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(Stroke. 1973;4:12.)
© 1973 American Heart Association, Inc.

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Cerebrovascular Regulation in Preganglionic and Postganglionic Autonomic Insufficiency

JOHN J. CARONNA M.D.¹ FRED PLUM M.D.¹

¹ Cerebrovascular Research Center, Department of Neurology, New York Hospital--Cornell Medical Center, New York, New York, 10021

Cerebral blood flow was measured in four subjects with chronic idiopathic autonomic insufficiency using ⁸⁵Kr inhalation, cerebral A-V samples for scintillation counting, and O₂ content determination. Blood pressure was varied by up or down tilting and L-norepinephrine infusion. In three patients with typical Shy-Drager syndrome and preganglionic denervation, CBF regulation to pressure and Pa_COCO2 change was intact. In a fourth patient with postganglionic denervation, CBF autoregulation was absent to changes in blood pressure but was preserved normally to increases or decreases in Pa_COCO2 CBF and CMRO₂, at rest were normal (52.6 cc and 3.1 cc). Hyperventilation to Pa_COCO2 34.3 mm failed to restore autoregulation to increased blood pressure. The results imply a functional role for postganglionic autonomic fibers in CBF autoregulation.

Key Words: Shy-Drager syndrome • orthostatic hypertension • CBF autoregulation

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