Neurosurgery,
Год журнала:
1993,
Номер
33(6), С. 1052 - 1064
Опубликована: Дек. 1, 1993
BRAIN
RETRACTION
IS
required
for
adequate
exposure
during
many
intracranial
procedures.
The
incidence
of
contusion
or
infarction
from
overzealous
brain
retraction
is
probably
10%
in
cranial
base
procedures
and
5%
aneurysm
literature
on
injury
reviewed,
with
particular
attention
to
the
use
intermittent
retraction.
Intraoperative
monitoring
techniques–brain
electrical
activity,
cerebral
blood
flow,
pressure–are
evaluated.
Various
intraoperative
interventions–anesthetic
agents,
positioning,
cerebrospinal
fluid
drainage,
operative
approaches
involving
bone
resection
osteotomy,
hyperventilation,
induced
hypotension,
hypertension,
mannitol,
nimodipine–are
assessed
regard
their
effects
Because
injury,
like
other
forms
focal
ischemia,
multifactorial
its
origins,
a
multifaceted
approach
will
be
most
advantageous
minimizing
injury.
Recommendations
management
cases
significant
are
made.
These
recommendations
optimize
following
goals:
anesthesia
metabolic
depression,
improvement
flow
calcium
channel
blockade,
monitoring,
efficacy.
Through
combination
judicious
retraction,
appropriate
anesthetic
pharmacological
management,
aggressive
should
become
much
less
common
source
morbidity
future.
Trends in Neurosciences,
Год журнала:
1997,
Номер
20(10), С. 435 - 442
Опубликована: Окт. 1, 1997
Brain
activity
is
associated
with
changes
in
optical
properties
of
brain
tissue.
Optical
measurements
during
activation
can
assess
haemoglobin
oxygenation,
cytochrome-c-oxidase
redox
state,
and
two
types
light
scattering
reflecting
either
membrane
potential
(fast
signal)
or
cell
swelling
(slow
signal),
respectively.
In
previous
studies
exposed
tissue,
imaging
has
been
achieved
at
high
temporal
microscopical
spatial
resolution.
Now,
using
near-infrared
that
penetrate
biological
tissue
reasonably
well,
it
become
possible
to
human
subjects
through
the
intact
skull
non-invasively.
After
early
employing
single-site
spectroscopy,
first
devices
are
being
applied
successfully
for
low-resolution
functional
imaging.
Advantages
methods
include
biochemical
specificity,
a
resolution
millisecond
range,
measuring
intracellular
intravascular
events
simultaneously
portability
enabling
bedside
examinations.
Journal of Cerebral Blood Flow & Metabolism,
Год журнала:
2001,
Номер
21(3), С. 195 - 201
Опубликована: Март 1, 2001
A
method
for
dynamic,
high-resolution
cerebral
blood
flow
(CBF)
imaging
is
presented
in
this
article.
By
illuminating
the
cortex
with
laser
light
and
resulting
speckle
pattern,
relative
CBF
images
tens
of
microns
spatial
millisecond
temporal
resolution
are
obtained.
The
regional
changes
measured
technique
validated
through
direct
comparison
conventional
laser-Doppler
measurements.
Using
method,
dynamic
during
focal
ischemia
cortical
spreading
depression
were
obtained
along
electrophysiologic
recordings.
Upon
middle
artery
(MCA)
occlusion,
yielded
residual
gradient
encompassing
ischemic
core,
penumbra,
oligemic,
normally
perfused
tissues
over
a
6
×
4
mm
area.
Successive
demonstrated
further
decrease
indicating
an
expansion
zone
finely
delineated
borders.
Dynamic
revealed
2
to
3
area
increased
(160%
250%)
that
propagated
velocity
mm/min.
This
easy
implement
can
be
used
monitor
evolution
high
studies
pathophysiology.
Journal of Clinical Investigation,
Год журнала:
1996,
Номер
97(1), С. 209 - 216
Опубликована: Янв. 1, 1996
Acute
neutrophil
(PMN)
recruitment
to
postischemic
cardiac
or
pulmonary
tissue
has
deleterious
effects
in
the
early
reperfusion
period,
but
mechanisms
and
of
influx
pathogenesis
evolving
stroke
remain
controversial.
To
investigate
whether
PMNs
contribute
adverse
neurologic
sequelae
mortality
after
stroke,
study
potential
role
leukocyte
adhesion
molecule
intercellular
molecule-1
(ICAM-1)
we
used
a
murine
model
transient
focal
cerebral
ischemia
consisting
intraluminal
middle
artery
occlusion
for
45
min
followed
by
22
h
reperfusion.
PMN
accumulation,
monitored
deposition
111In-labeled
tissue,
was
increased
2.5-fold
ipsilateral
(infarcted)
hemisphere
compared
with
contralateral
(noninfarcted)
(P
<
0.01).
Mice
immunodepleted
neutrophils
before
surgery
demonstrated
3.0-fold
reduction
infarct
volumes
0.001),
based
on
triphenyltetrazolium
chloride
staining
serial
sections,
improved
cortical
blood
flow
(measured
laser
Doppler),
reduced
neurological
deficit
controls.
In
wild-type
mice
subjected
reperfusion,
ICAM-1
mRNA
hemisphere,
immunohistochemistry
localizing
expression
microvascular
endothelium.
The
investigated
homozygous
null
(ICAM-1
-/-)
comparison
controls
+/+).
-/-
3.7-fold
volume
0.005),
35%
increase
survival
0.05),
+/+
Cerebral
infarcted
3.1-fold
greater
0.01),
suggesting
an
important
genesis
no-reflow.
Because
PMN-depleted
ICAM-1-deficient
are
relatively
resistant
ischemia-reperfusion
injury,
these
studies
suggest
ICAM-1-mediated
pathophysiology
stroke.
Proceedings of the National Academy of Sciences,
Год журнала:
1997,
Номер
94(26), С. 14826 - 14831
Опубликована: Дек. 23, 1997
Modern
functional
neuroimaging
methods,
such
as
positron-emission
tomography
(PET),
optical
imaging
of
intrinsic
signals,
and
MRI
(fMRI)
utilize
activity-dependent
hemodynamic
changes
to
obtain
indirect
maps
the
evoked
electrical
activity
in
brain.
Whereas
PET
flow-sensitive
map
cerebral
blood
flow
(CBF)
changes,
oxygenation
level-dependent
areas
with
concentration
deoxygenated
hemoglobin
(HbR).
However,
relationship
between
CBF
HbR
during
activation
has
never
been
tested
experimentally.
Therefore,
we
investigated
this
by
using
spectroscopy
laser-Doppler
flowmetry
techniques,
simultaneously,
visual
cortex
anesthetized
cats
sensory
stimulation.
We
found
that
earliest
microcirculatory
change
was
indeed
an
increase
HbR,
whereas
lagged
more
than
a
second
after
HbR.
The
increased
accompanied
simultaneous
total
(Hbt),
presumably
reflecting
early
volume
increase.
Hbt
1
2
sec
throughout
response.
These
results
support
notion
active
neurovascular
regulation
capillary
bed
existence
delayed,
passive
process
filling.
Stroke,
Год журнала:
1995,
Номер
26(6), С. 1086 - 1092
Опубликована: Июнь 1, 1995
Acute
cerebral
ischemia
after
subarachnoid
hemorrhage
(SAH)
is
a
major
cause
of
morbidity
whose
precise
etiology
unclear.
The
purpose
this
study
was
to
examine
the
relationships
between
perfusion
pressure
(CPP)
and
cortical
blood
flow
during
SAH
using
new
experimental
model
in
rat.CPP
(mean
arterial
minus
intracranial
pressure),
laser-Doppler
flowmetry
(LDF),
electroencephalogram
were
continuously
recorded
16
ventilated
rats.
produced
by
advancing
an
intraluminal
suture
from
external
carotid
artery
through
internal
perforate
vessel
near
its
bifurcation.Eight
rats
(50%)
died
within
24
hours
SAH.
In
all
rats,
widely
distributed
throughout
basal,
convexity,
interhemispheric
spaces
ventricular
system.
CPP
decreased
at
initial
rate
1.1
+/-
0.2
mm
Hg/s,
reaching
nadir
59
9
seconds
onset
During
same
period,
LDF
fell
1.4
0.3%/s
(P
=
NS
vs
CPP).
After
nadir,
rose
0.4
0.01
but
continued
fall
0.03%/s
<
.05
CPP)
21.7
2.5%
significantly
later
than
(189.5
39
s
SAH,
P
.05).
No
correlation
found
peak
changes
LDF.
Electroencephalogram
activity
followed
LDF,
values
289
55
SAH.These
findings
demonstrate
that
although
reduced
causes
decrease
secondary
reductions
occurring
has
reached
are
caused
other
factors
such
as
acute
vasoconstriction.
This
noncraniotomy
rat
several
advantages
over
existing
models.
Journal of Cerebral Blood Flow & Metabolism,
Год журнала:
2012,
Номер
32(7), С. 1277 - 1309
Опубликована: Фев. 1, 2012
The
cerebral
vascular
system
services
the
constant
demand
for
energy
during
neuronal
activity
in
brain.
Attempts
to
delineate
logic
of
neurovascular
coupling
have
been
greatly
aided
by
advent
two-photon
laser
scanning
microscopy
image
both
blood
flow
and
individual
cells
below
surface
Here
we
provide
a
technical
guide
imaging
rodents.
We
describe
detail
surgical
procedures
required
generate
cranial
windows
optical
access
cortex
rats
mice
use
accurately
measure
cortical
vessels
concurrent
with
local
cellular
activity.
further
examples
on
how
these
techniques
can
be
applied
study
regulation
pathologies
such
as
small-scale
stroke.
Neurophotonics,
Год журнала:
2016,
Номер
3(3), С. 031411 - 031411
Опубликована: Июнь 21, 2016
Cerebral
blood
flow
(CBF)
and
cerebral
autoregulation
(CA)
are
critically
important
to
maintain
proper
brain
perfusion
supply
the
with
necessary
oxygen
energy
substrates.
Adequate
is
required
support
normal
function,
achieve
successful
aging,
navigate
acute
chronic
medical
conditions.
We
review
general
principles
of
CBF
measurements
current
techniques
measure
based
on
direct
intravascular
measurements,
nuclear
medicine,
X-ray
imaging,
magnetic
resonance
ultrasound
techniques,
thermal
diffusion,
optical
methods.
also
for
arterial
pressure
as
well
theoretical
experimental
methods
assessment
CA,
including
recent
approaches
techniques.
The
in
clinical
practice
presented.
comprehensive
description
principles,
methods,
requirements
CA
highlights
potentially
role
that
noninvasive
can
play
neurovascular
health.
In
fact,
have
ability
provide
a
noninvasive,
quantitative,
continuous
monitor
autoregulation.
Journal of Cerebral Blood Flow & Metabolism,
Год журнала:
2012,
Номер
32(7), С. 1233 - 1247
Опубликована: Апрель 18, 2012
Anesthesia
has
broad
actions
that
include
changing
neuronal
excitability,
vascular
reactivity,
and
other
baseline
physiologies
eventually
modifies
the
neurovascular
coupling
relationship.
Here,
we
review
effects
of
anesthesia
on
spatial
propagation,
temporal
dynamics,
quantitative
relationship
between
neural
responses
to
cortical
stimulation.
Previous
studies
have
shown
onset
latency
evoked
cerebral
blood
flow
(CBF)
changes
is
relatively
consistent
across
conditions
compared
with
variations
in
time-to-peak.
This
finding
indicates
mechanism
vasodilation
less
dependent
interference,
while
dynamics
are
subject
this
interference.
The
largely
influenced
by
type
dosage
anesthesia,
including
processing,
vasoactive
signal
transmission,
reactivity.
gap
response
regions
not
fully
understood
require
further
attention
elucidate
control
CBF
supply
underlying
focal
surrounding
activity.
in-depth
understanding
elements
allows
for
better
decision-making
regarding
anesthetics
used
specific
models
experiments
may
also
help
source
issues
hemodynamic-based
neuroimaging
techniques.
Journal of Cerebral Blood Flow & Metabolism,
Год журнала:
1992,
Номер
12(3), С. 380 - 389
Опубликована: Май 1, 1992
The
purpose
of
this
study
was
to
determine
the
effect
selective
modulation
brain
temperature
in
experimental
settings
permanent
and
reversible
middle
cerebral
artery
(MCA)
occlusion
Sprague–Dawley
rats.
Three
models
proximal
MCA
were
used,
which
brain-temperature
modulations
could
be
studied.
These
included
(a)
with
an
initial
30-min
period
hypotension
(30
or
36°C
×
4
h),
(b)
alone
(30,
36,
39°C
2
(c)
h
h).
In
transient
series,
intra-
postischemic
cortical
blood
flow
assessed
using
a
laser–Doppler
flowmeter
placed
over
dorsolateral
cortex.
After
3-day
survival,
all
rats
perfusion
fixed
for
histopathological
analysis
determination
infarct
volume.
animals
plus
hypotension,
no
significant
difference
volume
demonstrated
between
30
groups.
without
differences
again
not
demonstrable,
but
interaction
area
class
shown
by
repeated-measures
analysis,
indicating
that
hypothermia
altered
topographic
pattern
infarct.
With
occlusion,
there
statistically
reduction
30°C
group
compared
Although
CBF
significantly
different
among
three
groups,
positively
correlated
CBF.
CBF,
turn,
intraischemic
negatively
during
ischemic
period.
findings
demonstrate
moderate
manipulations
have
greater
influence
on
resulting
infarction
setting
focal
ischemia
than
context
vascular
occlusion.