Further considerations in the use of hypothermia and intermittent cerebral ischemia: an experimental study in primates.

Abstract

Although occlusion of the cerebral arterial circulation has been of considerable value in temporarily controlling hemorrhage during the surgical treatment of intracranial vascular anomalies, its elective use for any prolonged length of time to facilitate the removal of otherwise inoperable lesions has been limited by the substantial risk of impairing neural function. Total cessation of the circulation under hypothermia has been pioneered by the cardiovascular surgeon to allow direct attack upon lesions of the heart and great vessels. The relatively short length of time which the central nervous system will withstand total ischemia even under hypothermic conditions, however, has restricted its usefulness and has stimulated the study of means to shunt the circulation around the diseased area in order to maintain the cerebral blood supply during surgery. As such techniques are of little value to the neurosurgeon, it is important to understand the conditions for deriving the maximum possible benefit