The variation of cerebral brain flow (CBF) and pathological characteristics in peripheral brain tissue of nidns after microsurgical resection of brain arterivanous malformations (BAVM)
10.3760/cma.j.issn.1001-2036.2009.02.016
- VernacularTitle:脑动静脉畸形显微手术后周围脑组织血流变化及病理特征
- Author:
Xuesong LI
;
Nan JIANG
;
Shaolei GUO
;
Tiewei QI
;
Lingyan WANG
;
Feng LIANG
;
Zhengsong HUANG
- Publication Type:Journal Article
- Keywords:
Brain arteriverous malformations (BAVM);
Cerebral blood flow (CBF);
Normal perfusion pressure breakdown(NPPB);
Pathologcial characticristics;
Embolization
- From:
Chinese Journal of Microsurgery
2009;32(2):130-132,illust 7
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the variation of cerebral brain flow (CBF)and pathological characteristics in peripheral brain tissue of nidus after operation of brain arterivenous malformations (BAVM) and explore the mechanism and theaputic strategy of normal perfusion pressure breakdown (NPPB)after microsurgery. Methods 12 cases of BAVM that have received surgical resection were analyzed prospectively, and 8 cases of them were embolized with Onyx. The pathological characteristics of the nidus and peripheral brain tissue was observed with microscope and electron microscope. The variation of CBF in peripheral brain tissue of the nidus following microsurgical resection was observed by using Laser Doppuler Perfusion Imaging (LDPI) system. The monitering result of CBF in little meniugioma(n=6) during surgery was used as the control. Results There was small vessel expantion, neuron necrosis, gliocyte hyperplasia and blood brain barriar (BBB) destruction in peripheral brain tissue of BAVM nidus, the visibal brain tissue edema and inflammatory cell infiltration in peripheral brain tissue of the nidus and the revascularization in the emolized nidus vessels were observed after embolization with Onyx. There was significant change of CBF between pre-and post-operation (P<0.05),and after controlling depressurization during surgery was the increasing CBF step down (P<0.05). Conclusion The BBB breakdown and increasing CBF of peripheral brain tissue of the nidus may be the pathological foundation of brain hemorrhage and edema after BAVM microsurgical resection. So embolization before the operation, controlling depressuriation during and after surgery is the important methods for preventing and curing the NPPB of BAVM after microsurgery.
