Stroke, Vol 22, 1148-1154, Copyright © 1991 by American Heart Association
R Aaslid, DW Newell, R Stooss, W Sorteberg and KF Lindegaard
We investigated the validity of transcranial Doppler recordings for the
analysis of dynamic responses of cerebral autoregulation. We found no
significant differences in percentage changes among maximal (centerline)
blood flow velocity, cross-sectional mean blood flow velocity, and signal
power-estimated blood flow during 24-mm Hg stepwise changes in arterial
blood pressure. We investigated blood flow propagation delays in the
cerebral circulation with simultaneous Doppler recordings from the middle
cerebral artery and the straight sinus. The time for a stepwise decrease in
blood flow to propagate through the cerebral circulation was only 200 msec.
Brief (1.37-second) carotid artery compression tests also demonstrated that
the volume compliance effects of the cerebral vascular bed were small, only
about 2.2% of normal blood flow in 1 second. Furthermore, transients
associated with inertial and volume compliance died out after 108 msec. We
also investigated the hypothesis that autoregulatory responses are
influenced by hyperventilation using the same brief carotid artery
compressions. One second after release, the flow index increased by 17%
during normocapnia and 36% during hypocapnia. After 5 seconds, the flow
index demonstrated a clear oscillatory response during hypocapnia that was
not seen during normocapnia. These results suggest that the intact human
cerebral circulation in the absence of pharmacological influences does not
function as predicted from pial vessel observations in animals.
ARTICLES
Assessment of cerebral autoregulation dynamics from simultaneous arterial and venous transcranial Doppler recordings in humans
Department of Neurosurgery, Inselspital, University of Berne, Switzerland.
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