Subscribe to RSS
Decoding the Onset of Intraoperative Normal Pressure Perfusion Breakthrough with Near-Infrared Spectroscopy and Jugular Venous Oxygen Saturation Catheter in a Case of Arteriovenous Malformation Surgery
Multimodal monitoring can be a useful tool to design an appropriate anesthesia technique in the intraoperative period during the surgical excision of an intracerebral arteriovenous malformation (AVM). Intraoperatively, hyperperfusion syndrome can be attributed to causes like insufficient blood pressure control, occlusion of venous drainage before complete resection of arterial feeders, or inadequate hemostatic control of distended capillaries receiving arterial flow. We would like to highlight the potential role of near-infrared spectroscopy and jugular venous oxygen saturation catheter in detection of intraoperative normal perfusion pressure breakthrough and take necessary measures to prevent further insult with the help of this case report.
Keywordsmultimodal monitoring - near infrared spectroscopy - hyperperfusion syndrome - arteriovenous malformation
Article published online:
24 October 2021
© 2021. Indian Society of Neuroanaesthesiology and Critical Care. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
- 1 Rangel-Castilla L, Spetzler RF, Nakaji P. Normal perfusion pressure breakthrough theory: a reappraisal after 35 years. Neurosurg Rev 2015; 38 (03) 399-404
- 2 Miller C, Mirski M. Anesthesia considerations and intraoperative monitoring during surgery for arteriovenous malformations and dural arteriovenous fistulas. Neurosurg Clin N Am 2012; 23 (01) 153-164
- 3 Tamaki N, Ehara K, Fujita K, Shirakuni T, Asada M, Yamashita H. Cerebral hyperperfusion during surgical resection of high-flow arteriovenous malformations. Surg Neurol 1993; 40 (01) 10-15
- 4 Green DW, Kunst G. Cerebral oximetry and its role in adult cardiac, non-cardiac surgery and resuscitation from cardiac arrest. Anaesthesia 2017; 72 (Suppl. 01) 48-57
- 5 Arikan F, Vilalta J, Noguer M, Olive M, Vidal-Jorge M, Sahuquillo J. Intraoperative monitoring of brain tissue oxygenation during arteriovenous malformation resection. J Neurosurg Anesthesiol 2014; 26 (04) 328-341
- 6 Calderon-Arnulphi M, Alaraj A, Amin-Hanjani S. et al. Detection of cerebral ischemia in neurovascular surgery using quantitative frequency-domain near-infrared spectroscopy. J Neurosurg 2007; 106 (02) 283-290
- 7 Tanaka K, Yonekawa Y, Kaku Y, Kazekawa K. Arteriovenous malformation and diaschisis. Acta Neurochir Wien 1993; 120 (01/02) 26-32
- 8 Wilder-Smith OH, Fransen P, de Tribolet N, Tassonyi E. Jugular venous bulb oxygen saturation monitoring in arteriovenous malformation surgery. J Neurosurg Anesthesiol 1997; 9 (02) 162-165
- 9 Schneider GH, von Helden A, Lanksch WR, Unterberg A. Continuous monitoring of jugular bulb oxygen saturation in comatose patients–therapeutic implications. Acta Neurochir Wien 1995; 134 (01/02) 71-75
- 10 Ajayan N, Hrishi AP, Nagendra V, Sethuraman M. Role of multimodal cerebral oximetry monitoring in the anesthetic management of a patient with high-grade intracranial arteriovenous malformation: a case report. A A Pract 2020; 14 (06) e01192
- 11 Pennekamp CWA, Immink RV, den Ruijter HM. et al. Near-infrared spectroscopy can predict the onset of cerebral hyperperfusion syndrome after carotid endarterectomy. Cerebrovasc Dis 2012; 34 (04) 314-321