Division of Neurological Surgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan.
Adv Exp Med Biol. 2010;662:491-6. doi: 10.1007/978-1-4419-1241-1_71.
Although endovascular treatment has a high success rate, it is not clear how endovascular treatment affects cerebral perfusion and hemodynamics during the perioperative period. We evaluated changes in cerebral blood oxygenation (CBO) repeatedly after endovascular treatment employing time-resolved spectroscopy (TRS). We investigated a patient (10 months old, female) who suffered cerebral arteriovenous fistula. Cerebral angiography demonstrated a pial arteriovenous fistula with three feeders (left PICA, SCA, and AICA). TRS demonstrated a decrease of oxyhemoglobin, total hemoglobin, and oxygen saturation associated with an increase of deoxyhemoglobin in all of the regions measured just after embolization, indicating that embolization improved hyperemia caused by the AV shunt. Interestingly, progressive improvement of hyperemia was observed 3 and 8 days after embolization of the feeders. The present study demonstrated that embolization of the feeders caused progressive changes in CBO and hemodynamics during the perioperative period. TRS may be a useful tool for monitoring cerebral blood perfusion changes after endovascular surgery.
虽然血管内治疗的成功率很高，但目前尚不清楚血管内治疗在围手术期如何影响脑灌注和血液动力学。我们使用时分辨谱（TRS）在血管内治疗后反复评估脑血氧（CBO）的变化。我们研究了一位患有脑动静脉瘘的患者（10 个月大，女性）。脑血管造影显示有三个供血动脉（左椎动脉、小脑后下动脉和小脑前下动脉）的脑膜动静脉瘘。TRS 显示所有测量区域的氧合血红蛋白、总血红蛋白和氧饱和度降低，脱氧血红蛋白增加，这表明栓塞改善了动静脉分流引起的充血。有趣的是，在栓塞供血动脉后 3 天和 8 天观察到充血的逐渐改善。本研究表明，栓塞供血动脉导致围手术期 CBO 和血液动力学的进行性变化。TRS 可能是监测血管内手术后脑血流灌注变化的有用工具。
