[Specific features of cerebral blood flow changes after surgical removal of chiasmatic-sellar region tumors using data of transcranial duplex sonography]

Zh Vopr Neirokhir Im N N Burdenko. 2008 Jul-Sep:(3):35-41.
[Article in Russian]

Abstract

Aim of the study was to discover specific features of linear blood velocity in early postoperative period in patients with tumors of chiasmatic-sellar region. Measurement of linear blood velocity using transcranial duplex sonography was performed in 294 patients with tumors of hypothalamo-hypophyseal area (149 suprasellar pituitary adenomas, 145 endosuprasellar, hypophyseal and ventricular craniopharyngiomas). It was found that vasospasm of different severity was present in 62% cases after surgical removal of chiasmatic-sellar region tumors. This "primary vasospasm" was associated with intraoperative damage to a vessel. Delayed angiospasm was caused by subarachnoid hemorrhage into basal cisterns due to hyperactivation of neuroendocrine systems of adenohypophysis and aldosterone. Persistent vasospasm with linear blood velocity over 200 cm/s results in irreversible ischemic damage of subcortical and hypothalamic structures.

MeSH terms

  • Adenoma / surgery*
  • Cerebrovascular Circulation / physiology*
  • Craniopharyngioma / surgery*
  • Humans
  • Neurosurgical Procedures* / adverse effects
  • Neurosurgical Procedures* / methods
  • Pituitary Neoplasms / surgery*
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / etiology
  • Subarachnoid Hemorrhage / physiopathology
  • Ultrasonography, Doppler, Transcranial*
  • Vasospasm, Intracranial / diagnostic imaging
  • Vasospasm, Intracranial / etiology
  • Vasospasm, Intracranial / physiopathology