Experimental cerebral hemodynamics

1974/11/01 by Richard C. Dewey, Heinz P. Pieper, William E. Hunt · 25 citations
Medicine · #Traumatic Brain Injury and Neurovascular Disturbances #Optical Imaging and Spectroscopy Techniques #Hemodynamic Monitoring and Therapy

paper · doi:10.3171/jns.1974.41.5.0597

Abstract

✓ Application of Burton's concept of the critical closing pressure to experimental data on brain-blood flow in the monkey suggests that perfusion pressure, not vascular bed resistance, is the primary variable affecting cerebral blood flow. Perfusion pressure for the cerebral circulation is the mean arterial pressure minus the critical closing pressure (MAP — CCP). Vasomotor tone and intracranial pressure are the major determinants of the critical closing pressure. Changes in either of these variables, therefore, affect perfusion pressure and flow. Data on brain-blood flow at fixed vasomotor tone obtained over wide pressure ranges show little change in vascular bed resistance despite significant changes in flow. The diameter of resistance vessels probably does not change significantly throughout the normal physiological range of cerebral blood flow. The limits of the critical closing pressure in the anesthetized monkey are from 10 to 95 mm Hg. Using these limits, and beginning with the average values for MAP and CCP in 11 awake monkeys breathing room air, the authors present theoretical flow curves in response to changes in intracranial pressure and mean arterial pressure that closely approximate the data reported in man.

Cited by

• Continual transcranial Doppler in the monitoring of hemodynamic change following aneurysmal subarachnoid hemorrhage. [europepmc]
• Critical closing pressure determined with a model of cerebrovascular impedance. [europepmc]
• Altered oscillatory cerebral blood flow velocity and autoregulation in postural tachycardia syndrome. [europepmc]
• The ontogeny of cerebrovascular pressure autoregulation in premature infants. [europepmc]
• Oscillatory cerebral blood flow is associated with impaired neurocognition and functional hyperemia in postural tachycardia syndrome during graded tilt. [europepmc]
• Prospective Study on Noninvasive Assessment of Intracranial Pressure in Traumatic Brain-Injured Patients: Comparison of Four Methods. [europepmc]
• Orthostatic Cerebral Hypoperfusion Syndrome. [europepmc]
• Cerebral Blood Flow Autoregulation and Dysautoregulation. [europepmc]
• Cerebral Perfusion and Cerebral Autoregulation after Cardiac Arrest. [europepmc]
• Cerebrovascular assessment of patients undergoing shoulder surgery in beach chair position using a multiparameter transcranial Doppler approach. [europepmc]
• Defining a Taxonomy of Intracranial Hypertension: Is ICP More Than Just a Number? [europepmc]
• Pathophysiological and clinical considerations in the perioperative care of patients with a previous ischaemic stroke: a multidisciplinary narrative review. [europepmc]
• Non-invasive estimation of cerebral perfusion pressure using transcranial Doppler ultrasonography in children with severe traumatic brain injury. [europepmc]
• Validation of diffuse correlation spectroscopy measures of critical closing pressure against transcranial Doppler ultrasound in stroke patients. [europepmc]
• Cerebral critical closing pressure and resistance-area product: the influence of dynamic cerebral autoregulation, age and sex. [europepmc]
• Blood Pressure Affects the Early CT Perfusion Imaging in Patients with aSAH Reflecting Early Disturbed Autoregulation. [europepmc]
• Applications of near-infrared spectroscopy in neurocritical care. [europepmc]
• Characterization of cerebral macro- and microvascular hemodynamics during transient hypotension. [europepmc]
• Changes of Arterial and Venous Cerebral Blood Flow Correlation in Moderate-to-Severe Traumatic Brain Injury: A CT Perfusion Study. [europepmc]
• Diffuse Optical Monitoring of Cerebral Hemodynamics and Oxygen Metabolism during and after Cardiopulmonary Bypass: Hematocrit Correction and Neurological Vulnerability. [europepmc]
• Modified Beer-Lambert algorithm to measure pulsatile blood flow, critical closing pressure, and intracranial hypertension. [europepmc]
• The method described by Czosnyka is particularly suitable for measuring CPPe in patients undergoing cerebral angiography. [europepmc]
• Advancing Understanding of Cerebrovascular Hemodynamic Perturbations in Pediatric Cerebral Malaria Using a Modified Critical Closing Pressure Evaluation- A Prospective, Observational Study. [europepmc]
• Identifying the state of cerebrovascular autoregulation using the pressure reactivity index versus the mean flow index: Why metric matters. [europepmc]
• Towards a physics informed digital twin to predict cerebral blood flow and cerebral vascular regulation. [europepmc]

Related

• Arterial Pco2 and cerebral hemodynamics
• Evaluation of the Extension of the Cerebral Blood Flow and its Main Parameters
• A simple model of cerebral blood flow dependence on arterial blood pressure
• Peculiarities of Brain's Blood Flow : Role of Carbon Dioxide
• Neurovascular coupling in humans: Physiology, methodological advances and clinical implications