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Spatially extended versus frontal cerebral near-infrared spectroscopy during cardiac surgery: a case series identifying potential advantages
- Source :
- Journal of Biomedical Optics. 23:1
- Publication Year :
- 2018
- Publisher :
- SPIE-Intl Soc Optical Eng, 2018.
-
Abstract
- Stroke due to hypoperfusion or emboli is a devastating adverse event of cardiac surgery, but early detection and treatment could protect patients from an unfavorable postoperative course. Hypoperfusion and emboli can be detected with transcranial Doppler of the middle cerebral artery (MCA). The measured blood flow velocity correlates with cerebral oxygenation determined clinically by near-infrared spectroscopy (NIRS) of the frontal cortex. We tested the potential advantage of a spatially extended NIRS in detecting critical events in three cardiac surgery patients with a whole-head fiber holder of the FOIRE-3000 continuous-wave NIRS system. Principle components analysis was performed to differentiate between global and localized hypoperfusion or ischemic territories of the middle and anterior cerebral arteries. In one patient, we detected a critical hypoperfusion of the right MCA, which was not apparent in the frontal channels but was accompanied by intra- and postoperative neurological correlates of ischemia. We conclude that spatially extended NIRS of temporal and parietal vascular territories could improve the detection of critically low cerebral perfusion. Even in severe hemispheric stroke, NIRS of the frontal lobe may remain normal because the anterior cerebral artery can be supplied by the contralateral side directly or via the anterior communicating artery.
- Subjects :
- Male
medicine.medical_specialty
Intraoperative Neurophysiological Monitoring
Cerebral arteries
Biomedical Engineering
Neuroimaging
Biomaterials
03 medical and health sciences
0302 clinical medicine
030202 anesthesiology
Internal medicine
medicine.artery
Image Interpretation, Computer-Assisted
medicine
Anterior cerebral artery
Humans
Cerebral perfusion pressure
Stroke
Aged
Cardiopulmonary Bypass
Spectroscopy, Near-Infrared
business.industry
Brain
medicine.disease
Atomic and Molecular Physics, and Optics
Electronic, Optical and Magnetic Materials
Transcranial Doppler
Anterior communicating artery
Frontal lobe
Cerebrovascular Circulation
Middle cerebral artery
Cardiology
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 10833668
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- Journal of Biomedical Optics
- Accession number :
- edsair.doi.dedup.....d95ee71e20fe42b407275b41f2c16adb