Search results for " blood flow"

The effects of arterial CO2 on the injured brain: Two faces of the same coin

2021

Serum levels of carbon dioxide (CO2) closely regulate cerebral blood flow (CBF) and actively participate in different aspects of brain physiology such as hemodynamics, oxygenation, and metabolism. Fluctuations in the partial pressure of arterial CO2 (PaCO2) modify the aforementioned variables, and at the same time influence physiologic parameters in organs such as the lungs, heart, kidneys, and the gastrointestinal tract. In general, during acute brain injury (ABI), maintaining normal PaCO2 is the target to be achieved. Both hypercapnia and hypocapnia may comprise secondary insults and should be avoided during ABI. The risks of hypocapnia mostly outweigh the potential benefits. Therefore, i…

Vasomotor reactivity in dementia of alzheimer type

1994

The objective of this study was to examine the cerebral blood flow and the vasomotor function of CO2-responsive intracerebral vessels in Alzheimer's disease. Patients met DSM-III-R criteria for dementia of Alzheimer type and had neither symptoms nor signs of cardiovascular or cerebrovascular disease. Blood flow velocities in both middle cerebral arteries (MCA) were recorded using transcranial Doppler sonography during hypercapnia, normocapnia and hypocapnia. Several psychometric tests were performed. Patients' age, disease duration and severity of dementia did not correlate with vasomotor reactivity. Exploratory analysis revealed that mean flow velocities under hypercapnia correlated with s…

Precapillary Servo Control of Blood Pressure and Postcapillary Adjustment of Flow to Tissue Metabolic Status

1996

Background There are several shortcomings in current understanding of how the microvasculature maintains tissue homeostasis. Presently unresolved issues include (1) integration of the potentially conflicting needs for capillary perfusion and hydrostatic pressure regulation, (2) an understanding of signal transmission pathways for conveying information about tissue energetic status from undersupplied tissue sites to the arterioles, (3) accounting for the experimentally observed interrelations between precapillary and postcapillary resistances, and (4) an explanation of how precise local adjustment of perfusion to metabolic demands is achieved. Methods and Results A novel conceptualization o…

Relationship of Cerebral Blood Flow Disturbances with Brain Oedema Formation

1993

Brain oedema is an important factor which compromises maintenance of the cerebral blood flow. Conversely, primary blood flow disturbances are leading to brain oedema. The mechanisms underlying blood flow impairment by brain oedema are associated with an increased regional tissue pressure in proportion to the degree of water accumulation in the parenchyma. The release of vasoactive mediator compounds might be considered in addition. Primary disturbances of the cerebral blood flow, such as focal or global cerebral ischaemia are leading to an increased cerebral water content. A decrease of the cerebral blood flow to ca. 40% of normal or below has been found to result in the development of brai…

“Small Volume Resuscitation” as Treatment of Cerebral Blood Flow Disturbances and Increased ICP in Trauma and Ischemia

1996

“Small volume resuscitation” (SVR) is a promising concept for the treatment of shock and trauma patients. SVR utilizes the fast infusion of a small volume of hypertonic saline to mobilize intraendothelial and parenchymal water to expand and restitute intravascular volume. Therefore it seems warranted to also consider SVR for the treatment of disturbances of the cerebral circulation and of increased intracranial pressure (ICP). The current study uses a rabbit model of global cerebral ischemia combined with mild hemorrhage to test SVR. Somatosensory evoked potentials (SEPs) serve as a short-term outcome parameter. The data demonstrate a beneficial effect on ICP, a better reperfusion, and an i…

Temporal and Spatial Evolution of Cortical Blood Flow in the Penumbra of Venous Infarcts

2001

A cortical venous infarction model has been evaluated regarding the temporal and spatial evolution of regional flow reduction. Two cortical veins were occluded photochemically with rose bengal and fiberoptic illumination. Seven rats served to demonstrate effects on regional cortical blood flow using laser Doppler scanning. After two-vein occlusion, there was a widespread reduction of flow that gradually deteriorated after vein occlusion when regional cortical flow in a 3.5 x 7.0 mm window: after 15 min it had decreased to 57.8% ± 8.0%, and after 75 min it was 34.3% ± 5.4%. Infarct volumes as determined in 10 rats 5 days after two-vein occlusion had an average size of 3.6 ± 0.7 mm3. The data…

Pathophysiology of Hypovolemic Shock

2001

Cerebral Autoregulation in Non-Brain Injured Patients: A Systematic Review.

2021

Introduction: Cerebral autoregulation (CA) plays a fundamental role in the maintenance of adequate cerebral blood flow (CBF). CA monitoring, through direct and indirect techniques, may guide an appropriate therapeutic approach aimed at improving CBF and reducing neurological complications; so far, the role of CA has been investigated mainly in brain-injured patients. The aim of this study is to investigate the role of CA in non-brain injured patients.Methods: A systematic consultation of literature was carried out. Search terms included: “CA and sepsis,” “CA and surgery,” and “CA and non-brain injury.”Results: Our research individualized 294 studies and after screening, 22 studies were anal…

Lateralization Effects on Cerebral Blood Flow in Patients With Unilateral Pulsatile Tinnitus Measured With Arterial Spin Labeling

2020

Purpose: To investigate cerebral blood flow (CBF) differences in patients with left- and right-sided pulsatile tinnitus (LPT and RPT) and healthy controls (HCs) to further explore the lateralization effects of PT using arterial spin labeling (ASL). Methods: ASL data from 21 RPT patients, 17 LPT patients and 21 HCs were reviewed. Voxel-wise analysis and region of interest analysis were performed to explore differences in CBF among the three groups. Tinnitus Handicap Inventory (THI) score and tinnitus duration were obtained from each patient. Results: Voxel-wise analysis showed that the CBF of the left inferior parietal gyrus was increased in both RPT and LPT patients compared with HCs (P < 0…

Implementation of computed tomography angiography (CTA) and computed tomography perfusion (CTP) in Polish guidelines for determination of cerebral ci…

2021

Background: Brain death/death by neurologic criteria (BD/DNC) guidelines are routinely analyzed, compared and updated in the majority of countries and are later implemented as national criteria. At the same time, extensive works have been conducted in order to unify clinical procedures and to validate and implement new technologies into a panel of ancillary tests. Recently evaluated computed tomography angiography and computed tomography perfusion (CTA/CTP) seem to be superior to traditionally used digital subtraction angiography (DSA), transcranial Doppler (TCD) and cerebral perfusion scintigraphy for diagnosis of cerebral circulatory arrest (CCA). In this narrative review, we would like t…