Intracarotid coomassie blue eye as an aid in the surgery of intracranial vascular lesions.

Abstract

T RANSIENT coloring of the vessels of the retina or of the face by intracarotid Coomassie Blue, t a deepcolored, nontoxic dye, provides a means of confirming the correct placement of a polyethylene catheter in ei ther the external or internal carotid ar tery . This technique has been developed in conjunction with circulation studies requiring selective internal carotid injection of radioisotopes for direct recording from the surface of the brain during operation. 6-s The dye injection also displays the a n a t o m y of the pial and cortical circulation of the surgically exposed brain. This has supplied useful quali tat ive information to supplement quant i ta t ive radioisotopic flow curves obtained during operation on various lesions, including cerebral neoplasms, angiomas, aneurysms, and epilel)togenie scars. 7,s The combination of these techniques provides the neurosurgeon with a means for examining the cerebral circulation directly during craniotomy. Thus, it has been possible to distinguish arterial and venous vessels in the pial circulation, to define differences in regional blood flow in the distribution of the major cerebral arteries, and to assess changes in local blood flow after excisions which have necessitated surgical interruption of arteries or veins. ~,1~ Intra-arterial dye injection has been found useful as a means of confirming catheter placement in radioisotopic circulation studies, with external monitoring over the head. I t has also made possible controlled injection of amy ta l and metrazol into the internal carotid a r t e ry in epileptic patients when electroencephalographic localization