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

• Published in: Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko no. 3; p. 35
• Main Authors: Madorskiĭ, S V, Parfenov, A L, Voronina, I A, Shovikova, O A, Safin, A M
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 01-07-2008
• Subjects: 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
• ISSN: 0042-8817

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.