| Popis: |
There is considerable controversy and a surprising lack of data regarding cerebral hemodynamic status right after craniotomy. Cerebral hyperemia occurs frequently after brain tumor resection procedures. Therefore, it needs more clinical concerns. Initially, we start with reviewing studies focusing on postoperative cerebral hyperemia, outlining the changes of cerebral blood flow and brain metabolism in the immediate postoperative period. Afterwards, we review the mechanisms currently thought to be responsible for postoperative cerebral hyperemia. Impaired cerebral autoregulation, postoperative hypertension, hypercapnia and adaption to hypocapnia, hemodilution, the effect of anesthetics, sympathetic overactivity and surgery related factors are discussed respectively. Lastly, we introduce several available monitoring techniques in the clinical setting, possible preventions and therapies of cerebral hyperemia after craniotomy. Further understanding of its pathophysiology will allow the rational development of prophylactic and therapeutical interventions of postoperative cerebral hyperemia, and eventually improve patient safety as well as outcome. |
