Intraoperative use of laser Doppler in the study of cerebral microvascular circulation.

Laser Doppler (LD) flowmetry has been used for evaluation of microcirculatory flow in a variety of human tissues, including skin, muscle, retina and recently the brain. In the present paper, intraoperative Laser Doppler recordings have been performed in 72 cases, in basal conditions and after stimulation. The morphology of basal recordings obtained from normal cortical areas were analyzed and three different rhythmical variations were identified; these rhythmical variations are described and explained. Several kinds of stimulation have been used: hypotensive drugs, mannitol, nimodipine, eupaverine, hypercapnia, decompressive manoeuvres and temporary occlusion of the ICA in the neck. Laser Doppler recordings obtained during and after these stimulations are reported and explained. The results have been evaluated in order to verify the reliability and the reproducibility of this technique in the study of the cerebral microvascular circulation intraoperatively.