OBJECTIVE: Some @entity438 may not be operable by conventional neurosurgery due to their location or morphology. Cardiopulmonary bypass (CPB) and deep hypothermic @entity1167 renders surgery of these complex @entity439 possible. Brain temperatures can be measured directly in this setting. METHODS: Eight @entity1 with @entity438 were operated on with the aid of CPB. Femoro-femoral bypass with heparin-coated circuit components was used in all cases. @entity1211 was augmented by a centrifugal pump in six @entity1 and by a newly developed vacuum technique in two @entity1 . Temperatures were monitored by probes in brain, tympanum, nasopharynx, bladder, rectum, arterial and venous blood. These measurements were recorded on-line together with those of cerebral @entity26 saturation, AP, CVP and PAP. Blood gas analyses and an EEG were also performed continuously. RESULTS: Outcome was excellent in seven @entity1 , in one @entity1 moderate @entity16 occurred. Mean time on cardiopulmonary bypass was 160 (117-215) min, for cooling to a brain temperature of 18 degrees C 33 (20-47) min, and for total @entity1167 27 (15-45) min. Additionally, terminal brain arteries were clamped for up to 68 min in four @entity1 . No @entity299 were observed. Actual brain temperatures were best reflected by the tympanum probes (max. deviation 2 degrees C), whereas temperatures measured in bladder or rectum exhibited deviations of up to 10 degrees C. EEG activities were arrested between brain temperatures of 19 and 26 degrees C. CONCLUSIONS: Complex @entity438 can be treated successfully using deep hypothermic @entity1167 . Extensive monitoring adds to the speed and safety of the procedure. The resulting comparative measurements of temperatures at different body sites including brain, EEG, and other variables may be of general relevance for operations employing deep @entity2332 and @entity1167 .

XXXX and @entity1167 for surgery of @entity438 .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurological disability'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac complications'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['circulatory arrest'] @entity1211 :: ('MESH:D054556', 'Disease') :: ['Venous drainage'] @entity2332 :: ('MESH:D007035', 'Disease') :: ['hypothermia'] @entity438 :: ('MESH:D002532', 'Disease') :: ['intracranial aneurysms', 'complex intracranial aneurysms']
@entity2332 :: (MESH:D007035,Disease) :: ['Deep hypothermia']
