Monitoring of cortical blood flow: clinical relevance of experimental laser Doppler studies.

Continuous monitoring of cortical blood flow provides real time information of CBF-changes during neurosurgical operations and on the neurointensive care unit. Laser Doppler flowmetry is a continuous, noninvasive technique suitable for measurement of the cortical microcirculation. In a number of experimental studies we have analyzed the characteristics of this method for cortical blood flow monitoring. The high spatial resolution of laser Doppler flowmetry and the heterogeneity of the cortical microvascular network results in a scatter of flow values over a wide range depending on the site of measurement. Data collection from different spots and calculation of frequency histogram may serve as a measure of cortical blood flow. For clinical application instead of single fiber probes a multispot measurement approach will provide a reliable cortical blood flow monitoring. The use of continuous techniques will lead to a better understanding of cerebral hemodynamics under pathological conditions.