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Cerebral autoregulation

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https://www.readbyqxmd.com/read/28634025/impaired-cerebral-autoregulation-in-preoperative-newborn-infants-with-congenital-heart-disease
#1
Jodie K Votava-Smith, Christopher J Statile, Michael D Taylor, Eileen C King, Jesse M Pratt, David P Nelson, Erik C Michelfelder
OBJECTIVES: To characterize cerebral autoregulation (CA) in preoperative newborn infants with congenital heart disease (CHD). METHODS: This was a prospective, pilot study of term newborns with CHD who required intensive care. Continuous mean arterial blood pressure (MAP), cerebral tissue oxygen saturation (SCTO2) via near-infrared spectroscopy, and arterial oxygen saturation (SaO2) were collected. Significant low-frequency coherence between MAP and SCTO2 was used to define impaired CA in 20-minute epochs...
May 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28625390/dopamine-protects-cerebral-autoregulation-and-prevents-hippocampal-necrosis-after-traumatic-brain-injury-via-block-of-erk-mapk-in-juvenile-pigs
#2
Victor Curvello, Hugh Hekierski, Philip Pastor, Monica S Vavilala, William M Armstead
Traumatic brain injury (TBI) contributes to morbidity in children, and more boys experience TBI. Cerebral autoregulation is impaired after TBI, contributing to poor outcome. Cerebral Perfusion Pressure (CPP) is often normalized by use of vasoactive agents to increase mean arterial pressure (MAP). In prior studies of newborn and juvenile pigs, vasoactive agent choice influenced outcome after TBI as a function of age and sex, with none protecting cerebral autoregulation in both ages and sexes. Dopamine (DA) prevents impairment of cerebral autoregulation in male and female newborn pigs via inhibition of upregulation of ERK mitogen activated protein kinase (MAPK) after fluid percussion injury (FPI)...
June 15, 2017: Brain Research
https://www.readbyqxmd.com/read/28623095/chasing-the-elusive-cerebral-autoregulation-curve-in-pursuit-of-intraoperative-brain-protection
#3
EDITORIAL
David L Reich, Matthew A Levin
No abstract text is available yet for this article.
May 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28611578/prefrontal-hemodynamics-in-toddlers-at-rest-a-pilot-study-of-developmental-variability
#4
Afrouz A Anderson, Elizabeth Smith, Fatima A Chowdhry, Audrey Thurm, Emma Condy, Lauren Swineford, Stacy S Manwaring, Franck Amyot, Dennis Matthews, Amir H Gandjbakhche
Functional near infrared spectroscopy (fNIRS) is a non-invasive functional neuroimaging modality. Although, it is amenable to use in infants and young children, there is a lack of fNIRS research within the toddler age range. In this study, we used fNIRS to measure cerebral hemodynamics in the prefrontal cortex (PFC) in 18-36 months old toddlers (n = 29) as part of a longitudinal study that enrolled typically-developing toddlers as well as those "at risk" for language and other delays based on presence of early language delays...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28597991/lack-of-linear-correlation-between-dynamic-and-steady-state-cerebral-autoregulation
#5
Daan L K de Jong, Takashi Tarumi, Jie Liu, Rong Zhang, Jurgen A H R Claassen
The purpose of this study was to investigate the relationship between dynamic (dCA) and steady-state cerebral autoregulation (sCA). In 28 healthy older adults, sCA was quantified by a linear regression slope of proportionate (%) changes in cerebrovascular resistance (CVR) in response to proportionate (%) changes in mean blood pressure (BP) induced by stepwise sodium nitroprusside (SNP) and phenylephrine (PhE) infusion. Cerebral blood flow (CBF) was measured at the internal carotid (ICA) and vertebral (VA) artery and cerebral blood flow velocity (CBFV) at the middle cerebral artery (MCA)...
June 9, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28596740/ultrasound-imaging-of-mouse-fetal-intracranial-hemorrhage-due-to-ischemia-reperfusion
#6
Kenichi Funamoto, Takuya Ito, Kiyoe Funamoto, Clarissa L Velayo, Yoshitaka Kimura
Despite vast improvement in perinatal care during the 30 years, the incidence rate of neonatal encephalopathy remains unchanged without any further Progress towards preventive strategies for the clinical impasse. Antenatal brain injury including fetal intracranial hemorrhage caused by ischemia/reperfusion is known as one of the primary triggers of neonatal injury. However, the mechanisms of antenatal brain injury are poorly understood unless better predictive models of the disease are developed. Here we show a mouse model for fetal intracranial hemorrhage in vivo developed to investigate the actual timing of hypoxia-ischemic events and their related mechanisms of injury...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28574155/a-systematic-review-of-neuroimaging-in-delirium-predictors-correlates-and-consequences
#7
Anita Nitchingham, Varun Kumar, Susan Shenkin, Karen J Ferguson, Gideon A Caplan
OBJECTIVE: Neuroimaging advances our understanding of delirium pathophysiology and its consequences. A previous systematic review identified 12 studies (total participants N = 764, delirium cases N = 194; years 1989-2007) and found associations with white matter hyperintensities (WMH) and cerebral atrophy. Our objectives were to perform an updated systematic review of neuroimaging studies in delirium published since January 2006 and summarise the available literature on predictors, correlates or outcomes...
June 2, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28573981/at-what-data-length-do-cerebral-autoregulation-measures-stabilise
#8
Adam Mahdi, Dragana Nikolic, Antony Birch, Stephen Payne
Cerebral autoregulation is commonly assessed through mathematical models that use non-invasive measurements of arterial blood pressure and cerebral blood flow velocity. There is no agreement in the literature as to what is the minimum length of data needed for the cerebral autoregulation coefficients to stabilise. We introduce a simple empirical tool for studying the minimum length of time series needed to parameterise three popular cerebral autoregulation coefficients ARI, Mx and Phase (in the low frequency range [0...
June 2, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28573058/uncommon-etiology-for-seizure-cerebral-hyperperfusion-syndrome
#9
Mohankumar Kurukumbi, Ahn Truong, Naghemeh Pirsaharkhiz
Cerebral hyperperfusion syndrome (CHS) is a rare life-threatening complication of carotid endarterectomy (CEA) and carotid artery stenting (CAS) for carotid artery stenosis. The incidence varies between 0 and 3%, depending on the severity of the stenosis, perioperative hypertension, and contralateral carotid stenosis. This case report reports a 53-year-old female patient presenting with decreased alertness and multiple tonic-clonic seizures, in the background of bilateral CEA. She was found to have bilateral carotid stenosis...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28536207/impaired-cerebral-autoregulation-measurement-and-application-to-stroke
#10
REVIEW
Li Xiong, Xiuyun Liu, Ty Shang, Peter Smielewski, Joseph Donnelly, Zhen-Ni Guo, Yi Yang, Thomas Leung, Marek Czosnyka, Rong Zhang, Jia Liu, Ka Sing Wong
Cerebral autoregulation (CA) is a protective mechanism that maintains cerebral blood flow at a relatively constant level despite fluctuations of cerebral perfusion pressure or arterial blood pressure. It is a universal physiological mechanism that may involve myogenic, neural control as well as metabolic regulations of cerebral vasculature in response to changes in pressure or cerebral blood flow. Traditionally, CA has been represented by a sigmoid curve with a wide plateau between about 50 mm Hg and 170 mm Hg of steady-state changes in mean arterial pressure, defined as static CA...
June 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28522231/large-amount-of-cannabis-ingestion-resulting-in-spontaneous-intracerebral-hemorrhage-a-case-report
#11
Kunakorn Atchaneeyasakul, Luis F Torres, Amer M Malik
Although multiple cases of cannabis-associated ischemic stroke have been reported, there are only 2 reported cases of hemorrhagic stroke with an associated cerebral vasoconstriction. To our knowledge, we present the first case of basal ganglia hemorrhage after a large-volume oral ingestion of cannabis without other identified risk factors. In our case, cerebral digital subtraction angiography within 24 hours of presentation did not reveal vasoconstriction leading to a possible alternative explanation for hemorrhagic stroke, including cannabis-induced transient arterial hypertension and autoregulation disruption...
May 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28497934/cerebral-autoregulation-monitoring-in-acute-traumatic-brain-injury-what-s-the-evidence
#12
Leanne A Calviello, Joseph Donnelly, Frederick A Zeiler, Eric P Thelin, Peter Smielewski, Marek Czosnyka
Cerebral autoregulation is conceptualized as a vascular self-regulatory mechanism within the brain. Controlled by elusive relationships between various biophysical processes, it functions to protect the brain against potential damages caused by sudden changes in cerebral perfusion pressures and flow. Following events such as traumatic brain injuries (TBI), autoregulation may be compromised, potentially leading to an unfavorable outcome. In spite of its complexity, autoregulation has been able to be quantified non-invasively within the neuro-critical care setting with the aid of transcranial Doppler...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28486883/monitoring-of-optimal-cerebral-perfusion-pressure-in-traumatic-brain-injured-patients-using-a-multi-window-weighting-algorithm
#13
Xiuyun Liu, Natasha M Maurits, Marcel J H Aries, Marek Czosnyka, Ari Ercole, Joseph Donnelly, Danilo Cardim, Dong-Joo Kim, Celeste Dias, Manuel Cabeleira, Peter Smieleweski
Methods to identify an autoregulation guided 'optimal' cerebral perfusion pressure (CPPopt) for traumatic brain injury patients (TBI) have been reported through several studies. An important drawback of existing methodology is that CPPopt can be calculated only in approximately 50-60% of the monitoring time. In this study, we hypothesized that the CPPopt yield and the continuity can be improved significantly through application of a multi-window and weighting calculation algorithm, without adversely affecting preservation of its prognostic value...
May 9, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28479402/tight-neurovascular-coupling-in-the-spinal-cord-during-nociceptive-stimulation-in-intact-and-spinal-rats
#14
Mathieu Piché, Thierry Paquette, Hugues Leblond
Functional magnetic resonance imaging (fMRI) is based on neurovascular coupling, which allows inferring neuronal activity from hemodynamic changes. Spinal fMRI has been used to examine pain processes, although spinal neurovascular coupling has never been investigated. In addition, fluctuations in mean arterial pressure (MAP) occur during nociceptive stimulation and this may affect neurovascular coupling. The objective of this study was to examine neurovascular coupling in the rat spinal cord during nociceptive stimulation while MAP was manipulated by cervical spinal transection, which prevents nociception-related MAP increases...
May 4, 2017: Neuroscience
https://www.readbyqxmd.com/read/28475214/the-angiotensin-ii-receptor-type-1b-is-the-primary-sensor-of-intraluminal-pressure-in-cerebral-artery-smooth-muscle-cells
#15
Paulo W Pires, Eun-A Ko, Harry A T Pritchard, Michael Rudokas, Evan Yamasaki, Scott Earley
Myogenic vasoconstriction, which reflects the intrinsic ability of smooth muscle cells to contract in response to increases in intraluminal pressure, is critically important for the autoregulation of blood flow. In SMC from cerebral arteries, increasing intraluminal pressure engages a signalling cascade that stimulates cation influx through transient receptor potential (TRP) melastatin 4 (TRPM4) channels to cause membrane depolarization and vasoconstriction. Substantial evidence indicates that the angiotensin II receptor type 1 (AT1 R) is inherently mechanosensitive and initiates this signalling pathway...
May 5, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28471439/relationships-between-cerebral-autoregulation-and-markers-of-kidney-and-liver-injury-in-neonatal-encephalopathy-and-therapeutic-hypothermia
#16
J K Lee, J Perin, C Parkinson, M O'Connor, M M Gilmore, M Reyes, J Armstrong, J M Jennings, F J Northington, R Chavez-Valdez
OBJECTIVE: We studied whether cerebral blood pressure autoregulation and kidney and liver injuries are associated in neonatal encephalopathy (NE). STUDY DESIGN: We monitored autoregulation of 75 newborns who received hypothermia for NE in the neonatal intensive care unit to identify the mean arterial blood pressure with optimized autoregulation (MAPOPT). Autoregulation parameters and creatinine, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were analyzed using adjusted regression models...
May 4, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28463046/the-influence-of-hyperthermia-on-intracranial-pressure-cerebral-oximetry-and-cerebral-metabolism-in-traumatic-brain-injury
#17
Lena Nyholm, Tim Howells, Anders Lewén, Lars Hillered, Per Enblad
BACKGROUND: Hyperthermia is a common secondary insult in traumatic brain injury (TBI). The aim was to evaluate the relationship between hyperthermia and intracranial pressure (ICP), and if intracranial compliance and cerebral blood flow (CBF) pressure autoregulation affected that relationship. The relationships between hyperthermia and cerebral oximetry (BtipO2) and cerebral metabolism were also studied. METHODS: A computerized multimodality monitoring system was used for data collection at the neurointensive care unit...
May 2, 2017: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/28443830/paco-sub-2-sub-measurement-in-cerebral-haemodynamics-face-mask-or-nasal-cannulae
#18
Jatinder Singh Minhas, Thompson Robinson, Ronney Panerai
Objective PaCO2 affects cerebral blood flow (CBF) and its regulatory mechanisms, but the effects of CO2 measurement technique on cerebrovascular parameters are unknown. In order to determine if the two most commonly used approaches, face mask (FM) or nasal cannulae (NC), are interchangeable or not, we tested the hypothesis that the use of FM versus NC does not lead to significant differences in CO2-related systemic and cerebrovascular parameters. Approach Recordings of CBF velocity (CBFV), blood pressure (BP), heart rate, and end-tidal CO2 (EtCO2) were performed in 42 subjects during normocapnia (FM or NC) and 5% CO2 inhalation (FM) or hyperventilation (NC)...
April 26, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28421173/cerebral-autoregulation-brain-injury-and-the-transitioning-premature-infant
#19
REVIEW
Zachary A Vesoulis, Amit M Mathur
Improvements in clinical management of the preterm infant have reduced the rates of the two most common forms of brain injury, such as severe intraventricular hemorrhage and white matter injury, both of which are contributory factors in the development of cerebral palsy. Nonetheless, they remain a persistent challenge and are associated with a significant increase in the risk of adverse neurodevelopment outcomes. Repeated episodes of ischemia-reperfusion represent a common pathway for both forms of injury, arising from discordance between systemic blood flow and the innate regulation of cerebral blood flow in the germinal matrix and periventricular white matter...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28416148/alterations-in-autonomic-cerebrovascular-control-after-spinal-cord-injury
#20
Dong-Il Kim, Can Ozan Tan
Among chronic cardiovascular and metabolic sequelae of spinal cord injury (SCI) is an up-to four-fold increase in the risk of ischemic and hemorrhagic stroke, suggesting that individuals with SCI cannot maintain stable cerebral perfusion. In able-bodied individuals, the cerebral vasculature is able to regulate cerebral perfusion in response to swings in arterial pressure (cerebral autoregulation), blood gases (cerebral vasoreactivity), and neural metabolic demand (neurovascular coupling). This ability depends, at least partly, on intact autonomic function, but high thoracic and cervical spinal cord injuries result in disruption of sympathetic and parasympathetic cerebrovascular control...
April 4, 2017: Autonomic Neuroscience: Basic & Clinical
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