (CV) were evaluated in 40 patients 12-25 months after operation, using single photon emission computed tomography (SPECT) with Tc-99m-hexamethylpropylene amine oxime (HMPAO) combined with acetazolamide test. The images were analysed semiquantitatively, focusing on regions of interest (ROIs) chosen for places retracted during the operation. The regions of hypoperfusion in the retracted tissue were clearly visible in 26 cases. Assymmetry of measured activity, expressed in the Assymmetry Index, reached 12% (SEM +/- 8). After injection of acetazolamide during hypercapnia, the assymmetry decreased.


CONCLUSIONS
The results confirm the negative role of brain retraction. However, these consequences seem to be diminished by good vasoreactivity.
Słoniewski
P
P
Department of Neurosurgery, Medical University of Gdansk, Poland.
Zieliński
P
P
D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D002560:Cerebrovascular Circulation; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D013525:Surgical Instruments / Q000009:adverse effects; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
D019690:Technetium Tc 99m Exametazime