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- Title:
Norepinephrine and cerebral blood flow regulation in patients with arteriovenous malformations.
- Document type:
- Journal Article
- Author(s):
- Stüer, C; Ikeda, T; Stoffel, M; Luippold, G; Sakowitz, O; Schaller, K; Meyer, B
- Abstract:
- OBJECTIVE: To test the hypothesis that the sympathetic nervous system plays a role in cerebral blood flow regulation in patients with arteriovenous malformations (AVM). METHODS: Cortical interstitial norepinephrine was measured by means of microdialysis, regional cerebral blood flow was measured by a thermal diffusion technique, and regional oxygen saturation (SO2) was measured by microspectrophotometry in 12 patients harboring cerebral AVMs (AVM group) and in 15 patients with deep-seated nonvascular lesions (control group) before and after resection. Measurements were compared according to groups and times of measurements. All values are given as means +/- standard deviation. RESULTS: Cortical regional SO2 increased significantly (P < 0.05) in both groups after surgery (AVM group: presurgery 52.4 +/- 12.5% SO2, postsurgery 71.4 +/- 7.4% SO2; control group: presurgery 57.1 +/- 8.4% SO2, postsurgery 69.9 +/- 8.7% SO2), whereas regional cerebral blood flow increased only in the AVM group (AVM group: presurgery 18.9 +/- 6.6 ml/100 g/min, postsurgery 26.2 +/- 6.9 ml/100 g/min; control group: presurgery 20.1 +/- 7.6 ml/100 g/min, postsurgery 19.4 +/- 7.8 ml/100 g/min). Norepinephrine concentrations were significantly lower in the AVM group as compared with the control group before surgery. Although there was no significant difference between pre- and postsurgery conditions in the AVM group, the norepinephrine level of the control group was significantly lower after surgery (AVM group: presurgery 3.3 +/- 1.2 nmol/L, postsurgery 2.9 +/- 1.7 nmol/L; control group: presurgery 5.4 +/- 1.4 nmol/L, postsurgery 4.2 +/- 1.1 nmol/L). CONCLUSION: Chronically lowered perfusion pressure seems to induce the hypothesized adaptive down-regulation of sympathetic nervous system activity, yet protective up-regulation after a sudden elevation of cerebral perfusion pressure after AVM excision could not be shown in this study.
- Journal title abbreviation:
- Neurosurgery
- Year:
- 2008
- Journal volume:
- 62
- Journal issue:
- 6
- Pages contribution:
- 1254-60; discussion 1260-
- Language:
- eng
- Fulltext / DOI:
- doi:10.1227/01.neu.0000333296.41813.74
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/18824991
- Print-ISSN:
- 0148-396X
- TUM Institution:
- Neurochirurgische Klinik und Poliklinik
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