By Werner Hassler
ISBN-10: 3211819703
ISBN-13: 9783211819708
ISBN-10: 3709188911
ISBN-13: 9783709188910
Up thus far, the remedy of arteriovenous racemose angiomas of the mind is still unsatisfactory. Intraoperative hemorrhages, post-embolizational or postoperative deficits reckoning on the positioning and measurement of the A VM in addition to inoperability of infrequent angioma kinds have promoted the technical development of diagnostic and healing methods. however, a few pathophysiological difficulties of A VM hemodynamics haven't been solved. Many angiographical reviews, observations in the course of embolization and operation, dopplersonographical and different perfusion measurements supplied a few perception. enough animal versions haven't begun to be built with a purpose to elucidate the pathophysiological mechanisms. This monograph describes A V fistula types in cats and rats, either traditional and newly constructed, which enable a greater comparability with human cerebral angiomas than past ones. an important result's that the version of the step forward of arterial strain waves into the capillaries following a failure of cerebrovascular law can't be proven. particularly, in line with the findings in precapillary vessels provided right here, the rules services regularly in order that a breakdown of legislation can't be liable for international mind edema frequently visible after removing of angiomas. The rules was once validated utilizing various 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 stream and strain were applied.
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Extra resources for Hemodynamic Aspects of Cerebral Angiomas
Sample text
Results: a) The Doppler device used cannot unequivocally detect oscillating flows. All flow directions cause an upward deflection on the Angioscan. b) Using the electromagnetic method, oscillating flows were recorded precisely (Fig. 31). c) Retrograde flow in the distal CCA showed a nonpulsatile, constant pattern in both recording methods (Fig. 31). d) With both proximal CCAs occluded, flow velocity spectra consisted of damped systolic 4 kHz waves (Fig. 32). This flow has lost its arterial character.
Discussion and Summary of Animal Experiments Qfe 13 'If. 15 14 15 o SO 151 1201099 92 Nitroglycerin Fig. 38. Intact autoregulation after sudden occlusion of an 8-week-old bilateral H-fistula: No relevant changes of flow rate occur in the distal CCA which had been exposed to low pressure conditions for 8 weeks 14 'If. 0 -. - fe 14 13 76 70 13 mVmin 65 mmHg ......... 12 12 11 10 11 SO 87 91 '0) 110 125 Effortil 12 ml/min 130mmHg described above, Evans blue was then given to study disturbances of the blood-brain barrier.
D) Stream resistance Peripheral stream resistance of the CCA drops after application of cervical A V fistulae. The resistance indices were calculated according to Pourcelot from our electromagnetic flow profiles. As expected, stream resistance was lower in direct (T) fistulae than in the Hmodel. e) Vascular changes Arterial and venous vessel diameters increase after cervical fistula application. Enlargement was much more pronounced in draining veins (up to 250%) than in the feeding arteries (average 23%).