Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
CO2 REACTIVITY IN ARTERIOVENOUS-MALFORMATIONS OF THE BRAIN - A TRANSCRANIAL DOPPLER ULTRASOUND STUDY
Autore:
DESALLES AAF; MANCHOLA I;
Indirizzi:
UNIV CALIF LOS ANGELES,SCH MED,DIV NEUROSURG,300 UCLA MED PLAZA,SUITEB-212 LOS ANGELES CA 90024 HARVARD UNIV,MASSACHUSETTS GEN HOSP,SCH MED,DEPT NEUROL BOSTON MA 00000
Titolo Testata:
Journal of neurosurgery
fascicolo: 4, volume: 80, anno: 1994,
pagine: 624 - 630
SICI:
0022-3085(1994)80:4<624:CRIAOT>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
MIDDLE CEREBRAL-ARTERY; BLOOD-FLOW VELOCITY; PRESSURE; CIRCULATION; VALIDATION; EXCISION; AVMS;
Keywords:
ULTRASOUND; ANGIOGRAPHY; ARTERIOVENOUS MALFORMATION; BLOOD FLOW VELOCITY; HYPOCAPNIA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
30
Recensione:
Indirizzi per estratti:
Citazione:
A.A.F. Desalles e I. Manchola, "CO2 REACTIVITY IN ARTERIOVENOUS-MALFORMATIONS OF THE BRAIN - A TRANSCRANIAL DOPPLER ULTRASOUND STUDY", Journal of neurosurgery, 80(4), 1994, pp. 624-630

Abstract

Arteriovenous malformations (AVM's) are congenital tangles of vesselsthat have a high blood flow through a low-resistance nidus. The vessels in the nidus may lack normal vasoreactivity in response to changes in PaCO2 or perfusion pressure (autoregulation). Arteriovenous malformation hemodynamics have been assessed based on the response of AVM feeding arteries to hypocapnia. Twenty-five AVM patients, aged 34 +/- 11 years (mean +/- standard deviation), were admitted to the Massachusetts General Hospital for proton-beam radiation therapy. Fourteen healthyvolunteers aged 30 +/- 7 years served as control subjects. Angiogramswith calibrated markers permitting magnification correction were available for all patients. The limits of the middle cerebral artery, as determined by transcranial Doppler ultrasonography, were compared to measurements made on the angiograms. Hyperventilation was induced at a rate set by a metronome. Fixed bilateral Doppler probes allowed almost simultaneous sampling of two vessels. Volunteer control subjects were hyperventilated in two steps. The two PaCO2 step decreases were significant (mean resting PaCO2 40.6 +/- 3.5 mm Hg, Step 1 level 29.4 +/- 3.5 mm Hg and Step 2 level 23.8 +/- 3.5 mm Hg; p < 0.01). These decreases induced a significant decrease in mean now velocity (V-m) and an increase in the pulsatility index (p < 0.001). Mean carbon dioxide reactivity (%Delta V-m/Delta PaCO2) was 2.74 +/- 1.0 for Step 1 and 1.44 +/-1.8 for Step 2 (p < 0.003). The mean PaCO2 decrease in patients was from 39.5 +/- 4.0 mm Hg to 27.0 +/- 3.5 mm Hg. Carbon dioxide reactivity was 0.92 +/- 1.12 for feeding vessels and 2.59 +/- 1.78 for nonfeeding vessels (p < 0.001). Transcranial Doppler ultrasound and angiographic depth measurements correlated well. Hyperventilation induced significantly more hemodynamic changes in control and nonfeeding middle cerebral arteries than in feeding vessels. Impaired CO2 reactivity may help to identify AVM feeding vessels as well as the relative magnitude ofthe flow provided to the malformation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 04:32:00