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Cerebral oxygenation and hemodynamic measurements during craniosynostosis surgery with near-infrared spectroscopy

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Abstract

Introduction

Focal pressure-related changes in brain perfusion and metabolism are discussed in single-suture craniosynostosis and brachycephalic cases (bicoronal synostosis). Raised intracranial pressure levels could be measured in some cases. In order to find possible loco-regional brain tissue changes during plastic surgery, we investigated oxygenation and perfusion parameters using non-invasive near-infrared spectroscopy (NIRS) probes.

Methods

Twenty-two consecutively operated cases (mean age 7 months) with single-suture craniosynostosis were prospectively investigated using a NIRS probe (LEA©, O2C, white light 500–800 nm, laser NIR). Measurements for oxygen saturation (SO2), relative quantity of hemoglobin (rHb), blood flow, and blood flow velocity of the bilateral frontal, temporal, and parietal cortices were taken transosseously (prior to decompression) and epidurally directly after decompression as well as 15 and 30 min after decompression and before closure.

Results

Twenty-two patients with scaphocephaly (11), trigonocephaly (6), anterior plagiocephaly (3), and brachycephaly (2) were investigated. SO2 was improving in all patient subgroups, showing the highest levels in the fronto-temporal region; rHb improved in scaphocephalic, trigonocephalic, and brachycephalic children. Again, the highest values were found not only in the temporal but also in the frontal region and in brachycephalic patients also in the parietal cortex.

Conclusion

These preliminary results of a new technology for brain tissue oxygenation and blood flow measurements suggest a regional compromise of cortical metabolism and circulation in patients with craniosynostosis.

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Conflict of interest

The authors report no conflicts of interest related to the contents of this paper and declare to have no funding for the underlying study.

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Authors and Affiliations

  1. Klinik und Poliklinik für Mund-, Kiefer- und Plastische Gesichtschirurgie, Universitätsklinik Bonn, Bonn, Germany

    M. Martini & M. Wenghoefer

  2. Abteilung für Kinderneurochirurgie, Asklepios Klinik Sankt Augustin, Arnold-Janssen-Str. 29, 53757, Sankt Augustin, Germany

    A. Röhrig & A. M. Messing-Jünger

  3. Zentrum für Kinderanästhesiologie, Asklepios Klinik Sankt Augustin, Sankt Augustin, Germany

    E. Schindler

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  1. M. Martini
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  2. A. Röhrig
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  3. M. Wenghoefer
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  4. E. Schindler
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  5. A. M. Messing-Jünger
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Correspondence to A. M. Messing-Jünger.

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Martini, M., Röhrig, A., Wenghoefer, M. et al. Cerebral oxygenation and hemodynamic measurements during craniosynostosis surgery with near-infrared spectroscopy. Childs Nerv Syst 30, 1367–1374 (2014). https://doi.org/10.1007/s00381-014-2418-3

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  • DOI: https://doi.org/10.1007/s00381-014-2418-3

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