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. 2018 Sep 20:9:188.
doi: 10.4103/sni.sni_58_18. eCollection 2018.

Infrared thermography brain mapping surveillance in vascular neurosurgery for anterior communicating artery aneurysm clipping

Enrique de Font-Réaulx Rojas  1 , Edith Elizabeth Martínez Ochoa  2 , Ramón López López  3 , Luis Guillermo López Díaz  2
Affiliations

Infrared thermography brain mapping surveillance in vascular neurosurgery for anterior communicating artery aneurysm clipping

Enrique de Font-Réaulx Rojas et al. Surg Neurol Int. .

Abstract

Background: Infrared thermography (IT) is a noninvasive, real-time diagnostic method that requires no contact with the patient and has a broad spectrum of potential applications in neurosurgery. It has been previously demonstrated the high sensitivity and specificity that IT has to detect brain blood flow changes.

Case description: The case is based on a 64-year-old diabetic and hypertensive male, to whom an anterior communicating artery (ACoA) incidental aneurysm was discovered. We performed the basal infrared thermography mapping (ITM) and immediately after the transitory clip placement in both A1 segments of the anterior cerebral artery (A1-ACA), we performed a second ITM of the exposed brain cortex. After the definitive clip placement in the neck of the ACoA aneurysm, we removed the transitory clips of both A1-ACA and performed a third ITM of the cortical surface, without finding any cortical cooling or significative temperature differences (Ϫt) compared to the basal ITM. The postoperatory computed tomography (CT) and angio-CT did not show any ischemic damage and confirmed the accurate aneurysm clipping.

Conclusions: The ITM seems to be a real-time, safe, and useful brain mapping method to identify different temperature zones and temperature dispersion gradients in the human brain cortex. More studies are needed to evaluate the potential applications of IT mapping of the human brain and its use in neurosurgery and vascular neurosurgery.

Keywords: Aneurysm clipping; infrared thermography; infrared thermography mapping; real-time brain mapping; vascular neurosurgery.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Unruptured incidental anterior communicating artery aneurysm of 8 × 5 mm
Figure 2
Figure 2
Image of the basal cortical metabolism measured by infrared thermography mapping (left). The temperature of the frontal lobe cortex is 31.4°C. Image of the second infrared thermography mapping during the transitory clipping of both A1-ACA (center). Image of the third infrared thermography mapping after definitive clipping of the neck of the anterior communicating artery aneurysm and removing of both transitory clips of both A1-ACA (right)
Figure 3
Figure 3
Postoperative computed tomography and angio-CT. No evidence of ischemia in the A1 or anterior communicating artery territory. Adequate clip placement in the neck of the aneurysm with total exclusion of arterial circulation and adequate filling of both A1-ACA
See this image and copyright information in PMC

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