Carter L P, White W L, Atkinson J R
Neurosurgery. 1978 May-Jun;2(3):223-9. doi: 10.1227/00006123-197805000-00007.
Regional cortical blood flow was monitored at craniotomy in 32 patients with a thermal diffusion flow probe in an attempt to assess the effects of surgical conditions on flow. Changes in flow due to vascular manipulation, retraction, hypotension, and hyperventilation were readily apparent. Eleven patients with supratentorial tumors had intermittent measurements of cerebral blood flow; the expected differences in blood flow with halothane anesthesia and hyperventilation were observed. Fourteen patients with aneurysms were monitored continuously and demonstrated a reduction in flow during hypotension; in two of these cases, the reduction was to disastrously low levels. Flow reduction occurred secondary to branch occlusion by the aneurysm clip in a patient with three middle cerebral artery aneurysms and was corrected by changing the clip position. Direct measurement of regional flow may be of value in estimating the safety of temporary clips and the degree of hypotension that can be tolerated.
在32例患者开颅手术时，使用热扩散血流探头监测局部皮质血流，以评估手术情况对血流的影响。血管操作、牵拉、低血压和过度通气引起的血流变化很明显。11例幕上肿瘤患者间歇性测量脑血流量；观察到氟烷麻醉和过度通气时血流的预期差异。14例动脉瘤患者进行连续监测，结果显示低血压时血流减少；其中2例患者血流减少到灾难性的低水平。1例患有3个大脑中动脉瘤的患者，由于动脉瘤夹闭塞分支导致血流减少，通过改变夹子位置得以纠正。直接测量局部血流可能有助于评估临时夹闭的安全性以及可耐受的低血压程度。
