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Chapter-25 The Use of Intraoperative Cerebral Blood Flow Measurements in Neurosurgery: Past, Present, and Future

BOOK TITLE: Neurovascular Surgical Techniques

Author
1. Alaraj Ali
2. Amin-Hanjani Sepideh
3. Charbel Fady T
4. Qahwash Omar
ISBN
9789350900888
DOI
10.5005/jp/books/11824_25
Edition
1/e
Publishing Year
2013
Pages
16
Author Affiliations
1. Neuropsychiatric Institute, University of Illinois at Chicago, 912 S. Wood Street, MC-799, Chicago, Illinois, USA
2. Neuropsychiatric Institute, University of Illinois at Chicago, 912 S. Wood Street, MC-799, Chicago, Illinois, USA
3. Neuropsychiatric Institute, University of Illinois at Chicago, 912S. Wood St, MC-799, Chicago, Illinois, USA, Neuropsychiatric Institute, University of Illinois at Chicago, 912 S. Wood St, MC-799, Chicago, Illinois, USA
4. Michigan Head and Spine Institute, 29275 Northwestern Highway, Suite 100, Southfield, Michigan, USA
Chapter keywords
Cerebrovascular surgery, laser Doppler flowmetry, thermal diffusion flowmetry, parenchymal perfusion, transit-time flowmetry, cerebral blood flow

Abstract

There are many methods available for the assessment of blood flow during cerebrovascular surgery. The quantification of cerebral blood flow (CBF) has developed the understanding of cerebrovascular physiology and various CBF monitoring systems. The intraoperative integration of these systems has helped advance our surgical achievements and develop safe protocols for complex cerebrovascular surgery. The parenchymal monitors including laser Doppler flowmetry (LDF), thermal diffusion flowmetry (TDF) and isotope clearance techniques all measure parenchymal perfusion within a region sampled. To minimize morbidity associated with intracranial cerebrovascular surgery, a flow-based approach is recommended to assure appropriate hemodynamic perfusion and thus prevent ischemic injury. The use of transit-time flowmetry for the measurement of quantitative volume blood flow has been more reliable and safe. The chapter explains about radionuclide clearance, the present intraoperative applications of flow assisted cerebrovascular surgery and their future aspects.

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