Clinical trial NCT01476670: Cerebral Blood Circulation in Patients With Posterior Fossa Brain Tumor
Official title: Cerebral Autoregulation and Carbon Dioxide Reactivity in Patients With Posterior Fossa Tumor
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Brain Tumor
Keywords: Posterior fossa brain tumor
Cerebral blood flow
Cerebral autoregulation
Carbon dioxide reactivity
Transcranial Doppler
Lead sponsor: All India Institute of Medical Sciences
Sponsor class: OTHER
First posted: 2011-11-22
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Due to their anatomic location, posterior fossa tumors result in obstruction of ventricular outflow, produce hydrocephalus and features of raise intracranial pressure (ICP). It is possible that lesions in the posterior fossa may affect Cerebral Autoregulation and Carbon dioxide reactivity. It should also be noted that posterior fossa surgeries are carried out in positions such as prone, lateral and sitting. Altered surgical positions themselves affect systemic hemodynamics which may influence cerebral blood flow; with presence of anesthetics further compromising the blood flow to the brain. Understanding the homeostatic mechanisms of CA and CO2R may help in deciding proper positioning of patients and maintenance of intraoperative hemodynamic.

Brief summary: The normal cerebral blood flow is guided by factors such as cerebral autoregulation (CA) and carbon dioxide reactivity (CO2R). Authors have demonstrated that CA and CO2R may be impaired in presence of intracranial tumors.Most studies pertaining to assessment of CA and CO2R in patients with brain tumors is limited to supratentorial tumors. Due to their anatomic location, posterior fossa tumors result in obstruction of ventricular outflow, produce hydrocephalus and features of raise intracranial pressure (ICP). It is possible that lesions in the posterior fossa may affect CA and CO2R. It should also be noted that posterior fossa surgeries are carried out in positions such as prone, lateral and sitting. Altered surgical positions themselves affect systemic hemodynamics which may influence cerebral blood flow; with presence of anesthetics further compromising the blood flow to the brain. Understanding the homeostatic mechanisms of CA and CO2R may help in deciding proper positioning of patients and maintenance of intraoperative hemodynamic.

The aim of this observational study was to evaluate CA and CO2R in patients with posterior fossa tumor prior to surgical decompression of the lesion.


Eligibility criteria: Inclusion Criteria:

* All patients with posterior fossa tumor
* Scheduled for elective surgery
* History of recent ventriculoperitoneal shunt (within 24 hours)

Exclusion Criteria:

* previous craniotomy
* patients on ventilatory support
* history of cerebrovascular accident
* syncope or carotid artery disease
* anemia
* polycythemia
* patients on vasoactive medications
* those suffering from medical conditions such as diabetes mellitus and hypertension.

Primary outcomes:
Secondary outcomes:
Other outcomes:
Locations:
city: New Delhi
country: India
facility: All India Institute of Medical Sciences
state: Delhi
Study officials:
affiliation: All India Institute of Medical Sciences
name: Hemanshu Prabhakar, MD
role: PRINCIPAL_INVESTIGATOR
References: