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Dynamic Autoregulation Testing Does Not Indicate Changes of Cerebral Blood Flow Before and After Resection of Small- and Medium-Sized Cerebral AVM

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Abstract

This study tested the hypothesis that dynamic cerebral autoregulation (AR) remains intact before and after the excision of human arteriovenous malformations (AVM). In 12 patients (six female and six male; mean age, 34 years) harboring cerebral AVMs (AVM group), and 15 patients (nine female/six male; mean age, 49 years) with deep-seated lesions (e.g., small frontobasal meningiomas) approached by transsylvian dissection (control group), we continuously assessed cerebral blood flow (CBF) using a thermo-diffusion technique, and mean arterial blood pressure (MABP). AR was estimated post-hoc using correlation-coefficient autoregulatory-index (Mx) analysis. Measurements were compared according to groups (AVM/control) and times (pre/post), referred to as conditions before and after AVM resection and transsylvian dissection, respectively. All values are given as mean ± SD. The correlation index Mx was without significant difference among the study groups, indicating unimpaired autoregulatory function. Intragroup comparisons related to AVM nidus size (small- (≤3 cm) and medium-sized (3–6 cm)) did not show significant influence on autoregulation. The study shows that in patients harboring small- and medium-sized AVMs, dynamic autoregulatory function as estimated by correlation-coefficient index analysis seems to be intact in the surrounding cerebrovascular bed perioperatively.

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Acknowledgements

We thank all neurosurgical OR staff and coworkers of the Department of Anesthesiology at the Medical Center University of Bonn for their extraordinary patience throughout our experimental procedures.

Disclosure / Conflict of Interest

This work was supported by the German Research Council (DFG grant ME 1082/1-1). There was no further financial support to this work.

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Authors and Affiliations

  1. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675, Munich, Germany

    Carsten Stüer, Michael Stoffel & Bernhard Meyer

  2. Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Bonn, Germany

    Carsten Stüer, Toshiki Ikeda, Michael Stoffel, Carlo Schaller & Bernhard Meyer

  3. Service Neurochirurgie, Hôpitaux Universitaires de Genève, Genève, Switzerland

    Carlo Schaller

  4. Department of Neurosurgery, Faculty of Medicine, Kyorin University, Tokyo, Japan

    Toshiki Ikeda

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  1. Carsten Stüer
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  2. Toshiki Ikeda
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  3. Michael Stoffel
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  4. Carlo Schaller
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  5. Bernhard Meyer
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Correspondence to Carsten Stüer.

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Stüer, C., Ikeda, T., Stoffel, M. et al. Dynamic Autoregulation Testing Does Not Indicate Changes of Cerebral Blood Flow Before and After Resection of Small- and Medium-Sized Cerebral AVM. Transl. Stroke Res. 2, 60–66 (2011). https://doi.org/10.1007/s12975-010-0031-7

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  • DOI: https://doi.org/10.1007/s12975-010-0031-7

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