Bedside monitoring of regional cortical blood flow in comatose patients using laser Doppler flowmetry. 1991

B A Meyerson, and L Gunasekera, and B Linderoth, and B Gazelius
Department of Neurosurgery, Karolinska Hospital, Stockholm, Sweden.

Continuous beside monitoring of regional cerebrocortical blood flow was carried out using laser Doppler flowmetry (LDF) in four comatose patients. Newly designed thin and flexible optical probes that were easily implanted into the cortex were employed. When the patients were in a deep comatose state, the recordings revealed a conspicuous relationship to intracranial pressure. As the patients improved, the flux values gradually increased, and the recordings showed characteristic changes in the wave pattern, presumably related to the restoration of an impaired cerebral autoregulation. Changes in regional cerebrocortical blood flow were also observed during routine nursing procedures, the use of medications, and voluntary activities, as demonstrated by one patient after a complete recovery. Although the volume of tissue scanned with LDF was limited, and the flux values did not directly express regional cerebrocortical blood flow in terms of milliliters per unit volume, changes in cerebral circulation were portrayed clearly in the flow recordings. Thus, LDF, which is simple to use, permits continuous bedside monitoring of the cerebral microcirculation. Its use should improve the management of comatose patients and also open avenues for a better understanding of the cerebral circulation in pathological states.

UI MeSH Term Description Entries
D007427 Intracranial Pressure Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. Intracerebral Pressure,Subarachnoid Pressure,Intracerebral Pressures,Intracranial Pressures,Pressure, Intracerebral,Pressure, Intracranial,Pressure, Subarachnoid,Pressures, Intracerebral,Pressures, Intracranial,Pressures, Subarachnoid,Subarachnoid Pressures
D007834 Lasers An optical source that emits photons in a coherent beam. Light Amplification by Stimulated Emission of Radiation (LASER) is brought about using devices that transform light of varying frequencies into a single intense, nearly nondivergent beam of monochromatic radiation. Lasers operate in the infrared, visible, ultraviolet, or X-ray regions of the spectrum. Masers,Continuous Wave Lasers,Pulsed Lasers,Q-Switched Lasers,Continuous Wave Laser,Laser,Laser, Continuous Wave,Laser, Pulsed,Laser, Q-Switched,Lasers, Continuous Wave,Lasers, Pulsed,Lasers, Q-Switched,Maser,Pulsed Laser,Q Switched Lasers,Q-Switched Laser
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D008991 Monitoring, Physiologic The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine. Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D001783 Blood Flow Velocity A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002540 Cerebral Cortex The thin layer of GRAY MATTER on the surface of the CEREBRAL HEMISPHERES that develops from the TELENCEPHALON and folds into gyri and sulci. It reaches its highest development in humans and is responsible for intellectual faculties and higher mental functions. Allocortex,Archipallium,Cortex Cerebri,Cortical Plate,Paleocortex,Periallocortex,Allocortices,Archipalliums,Cerebral Cortices,Cortex Cerebrus,Cortex, Cerebral,Cortical Plates,Paleocortices,Periallocortices,Plate, Cortical
D002560 Cerebrovascular Circulation The circulation of blood through the BLOOD VESSELS of the BRAIN. Brain Blood Flow,Regional Cerebral Blood Flow,Cerebral Blood Flow,Cerebral Circulation,Cerebral Perfusion Pressure,Circulation, Cerebrovascular,Blood Flow, Brain,Blood Flow, Cerebral,Brain Blood Flows,Cerebral Blood Flows,Cerebral Circulations,Cerebral Perfusion Pressures,Circulation, Cerebral,Flow, Brain Blood,Flow, Cerebral Blood,Perfusion Pressure, Cerebral,Pressure, Cerebral Perfusion
D003128 Coma A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION. Comatose,Pseudocoma,Comas,Pseudocomas

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