By Werner Hassler
Up so far, the therapy of arteriovenous racemose angiomas of the mind is still unsatisfactory. Intraoperative hemorrhages, post-embolizational or postoperative deficits counting on the positioning and dimension of the A VM in addition to inoperability of infrequent angioma forms have promoted the technical development of diagnostic and healing techniques. however, a few pathophysiological difficulties of A VM hemodynamics haven't been solved. Many angiographical reports, observations in the course of embolization and operation, dopplersonographical and different perfusion measurements supplied a few perception. adequate animal versions have not begun to be constructed as a way to elucidate the pathophysiological mechanisms. This monograph describes A V fistula versions in cats and rats, either traditional and newly constructed, which enable a greater comparability with human cerebral angiomas than prior ones. an important result's that the version of the leap forward of arterial strain waves into the capillaries following a failure of cerebrovascular rules can't be proven. particularly, in accordance with the findings in precapillary vessels provided the following, the legislation services as a rule in order that a breakdown of legislation can't be liable for worldwide mind edema usually noticeable after removing of angiomas. The rules used to be established utilizing diversified equipment, most vital of which being the CO reaction of two mind vessels to various CO contents of the inhaled air. Angiographical, dopplersonographical and a couple of perioperative dopplersonographical in addition to intraoperative measurements of circulation and strain were applied.
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Additional resources for Hemodynamic Aspects of Cerebral Angiomas
41 and 42) With the fistula patent, systemic BP was 160/100. Pressure in the distal CCA was 80/60. 4 kHz and cortical microcirculation was 44%. With occlusion of the proximal CCA, reversed blood flow in the distal CCA was induced with the blood now running into the jugular vein. e 213 Effortil 801 152 160 mmHg 283 mllmin 216 mmHg Systemic BP then increased by 10% and pressure in the distal CCA dropped to 30 mmHg. 2 kHz. Cortical microcirculation remained unchanged. After a steady state had been reached, the proximal CCA was reopened.
MCAI. 5 Calculated volume of angioma (cm 3) 2 3 Number of supplying vessels temperooccipital I. temperoparietal I. I. precentral parietal r. temperooccipital r. parietal r. Localisation 100% (PCA) 23% (MCA) 57% (MCA) 40% (PCA) 107% (PCA) 102% (MCA) Relation to the normal contralateral flow volume "~ O. " e P> 0 qg. ::l ;l> Er '< ::r P> '0 .... ()Q 0 ::l 0 C/l ~ >-t 0 '0 t:I e:. e. '" .... P> ::l n P> >-t ...... , tv v. PCA r. 32 ACAL PCAL MCAL 44 32 25 m m m 10 b- 11 b- 12 b+ + MCAL PCAL ACA r.
5 cm to permit examination of the contralateral vessels. Mean velocity in cm/sec is displayed on the monitor. (Arnolds \986). Nevertheless, this volume is greater than the basal arteries, so that small vessels in their proximity or tortuous parts of a vessel fall within the recording (Fig. 49). 5 cm from 3 to 8 cm, which is necessary for the evaluation of different basal vessels. The recorded frequency shift is displayed on a real-time frequency analyser (Angioscan); a flow adapter detects the direction of flow.