Dujovny M, Slavin K V, Luer M S, Hernandez-Avila G, Ausman J I
Department of Neurosurgery, College of Medicine, University of Illinois, Chicago, USA.
Acta Neurochir (Wien). 1995;133(1-2):83-6. doi: 10.1007/BF01404954.
Different methods have been used in the evaluation and monitoring of the cerebral oxygen supply during neuro-interventional therapies. Attenuation of near-infrared light by the chromophores oxyhemoglobin and deoxyhemoglobin have shown to be useful in the study of the cellular oxygen metabolism and oxygen delivery to the brain. Transcranial cerebral oximetry (TCCO) has the advantage of providing real-time information regarding regional brain oxygen saturation (rSO2) by using wavelengths in the near-infrared range. We present a patient with a carotid cavernous fistula who underwent balloon occlusion and concurrent continuous TCCO monitoring. TCCO was found to be a useful tool providing immediate rSO2 values during the angiographic and interventional procedures. Initial balloon occlusion of a carotid cavernous fistula resulted in partial occlusion of the internal carotid artery lumen causing an immediate decrease in rSO2 which correlated with angiographic findings. Subsequent reocclusion of the fistula produced a slower and smaller degree of decrease in rSO2 with clinical improvement in the patient. Changes in rSO2 were detected before any adverse clinical event was observed. TCCO was reliable, safe, sensitive, and provided a real-time assessment tool for the monitoring of brain oxygen supply in a patient undergoing a neuroendovascular procedure.
在神经介入治疗期间，已采用不同方法来评估和监测脑氧供应。氧合血红蛋白和脱氧血红蛋白等发色团对近红外光的衰减已被证明在细胞氧代谢和脑氧输送研究中有用。经颅脑血氧饱和度监测（TCCO）具有通过使用近红外范围内的波长提供有关局部脑血氧饱和度（rSO2）实时信息的优势。我们报告一名患有颈内动脉海绵窦瘘的患者，该患者接受了球囊闭塞并同时进行连续TCCO监测。发现TCCO是一种有用的工具，可在血管造影和介入手术期间提供即时rSO2值。颈内动脉海绵窦瘘的初始球囊闭塞导致颈内动脉管腔部分闭塞，导致rSO2立即下降，这与血管造影结果相关。随后瘘管的再次闭塞导致rSO2下降程度较慢且较小，患者临床症状改善。在观察到任何不良临床事件之前就检测到了rSO2的变化。TCCO可靠、安全、灵敏，为接受神经血管内手术的患者提供了一种监测脑氧供应的实时评估工具。
