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Cerebral autoregulation

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https://www.readbyqxmd.com/read/29218511/optical-monitoring-of-cerebral-microcirculation-in-neurointensive-care
#1
Peter Rejmstad, Neda Haj-Hosseini, Oscar Åneman, Karin Wårdell
Continuous optical monitoring of local cerebral microcirculation could benefit neurointensive care patients treated for subarachnoid hemorrhage (SAH). The aim of the study was to evaluate laser Doppler flowmetry (LDF) and diffuse reflectance spectroscopy (DRS) for long-term monitoring of brain microcirculation and oxygen saturation (SO2) in the neurointensive care unit (NICU). A fiber optic probe was designed for intraparenchymal use and connected to LDF and DRS for assessment of the local blood flow (perfusion and tissue reflectance (TLI)) and SO2 in the brain...
December 8, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29207213/crosstalk-proposal-dynamic-cerebral-autoregulation-should-be-quantified-using-spontaneous-blood-pressure-fluctuations
#2
Y C Tzeng, R B Panerai
No abstract text is available yet for this article.
December 5, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29207208/crosstalk-opposing-view-dynamic-cerebral-autoregulation-should-be-quantified-using-induced-rather-than-spontaneous-blood-pressure-fluctuations
#3
David Simpson, Jurgen Claassen
No abstract text is available yet for this article.
December 5, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29205668/cerebrovascular-blood-pressure-autoregulation-monitoring-and-postoperative-transient-ischemic-attack-in-pediatric-moyamoya-vasculopathy
#4
Jennifer K Lee, Monica Williams, Michael Reyes, Edward S Ahn
BACKGROUND: Children with moyamoya vasculopathy are at high risk of perioperative cerebral ischemia or hyperperfusion. Maintaining blood pressure within the range of functional cerebrovascular blood pressure autoregulation might reduce the risk of perioperative neurologic injury. AIMS: We tested whether blood pressure autoregulation is associated with postoperative transient ischemic attack in a study of patients with pediatric moyamoya vasculopathy. METHODS: We conducted an observational study of 15 pediatric patients undergoing surgical revascularization with pial synangiosis...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29190150/intravenous-saline-administration-in-patients-with-severe-acquired-brain-injury-and-orthostatic-intolerance-for-tilt-table-mobilization
#5
Christian Riberholt, Niels Olesen, Peter Hovind, Jesper Mehlsen, Tue Hvass Petersen
PRIMARY OBJECTIVE: This study aimed to investigate the effect of intravenous saline administration on orthostatic hypotension (OH) during head up tilt (HUT) and the change in the renin-angiotensin-aldosterone system before and after HUT in patients with severe acquired brain injury (ABI). RESEARCH DESIGN: The study is designed as an observational study. METHODS AND PROCEDURES: Fourteen patients with ABI, low level of consciousness and OH were monitored before, during and after HUT with non-invasive beat-to-beat blood pressure measurement, and transcranial Doppler determination of middle cerebral artery blood flow velocity...
November 30, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29182378/early-changes-in-cerebral-autoregulation-among-youth-hospitalized-after-sports-related-traumatic-brain-injury
#6
Monica S Vavilala, Carly K Farr, Arraya Watanitanon, Bs Crystalyn Clark-Bell, Theerada Chandee, Anne Moore, William Armstead
OBJECTIVE: To examine early cerebral haemodynamic changes among youth hospitalized with sports-related traumatic brain injury (TBI). STUDY DESIGN: Youth 0-18 years admitted to a level one trauma centre with sports-related TBI were enrolled. Daily measures included clinical symptoms and Glasgow Coma Scale (GCS) score. Using Transcranial Doppler (TCD) ultrasonography and tilt testing, we measured middle cerebral artery flow velocity (Vmca) and cerebral autoregulation index (ARI)...
November 28, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29179622/traumatic-brain-injury-impairs-myogenic-constriction-of-cerebral-arteries-role-of-mitochondria-derived-h2o2-and-trpv4-dependent-activation-of-bkca-channels
#7
Nikolett Szarka, Mallikarjuna R Pabbidi, Krisztina Amrein, Endre Czeiter, Gergely Berta, Krisztina Pohoczky, Zsuzsanna Helyes, Zoltan Ungvari, Akos Koller, Andras Buki, Peter Toth
Traumatic brain injury (TBI) impairs autoregulation of cerebral blood flow, which contributes to the development of secondary brain injury increasing mortality of patients. Impairment of pressure-induced myogenic constriction of cerebral arteries plays a critical role in autoregulatory dysfunction; however, the underlying cellular and molecular mechanisms are not well understood. To determine the role of mitochondria-derived H2O2 and large-conductance calcium-activated potassium channels (BKCa) in myogenic autoregulatory dysfunction, middle cerebral arteries (MCAs) were isolated from rats with severe weight drop-impact acceleration brain injury (24 h post-impact)...
November 27, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29163214/predictive-value-of-dynamic-cerebral-autoregulation-assessment-in-surgical-management-of-patients-with-high-grade-carotid-artery-stenosis
#8
Vladimir B Semenyutin, Gregory A Asaturyan, Anna A Nikiforova, Vugar A Aliev, Grigory K Panuntsev, Vadim B Iblyaminov, Alexander V Savello, Andreas Patzak
Dynamic cerebral autoregulation (DCA) capacity along with the degree of internal carotid artery (ICA) stenosis and characteristics of the plaque can also play an important role in selection of appropriate treatment strategy. This study aims to classify the patients with severe ICA stenosis according to preoperative state of DCA and to assess its dynamics after surgery. Thirty-five patients with severe ICA stenosis having different clinical type of disease underwent reconstructive surgery. DCA was assessed with transfer function analysis (TFA) by calculating phase shift (PS) between Mayer waves of blood flow velocity (BFV) and blood pressure (BP) before and after operation...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29163193/changes-in-muscle-and-cerebral-deoxygenation-and-perfusion-during-repeated-sprints-in-hypoxia-to-exhaustion
#9
Sarah J Willis, Laurent Alvarez, Grégoire P Millet, Fabio Borrani
During supramaximal exercise, exacerbated at exhaustion and in hypoxia, the circulatory system is challenged to facilitate oxygen delivery to working tissues through cerebral autoregulation which influences fatigue development and muscle performance. The aim of the study was to evaluate the effects of different levels of normobaric hypoxia on the changes in peripheral and cerebral oxygenation and performance during repeated sprints to exhaustion. Eleven recreationally active participants (six men and five women; 26...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29156025/cerebral-blood-flow-and-its-autoregulation-when-will-there-be-some-light-in-the-black-box
#10
F Grüne, M Klimek
No abstract text is available yet for this article.
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29155938/cerebral-autoregulation-in-cardiopulmonary-bypass-surgery-a-systematic-review
#11
Juliana R Caldas, Victoria J Haunton, Ronney B Panerai, Ludhmila A Hajjar, Thompson G Robinson
Cardiopulmonary bypass surgery is associated with a high incidence of neurological complications, including stroke, delirium and cognitive impairment. The development of strategies to reduce the incidence of such neurological events has been hampered by the lack of a clear understanding of their pathophysiology. Cerebral autoregulation (CA), which describes the ability of the brain to maintain a stable cerebral blood flow over a wide range of cerebral perfusion pressures despite changes in blood pressure, is known to be impaired in various neurological disorders...
November 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29149389/autoregulation-in-paediatric-tbi-current-evidence-and-implications-for-treatment
#12
REVIEW
Joseph E Donnelly, Adam M H Young, Ken Brady
BACKGROUND: Children who survive acute traumatic brain injury are at risk of death from subsequent brain swelling and secondary injury. Strict physiologic management in the ICU after traumatic brain injury is believed to be key to survival, and cerebral perfusion pressure is a prominent aspect of post brain injury care. However, optimal cerebral perfusion pressure targets for children are not known. Autoregulation monitoring has been used to delineate individualized optimal perfusion pressures for patients with traumatic brain injury...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29146434/cerebral-hyperperfusion-syndrome-after-endovascular-reperfusion-therapy-in-a-patient-with-acute-internal-carotid-artery-and-middle-cerebral-artery-occlusions
#13
Tetsuya Hashimoto, Shoji Matsumoto, Mitsushige Ando, Hideo Chihara, Atsushi Tsujimoto, Taketo Hatano
BACKGROUND: Cerebral hyperperfusion syndrome (CHS) is known to be a rare but devastating complication of carotid artery revascularization. Because patients with acute ischemic stroke due to acute major cerebral and/or cervical artery occlusion treated with endovascular reperfusion therapy may have impaired autoregulation in the cerebral vasculature, these patients may also develop CHS. Despite the growing number of endovascular reperfusion procedures for acute ischemic stroke, this complication has only rarely been reported...
November 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29120931/perioperative-neurocognition-in-elderly-patients
#14
Huiqun Fu, Long Fan, Tianlong Wang
PURPOSE OF REVIEW: The extrinsic risk factors for postoperative cognitive disturbance have been a source of concern during the perioperative period, and these risk factors remain the subject of controversy. This review of recent studies focuses on the effect of these factors on postoperative cognitive disturbance during the perioperative period. RECENT FINDINGS: Impairment of cerebral autoregulation may predispose patients to intraoperative cerebral malperfusion, which may subsequently induce postoperative cognitive disturbance...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29119370/vasoconstriction-and-impairment-of-neurovascular-coupling-after-subarachnoid-hemorrhage-a-descriptive-analysis-of-retinal-changes
#15
Catharina Conzen, Walid Albanna, Miriam Weiss, David Kürten, Walthard Vilser, Konstantin Kotliar, Charlotte Zäske, Hans Clusmann, Gerrit Alexander Schubert
Impaired cerebral autoregulation and neurovascular coupling (NVC) contribute to delayed cerebral ischemia after subarachnoid hemorrhage (SAH). Retinal vessel analysis (RVA) allows non-invasive assessment of vessel dimension and NVC hereby demonstrating a predictive value in the context of various neurovascular diseases. Using RVA as a translational approach, we aimed to assess the retinal vessels in patients with SAH. RVA was performed prospectively in 24 patients with acute SAH (group A: day 5-14), in 11 patients 3 months after ictus (group B: day 90 ± 35), and in 35 age-matched healthy controls (group C)...
November 8, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29116947/cerebrovascular-steal-phenomenon-and-electroconvulsive-therapy-a-case-report-and-review-of-the-literature
#16
Ana Hategan, Calvin H Hirsch
Electroconvulsive therapy (ECT) is a safe and effective treatment for major depressive disorder, but cerebrovascular and cardiovascular complications, although rare, remain the most concerning. This is particularly notable in those with preexisting cerebrovascular disease, which impacts dynamic cerebral autoregulation. In these patients, the increased blood flow to the seizing portions of the brain induced by ECT potentially can reduce cerebral blood flow to ischemic areas, possibly causing adverse neurological events...
November 8, 2017: Journal of ECT
https://www.readbyqxmd.com/read/29111029/hematoma-volume-is-a-predictive-factor-of-disturbed-autoregulation-after-spontaneous-intracerebral-hemorrhage
#17
Hongyin Ma, Zhen-Ni Guo, Xin Sun, Jia Liu, Shan Lv, Lu Zhao, Weitong Guo, Hang Jin, Yi Yang
BACKGROUND: Dynamic cerebral autoregulation (dCA) is probably disturbed after spontaneous intracerebral hemorrhage (ICH) and could be an independent predictor of clinical outcome. Clinical determinants of dCA status after ICH need to be further elucidated. METHODS: We finally enrolled 53 patients diagnosed with supratentorial ICH within 6days from onset. DCA was assessed 4-6days after ICH onset by monitoring middle cerebral artery blood flow velocities and simultaneous arterial blood pressure continuously, utilizing transcranial Doppler combined with a servo-controlled finger plethysmograph...
November 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29104807/neural-vascular-mechanism-for-the-cerebral-blood-flow-autoregulation-after-hemorrhagic-stroke
#18
REVIEW
Ming Xiao, Qiang Li, Hua Feng, Le Zhang, Yujie Chen
During the initial stages of hemorrhagic stroke, including intracerebral hemorrhage and subarachnoid hemorrhage, the reflex mechanisms are activated to protect cerebral perfusion, but secondary dysfunction of cerebral flow autoregulation will eventually reduce global cerebral blood flow and the delivery of metabolic substrates, leading to generalized cerebral ischemia, hypoxia, and ultimately, neuronal cell death. Cerebral blood flow is controlled by various regulatory mechanisms, including prevailing arterial pressure, intracranial pressure, arterial blood gases, neural activity, and metabolic demand...
2017: Neural Plasticity
https://www.readbyqxmd.com/read/29084196/multi-modality-neuromonitoring-in-severe-pediatric-traumatic-brain-injury-monitoring-pediatric-tbi
#19
REVIEW
Adam M H Young, Mathew R Guilfoyle, Joseph Donnelly, Peter Smielewski, Shruti Agarwal, Marek Czosnyka, Peter J Hutchinson
Each year, the annual hospitalization rates of traumatic brain injury (TBI) in children in the US are 57.7 per 100 K less than 5 years of age and 23.1 per 100 K in the 5-14 year age group. Despite this, little is known about the pathophysiology of TBI in children and how to manage it most effectively. Historically, TBI management has been guided by clinical examination. This has been assisted progressively by clinical imaging, intracranial pressure (ICP) monitoring and finally software that can calculate optimal brain physiology...
October 30, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29075198/impacts-of-simulated-weightlessness-by-dry-immersion-on-optic-nerve-sheath-diameter-and-cerebral-autoregulation
#20
Marc Kermorgant, Florian Leca, Nathalie Nasr, Marc-Antoine Custaud, Thomas Geeraerts, Marek Czosnyka, Dina N Arvanitis, Jean-Michel Senard, Anne Pavy-Le Traon
Dry immersion (DI) is used to simulate weightlessness. We investigated in healthy volunteers if DI induces changes in ONSD, as a surrogate marker of intracranial pressure (ICP) and how these changes could affect cerebral autoregulation (CA). Changes in ICP were indirectly measured by changes in optic nerve sheath diameter (ONSD). 12 healthy male volunteers underwent 3 days of DI. ONSD was indirectly assessed by ocular ultrasonography. Cerebral blood flow velocity (CBFV) of the middle cerebral artery was gauged using transcranial Doppler ultrasonography...
2017: Frontiers in Physiology
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