[Temporal arterial clipping and autoregulation of cerebral blood flow at surgery for intracranial aneurysms].
Preoperative dynamic autoregulatory responses in 20 patients considered as candidates for vessel temporal clipping (TC) and/or arterial hypotension (AH) at surgery for aneurysms were studied by the thigh cuff method. Normal autoregulatory responses at a regulation rate (RoR) of 20.4 +/- 2.8%/s were found in 10 patients > 30 days after subarachnoidal hemorrhage (SH) while RoR was 12.5 +/- 2.5%/s in 10 other patients (30 days, grade III WFNS showed autoregulation impairment. TC and/or AH were proceeded in 17 operated patients. One postoperative death was due to pulmonary embolism. Two poor results with persistent neurological disorders at discharge were associated with TC but in 1 patient. This patient had severe vasospasm and the lowest RoR (9%/s). There were no TC and/or AH postoperative complications in other 14 patients. All of them and 3 other patients with direct aneurysm clipping had a fair outcome.
G A
GA
Asaturian
V B
VB
Semeniutin
V A
VA
Aliev
V V
VV
Alekseev
S K
SK
Sergienko
V S
VS
Panuntsev
A N
AN
Kondrat'ev
D001921:Brain / Q000098:blood supply*; D002560:Cerebrovascular Circulation; D006706:Homeostasis; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000601:surgery; D002532:Intracranial Aneurysm / Q000601:surgery*; D009422:Nervous System Diseases / Q000209:etiology; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery; D013525:Surgical Instruments / Q000009:adverse effects; D013699:Temporal Arteries / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*