Evidence of redistribution of cerebral blood flow during treatment for an intracranial aorteriovenous malformation

H. H. Batjer, P. D. Purdy, Cole A. Giller, D. S. Samson

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

The presence of an intracranial arteriovenous malformation has a dramatic impact on local circulatory dynamics. Treatment of some arteriovenous malformations can result in disastrous hyperemic states caused by redistribution of prevously shunted blood. This report describes serial hemodynamic measurements of both cerebral blood flow and flow velocity in 3 patients during treatment of arteriovenous malformations. Measurements of cerebral blood flow were made by computed tomographic scan employing the stable xenon inhalation technique; flow velocity, including autoregulatory characteristics, was measured by transcranial Doppler ultrasonogram. Substantial hyperemia developed in one patient (Case 1) after resection and in another (Case 3) after embolization. Embolization resulted in restoration of normal regional cerebral blood flow in a patient who demonstrated hypoperfusion before treatment (Case 2). In Patient 1, postoperative hyperemia was associated with persistently elevated flow velocities, and may have been accompanied by hemispheric neurological deficits. Sequential hemodynamic measurements may predict patients at risk of perioperative complications, and may become useful clinical guidelines for the extent and timing of embolization and for the timing of surgery after intracranial hemorrhage or preoperative embolization procedures.

Original languageEnglish (US)
Pages (from-to)599-605
Number of pages7
JournalNeurosurgery
Volume25
Issue number4
DOIs
StatePublished - Jan 1 1989
Externally publishedYes

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Cerebrovascular Circulation
Arteriovenous Malformations
Hyperemia
Hemodynamics
Intracranial Arteriovenous Malformations
Preoperative Care
Therapeutics
Xenon
Intracranial Hemorrhages
Regional Blood Flow
Inhalation
Guidelines

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Evidence of redistribution of cerebral blood flow during treatment for an intracranial aorteriovenous malformation. / Batjer, H. H.; Purdy, P. D.; Giller, Cole A.; Samson, D. S.

In: Neurosurgery, Vol. 25, No. 4, 01.01.1989, p. 599-605.

Research output: Contribution to journalArticle

Batjer, H. H. ; Purdy, P. D. ; Giller, Cole A. ; Samson, D. S. / Evidence of redistribution of cerebral blood flow during treatment for an intracranial aorteriovenous malformation. In: Neurosurgery. 1989 ; Vol. 25, No. 4. pp. 599-605.
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