Normal perfusion pressure breakthrough syndrome in giant arteriovenous malformations

Yoko Kato, Hirotoshi Sano, Kazuhiko Nonomura, Tetsuo Kanno, Kazuhiro Katada, Gen Takeshita, Hiroshi Toyama

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The treatment of large, high-flow cerebral arteriovenous malformations is one of the most difficult operations which neurosurgeons encounter because of the complex surgery and the post-operative effects on the brain. We have evaluated 10 patients with large, high-flow AVMs who underwent surgical resection. Patients were investigated with contrast-enhanced computed tomography and magnetic resonance imaging, 1231-IMP single photon emission computed tomography (SPECT) studies of cerebral flow and cerebral vasodilatory function, intraoperative Laser Doppler flowmetry (4 or 10 patients), and conventional angiography. The volume of the arteriovenous malformation nidi ranged from 32.8 to 210.5 cc. SPECT imaging performed on the first post-operative day showed marked hyperperfusion in the brain tissue surrounding the resected nidus, and these regions were normal on images on the 7th post-operative day. Laser Doppler flowmetry showed sudden, and marked increase in CBF immediately following placement of temporary clips on the main feeding artery. Angiograms done on 7-14 days following surgery showed a stagnating artery, fragile vessel, and a prolonged circulation time. Our results indicate that pre- and post-operative SPECT study, especially a dynamic SPECT study done on the first post-operative day, was the most useful examination for ascertaining the post-operative normal perfusion pressure breakthrough.

Original languageEnglish
Pages (from-to)117-123
Number of pages7
JournalNeurological Research
Volume19
Issue number2
DOIs
Publication statusPublished - 01-01-1997

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Arteriovenous Malformations
Single-Photon Emission-Computed Tomography
Perfusion
Pressure
Laser-Doppler Flowmetry
Angiography
Arteries
Intracranial Arteriovenous Malformations
Inosine Monophosphate
Brain
Ambulatory Surgical Procedures
Surgical Instruments
Tomography
Magnetic Resonance Imaging
Therapeutics

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Kato, Yoko ; Sano, Hirotoshi ; Nonomura, Kazuhiko ; Kanno, Tetsuo ; Katada, Kazuhiro ; Takeshita, Gen ; Toyama, Hiroshi. / Normal perfusion pressure breakthrough syndrome in giant arteriovenous malformations. In: Neurological Research. 1997 ; Vol. 19, No. 2. pp. 117-123.
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Normal perfusion pressure breakthrough syndrome in giant arteriovenous malformations. / Kato, Yoko; Sano, Hirotoshi; Nonomura, Kazuhiko; Kanno, Tetsuo; Katada, Kazuhiro; Takeshita, Gen; Toyama, Hiroshi.

In: Neurological Research, Vol. 19, No. 2, 01.01.1997, p. 117-123.

Research output: Contribution to journalArticle

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