title: Local cortical cerebral blood flow and response to carbon dioxide during anesthesia in patients with moyamoya disease.
abstract: OBJECTIVE
  The CO(2) reactivity of cortical cerebral vessels and local cortical blood flow (l-CoBF) were evaluated during anesthesia in patients with moyamoya disease who were undergoing revascularization surgery.
  
  
  METHODS
  Using laser-Doppler flowmetry, the CO(2) reactivity of cortical cerebral vessels and l-CoBF were measured continuously in five patients at the local surgical field of the middle cerebral artery (MCA) territory.
  
  
  RESULTS
  Local-CoBF values obtained during the normocapnic condition varied from site to site of gyrus in the MCA region (0-73 ml. 100 g(-1).min(-1)). Local-CoBF was maximal at 39-43 mmHg of the PaCO(2) range, and decreased above and below this range. The response of l-CoBF to CO(2) was larger at the sites where the maximal level was obtained during normocapnia. In two patients, l-CoBF decreased by about 50%, and remained law even 40 min after administration of acetazolamide.
  
  
  CONCLUSIONS
  In patients with moyamoya disease, l-CoBF values obtained during the normocapnic condition varied from site to site of gyrus, and not only hypocapnia but also hypercapnia decreased l-CoBF within the MCA region.
authors.affiliation: Department of Anesthesiology and Neurosurgery, University of the Ryukyus, Faculty of Medicine, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa 903-0215, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yusa
authors.forename: K
authors.initials: K
authors.lastname: Yamashiro