title: Use of intracranial and ocular thermography before and after arteriovenous malformation excision.
abstract: Excision of arteriovenous malformations (AVMs) is known to carry a risk of postoperative hemorrhage, postulated to be the result of normal perfusion pressure breakthrough. It is also possible that AVMs may cause a steal effect, reducing perfusion in nearby vessels. There is currently no simple method of visualizing the presence or absence of steal effect intraoperatively. We hypothesized that the infrared thermographic (heat sensitive) imaging of perilesional brain may be useful for detecting reduced perfusion due to steal. Moreover, we hypothesized that if steal effect was present, it could impact on ocular perfusion and thereby temperature. Our objective was, therefore, to investigate whether perilesional cortical and ocular temperature (OT) may be a marker of steal effect. We intraoperatively acquired conventional and thermal images of the surgical field and eyes bilaterally, pre- and post-excisions of a large left hemisphere AVM. We found OT asymmetry preoperatively, which was absent after the AVM was excised. Intraoperative thermal images showed an increase of perilesional temperature, although this could be confounded by generalized changes in cortical perfusion due to anesthetics or surgery.
authors.affiliation: The Alfred Hospital, Department of Neurosurgery, Level 1, Old Baker Building, Prahran VIC 3188, Melbourne 3004, AustraliabMonash University, Central Clinical School, Department of Surgery, Melbourne 3004, Australia.
authors.forename: Peter Y K
authors.initials: PY
authors.lastname: Hwang
authors.affiliation: The Alfred Hospital, Department of Neurosurgery, Level 1, Old Baker Building, Prahran VIC 3188, Melbourne 3004, AustraliabMonash University, Central Clinical School, Department of Surgery, Melbourne 3004, AustraliacMonash University, Monash Institute of M.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Lewis
authors.affiliation: The Alfred Hospital, Department of Neurosurgery, Level 1, Old Baker Building, Prahran VIC 3188, Melbourne 3004, AustraliabMonash University, Central Clinical School, Department of Surgery, Melbourne 3004, AustraliacMonash University, Monash Institute of M.
authors.forename: Jerome J
authors.initials: JJ
authors.lastname: Maller
mesh_terms: D015901:Angiography, Digital Subtraction; D001165:Arteriovenous Malformations / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002540:Cerebral Cortex / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002560:Cerebrovascular Circulation / Q000502:physiology; D005145:Face / Q000098:blood supply; D005260:Female; D006801:Humans; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods*; D013817:Thermography / Q000379:methods*