[Using thermal diffusion flowmetry in the assesment of regional cerebral blood flow in XXXX microsurgery].

@entity1 @entity63 @entity12046 @entity3538 @entity439 @entity438
INTRODUCTION: the thermal diffusion flowmetry (TDF) is a technique that allows the measurement of the regional cerebral blood flow (rCBF) through an implanted microprobe in a cerebral region of interest. The monitoring is continuous, real-time and quantitative (ml/100g/min). The purpose of our clinical work has been to show the technical details and preliminary results by using this monitoring technique during the microsurgical management of @entity438 and along the postoperative period. The aim of the monitoring of the rCBF is to identify and evaluate @entity63 events related with the temporary artery clipping or malposition of the final clip. CLINICAL MATERIALS: a total of five @entity1 have been monitored (4 @entity1 and one @entity1 with an average age of 50.8 years). Two @entity1 harboured one @entity439 in the middle cerebral artery, other two @entity1 had two @entity439 each one on the internal carotid artery in the exit of the posterior communicating and anterior choroidal artery and the fifth harboured a @entity3538 . All @entity1 were operated on using standard microsurgical techniques through a pterional approach. Surgery was done under neurophysiological monitoring and direct microdoppler fluometry assesment. Just before craniotomy the TDF microprobe was inserted 2.5 cm deep into the white matter through a small burr-hole placed on the coronal line and 2 cm away the midline to measure in the anterior cereral artery vascular sector and 6cm away of the midline to measure in the middle cerebral artery territory. @entity1 were under continuous monitoring during surgery and along the postoperative period in the recovery unit. A total of 14 temporary artery clippings (between 2-4) with an average total clipping time of 7.2 minutes (ranging 1.6 to 16) and 16 definitive clip replacements (ranging 2 to 8) were done at surgery. @entity1 with paraclinoid @entity439 was operated on using the retrograde aspiration technique and the internal carotid artery was kept closed 45 mimutes. keeping Some illustrative cases and demonstrative records are presented. CONCLUSIONS: the use of @entity12046 allows a quantitative real-time measurement of the rCBF in the areas of interest monitored during the microsurgical management of the @entity438 which leads to detect @entity63 events helpping to avoid @entity63 sequelae. The detection of @entity63 events in real time would make possible the use of therapeutic measures ealier and more efficienty.
