Cerebral blood flow after surgery for unruptured cerebral aneurysms: Effects of surgical manipulation and irrigation fluid

Hiroaki Shimizu, Takashi Inoue, Miki Fujimura, Atsushi Saito, Teiji Tominaga

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Cerebral blood flow (CBF) is important in the management of cerebrovascular diseases. Surgical manipulation may compromise the appropriate interpretation of postoperative CBF changes, but the effects are not well understood. Objective: To investigate the effect of surgical manipulation on postoperative CBF in a setting of prospective randomized comparison of 2 irrigation fluids during surgery. Methods: Twenty patients undergoing the clipping of unruptured cerebral aneurysms through the pterional approach were randomly assigned to use of Artcereb, an artificial cerebrospinal fluid, or physiological saline as irrigation fluid. Postoperative CBF and clinical conditions were evaluated 3 times in the first 7 to 10 postoperative days. Results: Postoperative CBF decreased by 10 to 15% on the first postoperative day in the ipsilateral inferior frontal gyrus, where surgical manipulation may be greatest. CBF reduction was less in regions remote from the surgical site and later in the follow-up periods. Selection of irrigation fluid did not influence postoperative CBF significantly, although postoperative clinical conditions may be better using Artcereb. Conclusion: Postoperative CBF changes due to surgical manipulation should be considered in patients whose hemodynamic conditions are important for appropriate management.

Original languageEnglish
Pages (from-to)677-688
Number of pages12
JournalNeurosurgery
Volume69
Issue number3
DOIs
Publication statusPublished - 2011 Sep 1

Keywords

  • Aneurysm
  • Cerebral blood flow
  • Clipping
  • Surgery
  • Unruptured

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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