Premium
Presence and removal of arteriovenous malformation: Impact of regional cerebral blood flow, as assessed with Xenon/CT
Author(s) -
Roost D.,
Schramm J.,
Solymosi L.,
Hartmann A.
Publication year - 1996
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1996.tb00578.x
Subject(s) - cerebral blood flow , arteriovenous malformation , medicine , nuclear medicine , acetazolamide , radiology , cardiology , anesthesia
In 26 patients with supratentorial AVMs and 1 patient with a dural arteriovenous fistula, the regional cerebral blood flow (rCBF) was assessed by means of xenon‐enhanced computed tomography (Xe/CT) before and after complete resective surgery. Each assessment comprised an acetazolamide challenge in order to check the cerebrovascular reserve capacity. While scanning through the AVM was purposely avoided, a single brain slice at the level of the basal ganglia was examined. Five regions of interest (ROIs) in gray matter of the AVM‐bearing hemisphere were compared to the contralateral ROIs and categorized into 7 CBF groups. Interhemispherical differences exceeding 20% of the contralateral value in either direction were considered to the significant. AVM‐related (AVM‐R) and AVM‐non‐related (AVM‐NR) ROIs were looked at separately. Before surgery, all possible rCBF patterns were found, including a normal rCBF as well as a reduced or an increased rCBF, either in AVM‐R, AVM‐NR, or both. After AVM removal, a rCBF increase in AVM‐R is relatively rare, whereas a rCBF decrease is twice as frequent. A rCBF drop to a level of impaired reserve capacity correlates with the occurrence of a post‐operative neurological deficit.