Linked Life Data

7155329

Source:http://linkedlifedata.com/resource/pubmed/id/7155329

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
1983-3-11
pubmed:abstractText
Massive, multifocal bleeding after the technically successful removal of a cerebral arteriovenous malformation (AVM) represents a frightening and usually catastrophic complication. This phenomenon, termed normal perfusion pressure breakthrough by Spetzler et al., is caused by the diversion of blood flow from the AVM into adjacent, maximally dilated, and nonautoregulating small vessels. We recently encountered three cases of cerebral AVM that exhibited breakthrough bleeding immediately after an apparently successful operation. In all cases, the surgeon was unable to control the resultant hemorrhage by standard microsurgical techniques. High dose barbiturate anesthesia, combined with blood pressure reduction to the lower levels of the normal cerebral perfusion curve, was then initiated in each case. Controlled hyperventilation, steroids, and osmotic dehydrating agents were also used to control intracranial pressure elevation. After maintenance of this regimen for several days, the patients were returned to the operating room for hematoma evacuation. At this time, bleeding was controlled easily and breakthrough did not occur. Although this regimen requires intensive anesthetic, pulmonary, and cerebral monitoring, it successfully salvaged all three patients. Two made immediate, remarkable recoveries, and the third patient is slowly improving. This protocol therefore seems promising for the management of the massive, uncontrollable cerebral swelling or bleeding that may occur as a consequence of AVM removal.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
0148-396X
pubmed:author
pubmed:issnType
Print
pubmed:volume
11
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
625-30
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed:year
1982
pubmed:articleTitle
Successful treatment of the normal perfusion pressure breakthrough syndrome.
pubmed:publicationType
Journal Article, Case Reports