Stroke, Vol 25, 793-797, Copyright © 1994 by American Heart Association
DW Newell, R Aaslid, A Lam, TS Mayberg and HR Winn
BACKGROUND AND PURPOSE: We compared relative changes in middle cerebral
artery velocity and internal carotid artery flow during autoregulation
testing to test the validity of using transcranial Doppler recordings of
middle cerebral artery velocity to evaluate cerebral autoregulation in
humans. METHODS: Seven human volunteers had dynamic autoregulation tested
during surgical procedures that included exposure of the internal carotid
artery. The mean arterial blood pressure and middle cerebral artery
velocity spectral outline (Vmax), using transcranial Doppler, and
ipsilateral internal carotid artery flow, using an electromagnetic
flowmeter, were continuously and simultaneously recorded during transient
sharp decreases in blood pressure that were induced by rapid deflation of
thigh blood pressure cuffs. The resulting responses of velocity in the
middle cerebral artery and flow in the internal carotid artery were
compared. RESULTS: Moderate decreases in blood pressure evoked responses in
cerebral autoregulation. There were no significant (P = .97) differences
between the responses in middle cerebral artery velocity and internal
carotid artery flow to the blood pressure decreases. CONCLUSIONS: Relative
changes in Vmax accurately reflect relative changes in internal carotid
artery flow during dynamic autoregulation testing in humans. Therefore,
alterations in middle cerebral artery diameter do not occur to the extent
that they introduce a significant error in making these comparisons.
ARTICLES
Comparison of flow and velocity during dynamic autoregulation testing in humans
Department of Neurological Surgery, University of Washington School of Medicine, Seattle.
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