Stroke, Vol 22, 367-372, Copyright © 1991 by American Heart Association
MN Diringer, DS Heffez, L Monsein, JR Kirsch, DF Hanley and RJ Traystman
While the in vitro reactivity of cerebral conducting vessels following
subarachnoid hemorrhage has been extensively studied, in vivo
cerebrovascular CO2 reactivity has not been systematically investigated. We
tested the hypothesis that, in the canine model of subarachnoid hemorrhage,
the rise in cerebral blood flow normally seen with hypercapnia is blunted
during delayed vasospasm. Four groups of animals were studied: one received
two 4-ml subarachnoid injections of nonheparinized arterial blood into the
cisterna magna (n = 8), one received three subarachnoid injections of 5 ml
blood (n = 5), one received two subarachnoid injections of 4 ml saline (n =
5), and a control group (n = 5) had no subarachnoid injections or
angiography. Basilar artery diameter was measured from baseline and
follow-up angiography. We determined CO2 reactivity by randomly varying the
concentration of inspired CO2 and measuring regional cerebral blood flow
with radiolabeled microspheres. Basilar artery diameter was not affected by
saline injection and was reduced by 26 +/- 2.9% in the two- hemorrhage
group and 55 +/- 1.9% in the three-hemorrhage group. Baseline cerebral
blood flow and CO2 reactivity were similar in all four groups. We conclude
that, in this model of delayed vasospasm, regional cerebral vascular CO2
reactivity is intact and extrapolation of in vitro data regarding basilar
artery diameter and reactivity to cerebral blood flow must be done
cautiously.
ARTICLES
Cerebrovascular CO2 reactivity during delayed vasospasm in a canine model of subarachnoid hemorrhage
Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, Md.
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