Dynamic Autoregulation Testing Does Not Indicate Changes of Cerebral Blood Flow Before and After Resection of Small- and Medium-Sized Cerebral AVM

Abstract

This study tested the hypothesis that dynamic cerebral autoregulation (AR) remains intact before and after the excision of human arteriovenous malformations (AVM). In 12 patients (six female and six male; mean age, 34years) harboring cerebral AVMs (AVM group), and 15 patients (nine female/six male; mean age, 49years) with deep-seated lesions (e.g., small frontobasal meningiomas) approached by transsylvian dissection (control group), we continuously assessed cerebral blood flow (CBF) using a thermo-diffusion technique, and mean arterial blood pressure (MABP). AR was estimated post-hoc using correlation-coefficient autoregulatory-index (Mx) analysis. Measurements were compared according to groups (AVM/control) and times (pre/post), referred to as conditions before and after AVM resection and transsylvian dissection, respectively. All values are given as mean ± SD. The correlation index Mx was without significant difference among the study groups, indicating unimpaired autoregulatory function. Intragroup comparisons related to AVM nidus size (small- (≤3cm) and medium-sized (3-6cm)) did not show significant influence on autoregulation. The study shows that in patients harboring small- and medium-sized AVMs, dynamic autoregulatory function as estimated by correlation-coefficient index analysis seems to be intact in the surrounding cerebrovascular bed perioperatively.