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Cerebral perfusion pressure

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https://www.readbyqxmd.com/read/27912253/sex-and-age-differences-in-epinephrine-mechanisms-and-outcomes-after-brain-injury
#1
William M Armstead, John Riley, Monica S Vavilala
Traumatic brain injury (TBI) is the leading cause of injury related death in children, with boys and children under 4 years having particularly poor outcomes. Cerebral autoregulation is often impaired after TBI, contributing to poor outcome. Cerebral perfusion pressure can be normalized by use of vasoactive agents. The c-Jun-terminal kinase (JNK) isoform of mitogen activated protein kinase (MAPK) produces hemodynamic impairment after TBI, but less is known about its role in histopathology. We investigated whether epinephrine (EPI) age and sex dependently protected cerebral autoregulation and limited histopathology after TBI and the role of JNK in that outcome...
December 2, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#2
Henrik Sørensen
Likely, maintained organ and notably cerebral perfusion, secures rapid recovery following anesthesia. To secure cerebral blood flow (CBF) at least mean arterial pressure (MAP) and the arterial carbon dioxide tension (PaCO2) need to be considered. CBF is "autoregulated", i.e. stays more or less stable within a MAP of 50-150 mmHg, but the lower limit appears to depend on the central blood volume and/or cardiac output, illustrated by a decrease in CBF at a MAP of 80 mmHg with a compromised central blood volume, while CBF remains constant with a MAP < 40 mmHg, if the central blood volume is maintained...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27909604/effects-of-head-position-on-cerebral-oxygenation-and-blood-flow-velocity-during-thyroidectomy
#3
Ayten Saraçoğlu, Demet Altun, Ayşen Yavru, Nihat Aksakal, İsmail Cem Sormaz, Emre Camcı
OBJECTIVE: Determining the blood flow through intra and extra-cranial arteries during neck extension may be helpful but is a controversial issue. We aimed to elucidate the changes in cerebral blood flow related to head positioning during thyroid surgery by carotid Doppler examination and regional oxygen saturation variations. METHODS: Thirty patients were recruited to the study. Patients were positioned with a final position of thyroidectomy consisting a 30° semi Fowler with the extension of neck and head...
October 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27909230/the-protective-role-of-sex-hormones-in-females-and-exercise-prehabilitation-in-males-on-sternotomy-induced-cranial-hypoperfusion-in-aortic-banded-mini-swine
#4
T Dylan Olver, Jessica A Hiemstra, Jenna C Edwards, Brian S Ferguson, Harold Laughlin, Craig A Emter
During cardiac surgery, specifically sternotomy, cranial hypoperfusion is linked to cerebral ischemia, increased risk of perioperative watershed stroke and other neurocognitive complications. The purpose of this study was to retrospectively examine the effect of sex hormones in females and exercise prehabilitation in males on median sternotomy-induced changes in cranial perfusion in a large animal model of heart failure. Cranial blood flow (CBF) before, 10- and 60 min post-sternotomy was analyzed in eight groups of Yucatan mini-swine: female-control, aortic-banded, ovariectomized, and ovariectomized+aortic-banded; male-control, aortic-banded, aortic-banded+continuous exercise trained, and aortic-banded+interval exercise trained...
December 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27862767/dynamics-of-cerebral-blood-flow-in-patients-with-mild-non-ischaemic-heart-failure
#5
Christian D Erkelens, Haye H van der Wal, Bauke M de Jong, Jan-Willem Elting, Remco Renken, Marleen Gerritsen, Peter Jan van Laar, Vincent M van Deursen, Peter van der Meer, Dirk J van Veldhuisen, Adriaan A Voors, Gert-Jan Luijckx
AIMS: Heart failure (HF) is associated with tissue hypoperfusion and congestion leading to organ dysfunction. Although cerebral blood flow (CBF) is preserved over a wide range of perfusion pressures in healthy subjects, it is impaired in end-stage HF. We aimed to compare CBF, autoregulation, and cognitive function in patients with mild non-ischaemic HF with healthy controls. METHODS AND RESULTS: Fifteen patients with mild idiopathic dilated cardiomyopathy and 15 matched healthy controls were studied...
November 14, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27850399/761-improvements-to-the-optimal-cerebral-perfusion-pressure-calculation
#6
Christopher Hawthorne, Martin Shaw, Laura Moss, Ian Piper, Richard Elliott, Christine Lee, John Kinsella
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27848125/the-effect-of-positive-end-expiratory-pressure-on-intracranial-pressure-and-cerebral-hemodynamics
#7
Myles D Boone, Sayuri P Jinadasa, Ariel Mueller, Shahzad Shaefi, Ekkehard M Kasper, Khalid A Hanafy, Brian P O'Gara, Daniel S Talmor
BACKGROUND: Lung protective ventilation has not been evaluated in patients with brain injury. It is unclear whether applying positive end-expiratory pressure (PEEP) adversely affects intracranial pressure (ICP) and cerebral perfusion pressure (CPP). We aimed to evaluate the effect of PEEP on ICP and CPP in a large population of patients with acute brain injury and varying categories of acute lung injury, defined by PaO2/FiO2. METHOD: Retrospective data were collected from 341 patients with severe acute brain injury admitted to the ICU between 2008 and 2015...
November 15, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27837370/intraocular-pressure-and-cerebral-oxygenation-during-prolonged-headward-acceleration
#8
Ola Eiken, Michail E Keramidas, Nigel A S Taylor, Mikael Grönkvist
PURPOSE: Supra-tolerance head-to-foot directed gravitoinertial load (+Gz) typically induces a sequence of symptoms/signs, including loss of: peripheral vision-central vision-consciousness. The risk of unconsciousness is greater when anti-G-garment failure occurs after prolonged rather than brief exposures, presumably because, in the former condition, mental signs are not consistently preceded by impaired vision. The aims were to investigate if prolonged exposure to moderately elevated +Gz reduces intraocular pressure (IOP; i...
November 11, 2016: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/27837185/quantitative-estimation-of-a-ratio-of-intracranial-cerebrospinal-fluid-volume-to-brain-volume-based-on-segmentation-of-ct-images-in-patients-with-extra-axial-hematoma
#9
Ha Son Nguyen, Mohit Patel, Luyuan Li, Shekar Kurpad, Wade Mueller
BACKGROUND: Diminishing volume of intracranial cerebrospinal fluid (CSF) in patients with space-occupying masses have been attributed to unfavorable outcome associated with reduction of cerebral perfusion pressure and subsequent brain ischemia. OBJECTIVE: The objective of this article is to employ a ratio of CSF volume to brain volume for longitudinal assessment of space-volume relationships in patients with extra-axial hematoma and to determine variability of the ratio among patients with different types and stages of hematoma...
November 11, 2016: Neuroradiology Journal
https://www.readbyqxmd.com/read/27824693/aerobic-exercise-training-improves-orthostatic-tolerance-in-aging-humans
#10
Diqun Xu, Hong Wang, Shande Chen, Sarah Ross, Howe Liu, Albert Olivencia-Yurvati, Peter B Raven, Xiangrong Shi
PURPOSE: This study was designed to test the hypothesis that aerobic exercise training of the elderly will increase aerobic fitness without compromising orthostatic tolerance (OT). METHODS: Eight healthy sedentary volunteers (67.0±1.7 years old, 4 women) participated in 1-year of endurance exercise training (stationary bicycle and/or treadmill) program at the individuals' 65%-75% of peak heart rate (HRpeak). Peak O2 uptake (VO2peak) and HRpeak were determined by a maximal exercise stress test using a bicycle ergometer...
November 7, 2016: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/27821575/vasculo-neuronal-coupling-retrograde-vascular-communication-to-brain-neurons
#11
Ki Jung Kim, Juan Ramiro Diaz, Jennifer A Iddings, Jessica A Filosa
: Continuous cerebral blood flow is essential for neuronal survival, but whether vascular tone influences resting neuronal function is not known. Using a multidisciplinary approach in both rat and mice brain slices, we determined if flow/pressure-evoked increases or decreases in parenchymal arteriole vascular tone which result in arteriole constriction and dilation, respectively altered resting cortical pyramidal neuron activity. We present evidence for intercellular communication in the brain involving a flow of information from vessel-to-astrocyte-to neuron, a direction opposite to that of classic neurovascular coupling and referred here as vasculo-neuronal coupling (VNC)...
November 7, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27817953/mechanically-assisted-bidirectional-cavopulmonary-shunt-in-neonates-and-infants-an-acute-human-pilot-study
#12
Osami Honjo, Sandra L Merklinger, John B Poe, Anne-Marie Guerguerian, Hargen Zhang, Katherine L Taylor, Glen S Van Arsdell
OBJECTIVE: Poor survival following surgical palliation for hypoplastic left heart syndrome (HLHS) raises the question of the need for a paradigm shift. This is the first human study to investigate the possibility of primary "in-series" palliation in neonates and infants with HLHS in an acute setting with the aid of 2 types of mechanical assist: superior vena cava (SVC)-to-pulmonary artery (PA) pump assist and SVC-to-right atrium (RA) oxygenation assist. METHODS: By rearranging the cannula sites and flow rates for modified ultrafiltration, 2 types of mechanically assisted bidirectional cavopulmonary shunt (BCPS) circulation were simulated for 20 minutes...
September 28, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27809779/hypertension-and-cognitive-dysfunction-in-elderly-blood-pressure-management-for-this-global-burden
#13
REVIEW
Marijana Tadic, Cesare Cuspidi, Dagmara Hering
Arterial hypertension and stroke are strong independent risk factors for the development of cognitive impairment and dementia. Persistently elevated blood pressure (BP) is known to impair cognitive function, however onset of new cognitive decline is common following a large and multiple mini strokes. Among various forms of dementia the most prevalent include Alzheimer's disease (AD) and vascular dementia (VaD) which often present with similar clinical symptoms and challenging diagnosis. While hypertension is the most important modifiable vascular risk factor with antihypertensive therapy reducing the risk of stroke and potentially slowing cognitive decline, optimal BP levels for maintaining an ideal age-related mental performance are yet to be established...
November 3, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27805787/cerebral-haemodynamic-response-to-somatosensory-stimulation-in-near-term-fetal-sheep
#14
S Nakamura, D W Walker, F Y Wong
Functional hyperaemia induced by a localised increase in neuronal activity has been suggested to occur in the fetal brain from positive blood oxygen level-dependent (BOLD) signal recorded by functional magnetic resonance imaging (fMRI) following acoustic stimulation. To study the effect of somatosensory input on local cerebral perfusion we used Near-infrared spectroscopy (NIRS) in anaesthetized, partially exteriorized fetal sheep where the median nerve was stimulated with trains of pulses (2 ms, 3.3 Hz) for durations of 1...
November 2, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27802359/antihypertensive-withdrawal-for-the-prevention-of-cognitive-decline
#15
REVIEW
Susan Jongstra, Jennifer K Harrison, Terry J Quinn, Edo Richard
BACKGROUND: Clinical trials and observational data have variously shown a protective, harmful or neutral effect of antihypertensives on cognitive function. In theory, withdrawal of antihypertensives could improve cerebral perfusion and reduce or delay cognitive decline. However, it is also plausible that withdrawal of antihypertensives may have a detrimental effect on cognition through increased incidence of stroke or other vascular events. OBJECTIVES: To assess the effects of complete withdrawal of at least one antihypertensive medication on incidence of dementia, cognitive function, blood pressure and other safety outcomes in cognitively intact and cognitive impaired adults...
November 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27801767/pontine-warning-syndrome-a-chameleon-of-ischemic-stroke
#16
Alejandro Enriquez-Marulanda, Pablo Amaya-Gonzalez, Jorge L Orozco
INTRODUCTION: Crescendo transient ischemic attacks or "Stroke Warning Syndromes" consist of stereotyped frequent short-lasting episodes of focal neurological deficits. This is explained by intermittent hypoperfusion of the vascular territory of terminal arteries with insufficient collateral flow, presenting a high risk for subsequent infarction. Pontine warning syndrome (PWS) is a subtype of this atypical presentation of stroke/transient ischemic attack and is considered a challenge for diagnosis...
November 2016: Neurologist
https://www.readbyqxmd.com/read/27793855/functional-vascular-contributions-to-cognitive-impairment-and-dementia-vcid-mechanisms-and-consequences-of-cerebral-microvascular-dysfunction-in-aging
#17
Peter Toth, Stefano Tarantini, Anna Csiszar, Zoltan I Ungvari
Increasing evidence from epidemiological, clinical and experimental studies indicate that age-related cerebromicrovascular dysfunction and microcirculatory damage play critical roles in the pathogenesis of many types of dementia in the elderly, including Alzheimer's disease. Understanding and targeting the age-related pathophysiological mechanisms that underlie vascular contributions to cognitive impairment and dementia (VCID) is expected to have a major role in preserving brain health in older individuals...
October 28, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27780904/the-capillary-bed-offers-the-largest-hemodynamic-resistance-to-the-cortical-blood-supply
#18
Ian Gopal Gould, Philbert Tsai, David Kleinfeld, Andreas Linninger
The cortical angioarchitecture is a key factor in controlling cerebral blood flow and oxygen metabolism. Difficulties in imaging the complex microanatomy of the cortex have so far restricted insight about blood flow distribution in the microcirculation. A new methodology combining advanced microscopy data with large scale hemodynamic simulations enabled us to quantify the effect of the angioarchitecture on the cerebral microcirculation. High-resolution images of the mouse primary somatosensory cortex were input into with a comprehensive computational model of cerebral perfusion and oxygen supply ranging from the pial vessels to individual brain cells...
October 10, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27773372/cerebral-oxidative-metabolism-failure-in-traumatic-brain-injury-brain-shock
#19
Christos Lazaridis
Shock is a systemic form of acute circulatory failure leading to cellular dysoxia and death. Such a state of aerobic metabolism failure also underlies neuronal cell death in severe traumatic brain injury. It is becoming increasingly recognized that ischemic hypoxia is not the sole mechanism and that multiple alternate cooperating mechanisms may be responsible for compromising neuronal oxidative metabolism. These different mechanisms can be usefully understood via analysis of the classic subdivisions of tissue hypoxia...
October 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27757914/risks-of-routinely-clamping-external-ventricular-drains-for-intrahospital-transport-in-neurocritically-ill-cerebrovascular-patients
#20
Nophanan Chaikittisilpa, Abhijit V Lele, Vivian H Lyons, Bala G Nair, Shu-Fang Newman, Patricia A Blissitt, Monica S Vavilala
BACKGROUND: Current guidelines recommend routine clamping of external ventricular drains (EVD) for intrahospital transport (IHT). The aim of this project was to describe intracranial hemodynamic complications associated with routine EVD clamping for IHT in neurocritically ill cerebrovascular patients. METHODS: We conducted a retrospective review of cerebrovascular adult patients with indwelling EVD admitted to the neurocritical care unit (NICU) during the months of September to December 2015 at a tertiary care center...
October 18, 2016: Neurocritical Care
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