1988 Volume 16 Issue 2 Pages 191-196
During aneurysm surgery, regional cortical blood flow (CoBF) was continuously monitored in six patients with a thermal diffusion flow probe in an attempt to assess the effects of temporary major artery occlusion on flow.
The equipment and methods employed are presented in this paper. The CoBF was stable between 50 to 70ml/100g/min. Changes in flow due to vascular occlusion were readily apparent.
The reduction in flow was milder in common and internal carotid occlusion than in the obliteration of the middle (M1) and anterior (A1) cerebral artery.
The occlusion time varied from 0.5 to 14 minutes and CoBF decreased to 15 to 50ml/100g/mim.
Five patients showed no postoperative deficits. Their CoBF and occlusion time were as follows: 15ml/100g/min for one minute, 25ml/100g/min for eight minutes and 50ml/100g/min for 14 minutes.
One patient revealed bilateral basal ganglia infarction after occlusion of the dominant left A1 segment for six to eight minutes, which was not detected by CoBF monitoring.
Attention should be paid to the blood flow in the deep structures when a temporary clip is applied at the site proximal to perforating branches.
Direct measurement of CoBF may be of value in estimating the length of time that temporary clipping of a major vessel can be tolerated.
