Regional cerebral blood flow during temporary middle cerebral artery occlusion in waking monkeys.
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Biomedical subjects
Publications and source records attributed to R B Morawetz.
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Angiography in patients with subarachnoid hemorrhage secondary to aneurysm gives precise information on the location and size of the aneurysm and the aneurysm and the presence of spasm but gives incomplete information on ventricular size, size and location of hematoma, and extent of infarction. CT demonstrates precisely brain or intraventricular hematoma and, at times, subarachnoid hemorrhage, indicates the extent of infarction; and rapidly documents the degree of hydrocephalus. Infarction secondary to spasm, hematoma, and hydrocephalus are readily differentiated. The CT examination may be repeated as often as necessary without patient discomfort or morbidity. Serial scans allow rapid assessment of change in ventricular size, development and persistence of infarction, and change in size of hematoma.
rCBF was measured by 133Xenon inhalation at rest and during pCO2 manipulation in 19 patients prior to and at various times after STA-MCA bypass surgery. The resting flow increased gradually postoperatively, seemingly more due to progressive clinical recovery from the original neurologic disability than due to the surgical intervention. CO2 reactivity increased in some patients, more in those who preoperatively had the poorest reactivity. The negative relationship between preoperative reactivity and postoperative change in reactivity was highly significant. These observations are consistent with the interpretation that the surgery did not significantly affect the resting flow level but did augment the collateral reserve in those cases in which it had been most severely impaired by the arterial lesion.
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The anterior communicating artery was studied with the operating microscope in 10 autopsy cases. This vessel was present in all cases with reduplication in three. Arterial diameter ranged from 0.8 to 2.3 mm, with lengths of 5 to 10 mm. Branches of the anterior communicating artery were found in every case (range 3-13, average 5.4). Most branches were small (50-250 mu), but at least one large branch (250-1000 mu) was invariably present. Small ventral branches ramified on the optic chiasm. Small and large dorsal branches distributed themselves to lamina terminalis, hypothalamus, parolfactory areas, columns of fornix, and corpus callosum. Injury to these vessels caused by aneurysmal rupture or surgical manipulation may lead to serious clinical deficits.
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