Dynamic cerebral autoregulation in patients undergoing surgery for intracranial tumors

Abstract

Objective: Alterations of cerebral perfusion in brain parenchyma adjacent to tumors have been reported in the literature. The aim of this study was to test cerebral autoregulation in patients scheduled for tumor resection. Methods: Dynamic cerebral autoregulation was evaluated perioperatively using bilateral transcranial Doppler sonography and the thigh cuff method to alter arterial blood pressure in 50 patients (26 females and 24 males) with a mean age of 49.8 years (range 15–73 years). The alterations of cerebral autoregulation were correlated to size, location and histology of the tumor and the presence of accompanying diseases. Results: Mean cerebral autoregulation was normal before the induction of anesthesia, after intubation under normoventilation, after intubation under hyperventilation and after surgery on intensive care unit. Location, size or histological classification of the lesion was without influence on autoregulation. The patients with accompanying diseases, such as diabetes mellitus and/or hypertension had significantly lower autoregulation values prior to surgery and a significantly lower increase after hyperventilation. Conclusion: Cerebral autoregulation is preserved in patients with intracranial tumors regardless of tumor size, if the patient’s clinical status prior to surgery is good. The influence of accompanying diseases was demonstrable and should be considered in the perioperative patients management.