Perioperative Dynamics of Intracranial B-waves of Blood Flow Velocity in the Basal Cerebral Arteries in Patients with Brain Arteriovenous Malformation.

Abstract

Intracranial B-waves (8-30mHz) of blood flow velocity (BFV) in the cerebral arteries are observed in various pathologies of the brain. Changes in B-waves of BFV in pathological arteriovenous shunting and "steal" syndrome remain poorly understood. The aim of this study was to evaluate the dynamics of the B-wave amplitude of BFV (BWA) in patients with an arteriovenous malformation (AVM) in the brain. In 38 such patients, cerebral autoregulation (CA) was assessed using a cuff test and transfer function analysis of the mean blood pressure (BP) and BFV in the basal cerebral arteries within the range of Mayer waves (80-120mHz). BWA was calculated with spectral analysis. Reliable CA impairment was denoted on the AVM side as compared with the contralateral side prior to intervention. BWA was greater on the AVM side (4.5±2.7cm/s) than on the contralateral side (2.2±1.4cm/s, p<0.05). After embolization, there was a reliable improvement (p<0.05) in CA and a decrease in BWA on the AVM side (2.7±1.8cm/s). Thus, a considerable increase in BWA on the AVM side that is not induced by BP fluctuations may indicate additional compensation for blood flow under conditions of reduced perfusion pressure. This assumption is supported by a reduction in BWA after AVM embolization.