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Normal Perfusion Pressure Breakthrough Theory . Spetzler et al Normal perfusion pressure breakthrough theory Loss of autoregulation and carbon dioxide reactivity in presence of large arteriovenous malformation. Normal perfusion pressure breakthrough theory Loss of autoregulation and carbon dioxide reactivity in presence of large arteriovenous malformation. Normal hemispheric vessels are chronically maximally dilated to attempt to divert flow from the AVM Normal perfusion pressure breakthrough theory Loss of autoregulation and carbon dioxide reactivity in presence of large arteriovenous malformation. Normal hemispheric vessels are chronically maximally dilated to attempt to divert flow from the AVM Obliteration of the AVM diverts all flow to these maximally dilated vessels which have lost their normal control mechanisms Normal perfusion pressure breakthrough theory Loss of autoregulation and carbon dioxide reactivity in presence of large arteriovenous malformation. Normal hemispheric vessels are chronically maximally dilated to attempt to divert flow from the AVM Obliteration of the AVM diverts all flow to these maximally dilated vessels which have lost their normal control mechanisms Results in loss of protection of the capillary bed, with edema and hemorrhage ?Arterial inflow Mathematical Models ?Arterial inflow ?Nidus Mathematical Models ?Arterial inflow ?Nidus ?Venous Outflow Mathematical Models Anaesthesia Technique