Acute effect of the carbon dioxide laser on the epicerebral microcirculation

Experimental study by fluorescein angiography

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✓ The effect of laser radiation on the central nervous system has been studied in cases of clinical and experimental tumors. However, no report yet exists on the effects of laser radiation on the cerebral microcirculation in vivo. Cerebral fluorescein angiography permits observations of small vessels that are not possible by conventional angiography. In this study, disturbance in the epicerebral microcirculation after carbon dioxide laser radiation was localized. On fluorescein angiograms, a circular zone of nonfilling of fluorescein dye around the site of impact, 1 to 1.5 mm in diameter, was seen throughout from the arterial to late venous phase. Around the nonfilling area, thrombus formation in small vessels and extravasation of the dye were demonstrated. Such extravasation of the fluorescein remained after the dye had faded from the venules and veins. Microscopically, coagulation necrosis was observed to coincide with the area of nonfilling of fluorescein dye in the fluorescein angiograms. In areas surrounding this, edema, dilatation or rupture of the capillaries, and thrombus formation in the arterioles were observed. Such areas coincided with those of extravasation of the fluorescein dye.

Article Information

Contributor Notes

Address reprint requests to: Shigeo Toya, M.D., Department of Neurosurgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160, Japan.

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