Intraoperative tracking of tissue perfusion during cerebral aneurysm surgery with laser speckle contrast imaging: insights beyond standard intraoperative neuromonitoring for detecting ischemia.
Overview
- The University of Oklahoma, Stephenson School of Biomedical Engineering, Norman, Oklahoma, United States
- University of Oklahoma College of Medicine, Department of Neurosurgery, Oklahoma City, Oklahoma, United States
- University of Oklahoma Health Sciences Center, Department of Biostatistics and Epidemiology, Oklahoma City, Oklahoma, United States
- The University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
Abstract
Significance: Intraoperative cerebral ischemia is a critical complication that can arise during cerebral aneurysm clipping surgery. Although intraoperative neuromonitoring (IONM) can detect resulting functional deficits, these alerts may occur minutes after the initial ischemic event.
Aim: We aimed to demonstrate the clinical utility of laser speckle contrast imaging (LSCI) for continuous, real-time monitoring of cerebral blood flow (CBF) during aneurysm surgery.
Approach: In this case study, a 67-year-old female underwent a craniotomy for a left-sided cerebral aneurysm. A microscope-integrated LSCI system was used to continuously monitor cortical perfusion. After surgery, LSCI data were correlated with IONM alerts, indocyanine green angiography (ICGA), and surgical events, including an ischemic period following clip placement. A paired t-test, mixed effects model, and changepoint analysis were used to compare mean perfusion between the pre-ischemic and ischemic periods across seven regions of interest (ROIs) on the cortical surface.
Results: LSCI detected a widespread drop in cortical perfusion immediately following the application of an aneurysm clip. This perfusion deficit was detected by LSCI ∼8 min before the corresponding IONM alert. During the ischemic period, blood flow decreased across six of the seven ROIs, with reductions ranging from 7.9% to 28.0%. The overall decrease in perfusion from the pre-ischemic to the ischemic period was statistically significant (p<0.0001).
Conclusions: LSCI can provide continuous imaging of tissue perfusion during surgery, enabling the detection of developing ischemia before functional deficits may be evident on IONM. The ability of LSCI to track tissue perfusion changes highlights its potential as a valuable complementary tool for enhancing surgical safety alongside IONM and ICGA.
Reproduced under the paper's license (CC BY), from the paper cited above.
Code
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Data
Datasets cited
- github.com/
millerlabou — at github.com; found in “Code and Data Availability”
Code and Data Availability
Data files analyzed during the current study are available on GitHub: github.com/
Reproduced under the paper's license (CC BY), from the paper cited above.
Versions
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Version 1, 27 September 2026: the first record
Recorded: type, language, journal, volume, issue, pages, dates, 7 authors, 5 keywords, 2 funders, 36 references.
Cite
This paper
Mercyshalinie, E. R. S., Kharbat, A. F., Machiorlatti, M., Dunn, A. K., Bauer, A., Graffeo, C. S., & Miller, D. R. (2026). Intraoperative tracking of tissue perfusion during cerebral aneurysm surgery with laser speckle contrast imaging: insights beyond standard intraoperative neuromonitoring for detecting ischemia. Neurophotonics, 13(3), 035003. https://
BibTeX
@article{mercyshalinie20
author = {Mercyshalinie, Ebenezer Raj Selvaraj and Kharbat, Abdurrahman F. and Machiorlatti, Michael and Dunn, Andrew K. and Bauer, Andrew and Graffeo, Christopher S. and Miller, David R.},
title = {{Intraoperative tracking of tissue perfusion during cerebral aneurysm surgery with laser speckle contrast imaging: insights beyond standard intraoperative neuromonitoring for detecting ischemia}},
journal = {Neurophotonics},
year = {2026},
month = jul,
volume = {13},
number = {3},
pages = {035003},
publisher = {Society of Photo-Optical Instrumentation Engineers},
issn = {2329-423X},
doi = {10.1117/
url = {https://
pmid = {42416970},
pmcid = {PMC13340444}
}
RIS
TY - JOUR
AU - Mercyshalinie, Ebenezer Raj Selvaraj
AU - Kharbat, Abdurrahman F.
AU - Machiorlatti, Michael
AU - Dunn, Andrew K.
AU - Bauer, Andrew
AU - Graffeo, Christopher S.
AU - Miller, David R.
TI - Intraoperative tracking of tissue perfusion during cerebral aneurysm surgery with laser speckle contrast imaging: insights beyond standard intraoperative neuromonitoring for detecting ischemia
T2 - Neurophotonics
J2 - Neurophotonics
PY - 2026
DA - 2026/
VL - 13
IS - 3
SP - 035003
SN - 2329-423X
PB - Society of Photo-Optical Instrumentation Engineers
DO - 10.1117/
UR - https://
LA - en
ER -
CSL-JSON
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