{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T12:43:06Z","timestamp":1760100186767},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,12]]},"abstract":"\u2713 The effects of proximal occlusion of the parent artery during aneurysm surgery in humans are not fully understood, although this method is widely used. The reduction in substrate that can be tolerated by normal and subarachnoid hemorrhage (SAH)\u2014affected brain is unknown. Therefore, the authors measured brain oxygen tension (brain PO2<\/jats:sub>), carbon dioxide tension (brain PCO2<\/jats:sub>), pH, and hemoglobin oxygen (HbO2<\/jats:sub>) saturation before and after temporary occlusion in 12 patients with aneurysms. The effect of removal of a traumatic intracranial hematoma on cerebral oxygenation was also studied in four severely head injured patients.<\/jats:p>\nA multiparameter sensor was placed in the cortex of interest and locked by means of a specially designed skull bolt. The mean arterial blood pressure, inspired O2<\/jats:sub> fraction, and end-tidal PCO2<\/jats:sub> were analyzed. Brain PO2<\/jats:sub> and HbO2<\/jats:sub> saturation data were collected every 10 seconds. Descriptive and nonparametric analyses were used to analyze the data.<\/jats:p>\nA wide range in baseline PO2<\/jats:sub> was seen, although a decrease from baseline in brain PO2<\/jats:sub> was found in all patients. During temporary occlusion, brain PO2<\/jats:sub> in patients with unruptured aneurysm (seven patients) dropped significantly, from 60 \u00b1 31 to 27 \u00b1 17 mm Hg (p < 0.05). In the SAH group (five patients), the brain PO2<\/jats:sub> dropped from 106 \u00b1 74 to 87 \u00b1 73 mm Hg (not significant). Removal of intracranial hematomas in four severely head injured patients resulted in a significant increase in brain PO2<\/jats:sub>, from 13 \u00b1 9 to 34 \u00b1 13 mm Hg (p < 0.05).<\/jats:p>\nThe duration of safe temporary occlusion could not be determined from this group of patients, because none developed postoperative deterioration in their neurological status. However, the data indicate that this technique is useful to detect changes in substrate delivery during intraoperative maneuvers. This study also reemphasizes the need for emergency removal of intracranial hematomas to improve substrate delivery in severely head injured patients.<\/jats:p>","DOI":"10.3171\/jns.1997.87.6.0809","type":"journal-article","created":{"date-parts":[[2009,6,10]],"date-time":"2009-06-10T18:28:11Z","timestamp":1244658491000},"page":"809-816","source":"Crossref","is-referenced-by-count":40,"title":["Intraoperative monitoring of substrate delivery during aneurysm and hematoma surgery: initial experience in 16 patients"],"prefix":"10.3171","volume":"87","author":[{"given":"Egon M. 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