T M Traub, R Grabowski, K Rais-Bahrami
BACKGROUND: As neonates transition from a relatively hypoxic environment to extra-uterine life, arterial oxygen saturation dramatically increases. This transition occurs while most organs have not fully matured. The ability for immature tissue to adequately extract and utilize oxygen remains largely unknown. With the development of near-infrared spectroscopy (NIRS), measuring specific tissue oxygen saturation (StO2) noninvasively, clinicians can measure StO2 and determine if adequate tissue oxygenation is maintained...
January 12, 2021: Journal of Neonatal-perinatal Medicine
Ilaria Alice Crippa, Jacques Creteur, Peter Smielewski, Fabio Silvio Taccone, Marek Czosnyka
INTRODUCTION: Adequate cerebral perfusion prevents secondary insult after traumatic brain injury (TBI). Cerebral autoregulation (CAR) keeps cerebral blood flow (CBF) constant when arterial blood pressure (ABP) changes. Aim of the study was to evaluate the existence of delayed CAR in TBI patients and its possible association with outcome. METHODS: We retrospectively analysed TBI patients. Flow velocity (FV) in middle cerebral artery, invasive intra-cranial pressure (ICP) and ABP were recorded...
January 8, 2021: Clinical Neurology and Neurosurgery
Jichen Du, Jiangbo Cui, Jing Yang, Peifu Wang, Lvming Zhang, Bin Luo, Bailin Han
Most reported neurological symptoms that happen after exposure to microgravity could be originated from alterations in cerebral hemodynamics. The complicated mechanisms involved in the process of hemodynamics and the disparate experimental protocols designed to study the process may have contributed to the discrepancies in results between studies and the lack of consensus among researchers. This literature review examines spaceflight and ground-based studies of cerebral hemodynamics and aims to summarize the underlying physiological mechanisms that are altered in cerebral hemodynamics during microgravity...
January 15, 2021: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Lucy Beishon, Rebecca H Clough, Meeriam Kadicheeni, Tamara Chithiramohan, Ronney B Panerai, Victoria J Haunton, Jatinder S Minhas, Thompson G Robinson
The population is ageing worldwide, thus increasing the burden of common age-related disorders to the individual, society and economy. Cerebrovascular diseases (stroke, dementia) contribute a significant proportion of this burden and are associated with high morbidity and mortality. Thus, understanding and promoting healthy vascular brain ageing are becoming an increasing priority for healthcare systems. In this review, we consider the effects of normal ageing on two major physiological processes responsible for vascular brain function: Cerebral autoregulation (CA) and neurovascular coupling (NVC)...
January 13, 2021: Pflügers Archiv: European Journal of Physiology
Karen Maria Barlow, Kartik Iyer, Tingting Yan, Alex Scurfield, Helen L Carlson, Yang Wang
Persistent post-concussion symptoms (PPCS) following pediatric mild traumatic brain injury (mTBI) are associated with differential changes in cerebral blood flow (CBF). Given its potential as a therapeutic target, we examined CBF changes during recovery in children with PPCS. We hypothesized that CBF would decrease and that such decreases would mirror clinical recovery. In a prospective cohort study, 61 children (mean age 14 (SD=2.6) years; 41% male) with PPCS were imaged with 3D pseudo-continuous arterial spin-labelled (pCASL) MRI at 4-6 and 8-10 weeks post-injury...
January 11, 2021: Journal of Neurotrauma
Teodor Svedung Wettervik, Timothy Howells, Anders Lewén, Elisabeth Ronne-Engström, Per Enblad
BACKGROUND: High intracranial pressure (ICP) and low cerebral perfusion pressure (CPP) may induce secondary brain injury following aneurysmal subarachnoid hemorrhage (aSAH). In the current study, we aimed to determine the temporal incidence of insults above/below certain ICP/CPP thresholds, the role of pressure autoregulation in CPP management (PRx and CPPopt), and the relation to clinical outcome. METHODS: In this retrospective study, 242 patients were included with aSAH, who were treated in the neurointensive care unit, Uppsala University Hospital, Sweden, 2008-2018, with ICP monitoring the first 10 days post-ictus...
January 9, 2021: Neurocritical Care
Alexander Ruesch, Deepshikha Acharya, Samantha Schmitt, Jason Yang, Matthew A Smith, Jana M Kainerstorfer
The brain's ability to maintain cerebral blood flow approximately constant despite cerebral perfusion pressure changes is known as cerebral autoregulation (CA) and is governed by vasoconstriction and vasodilation. Cerebral perfusion pressure is defined as the pressure gradient between arterial blood pressure and intracranial pressure. Measuring CA is a challenging task and has created a variety of evaluation methods, which are often categorized as static and dynamic CA assessments. Because CA is quantified as the performance of a regulatory system and no physical ground truth can be measured, conflicting results are reported...
2021: PloS One
Verena Rass, Raimund Helbok
PURPOSE OF REVIEW: Delayed cerebral ischaemia (DCI) complicates the clinical course of patients with subarachnoid haemorrhage (SAH) in 20--30% and substantially worsens outcome. In this review, we intended to describe a multimodal diagnostic approach based on underlying mechanisms of DCI and provide treatment options with a special focus on the most recently published literature. RECENT FINDINGS: Symptomatic vasospasm refers to clinical deterioration in the presence of vasospasm whereas DCI constitutes multiple causes...
January 5, 2021: Current Opinion in Critical Care
Sabrina Hernandez, Katherine Kittelty, Carol L Hodgson
PURPOSE OF REVIEW: To describe recent literature evaluating the effectiveness of early rehabilitation in neurocritical care patients. RECENT FINDINGS: There is a drive for early rehabilitation within the ICU; however, there are unique considerations for the neurocritically ill patient that include hemiplegia, cognitive impairments and impaired conscious state that can complicate rehabilitation. Additionally, neurological complications, such as hemorrhage expansion and cerebral edema can lead to the risk of further neurological damage...
December 30, 2020: Current Opinion in Critical Care
Mark P M Harms, Ciáran Finucane, Laura Pérez-Denia, Stephen Jurachek, Veera K van Wijnen, Lewis A Lipsitz, Johannes J van Lieshout, Wouter Wieling
Transient cardiovascular and cerebrovascular responses within the first minute of active standing provide the means to assess autonomic, cardiovascular and cerebrovascular regulation using a real-world everyday stimulus. Traditionally, these responses have been used to detect autonomic dysfunction, and to identify the hemodynamic correlates of patient symptoms and attributable causes of (pre)syncope and falls. This review addresses the physiology of systemic and cerebrovascular adjustment within the first 60 s after active standing...
December 10, 2020: Autonomic Neuroscience: Basic & Clinical
Fiachra Maguire, Roman Romero-Ortuno, John D O'Connor, Richard B Reilly, Silvin P Knight, Rose-Anne Kenny
BACKGROUND: Orthostasis is a potent physiological stressor which adapts with age. The age-related accumulation of health deficits in multiple physiological systems may impair the physiological response to orthostasis and lead to negative health outcomes such as falls, depression and cognitive decline. Research to date has focused on changes with orthostasis at prespecified intervals of time, without consideration for whole signal approaches. METHODS: One-dimensional statistical parametric mapping (SPM 1d) identified regions in time of significant association between variables of interest using a general linear model...
December 23, 2020: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Shyan-Lung Lin, Shoou-Jeng Yeh, Ching-Kun Chen, Yu-Liang Hsu, Chih-En Kuo, Wei-Yu Chen, Cheng-Pu Hsieh
Postural orthostatic tachycardia syndrome (POTS) typically occurs in youths, and early accurate POTS diagnosis is challenging. A recent hypothesis suggests that upright cognitive impairment in POTS occurs because reduced cerebral blood flow velocity (CBFV) and cerebrovascular response to carbon dioxide (CO2 ) are nonlinear during transient changes in end-tidal CO2 (PETCO2 ). This novel study aimed to reveal the interaction between cerebral autoregulation and ventilatory control in POTS patients by using tilt table and hyperventilation to alter the CO2 tension between 10 and 30 mmHg...
December 18, 2020: Journal of Clinical Medicine
Shaoxun Wang, Richard J Roman, Fan Fan
Individuals with spinal cord injury (SCI) have a significantly increased risk for cognitive impairment that is associated with cerebrovascular remodeling and endothelial dysfunction. The sub-acute stage following high thoracic SCI is characterized by increased fibrosis and stiffness of cerebral arteries. However, a more prolonged duration after SCI exacerbates cerebrovascular injury by damaging endothelium. Endothelial dysfunction is associated with reduced expression of transient receptor potential cation channel 4 that mediates the production of nitric oxide and epoxyeicosatrienoic acids following shear stress and the response to carbachol and other endothelium-dependent vasodilators...
2020: Journal of neurobiology and physiology
Jan Willem van Dalen, Henri Jmm Mutsaerts, Jan Petr, Matthan Wa Caan, Eric P Moll van Charante, Bradley J MacIntosh, Willem A van Gool, Aart J Nederveen, Edo Richard
Consistent cerebral blood flow (CBF) is fundamental to brain function. Cerebral autoregulation ensures CBF stability. Chronic hypertension can lead to disrupted cerebral autoregulation in older people, potentially leading to blood pressure levels interfering with CBF. This study tested whether low BP and AHD use are associated with contemporaneous low CBF, and whether longitudinal change in BP is associated with change in CBF, using arterial spin labelling (ASL) MRI, in a prospective longitudinal cohort of 186 community-dwelling older individuals with hypertension (77 ± 3 years, 53% female), 125 (67%) of whom with 3-year follow-up...
December 16, 2020: Journal of Cerebral Blood Flow and Metabolism
Armin A Quispe-Cornejo, Shannon McDuff, Ilaria A Crippa, Jean-Louis Vincent, Jacques Creteur, Fabio S Taccone
No abstract text is available yet for this article.
December 16, 2020: Minerva Anestesiologica
Michael Heckelmann, Ganeshwaran Shivapathasundram, Danilo Cardim, Peter Smielewski, Marek Czosnyka, Rita Gaio, Mark M P Sheridan, Matthias Jaeger
Continuous measurement of cerebral blood flow velocity (CBFV) of the middle cerebral artery (MCA) using transcranial Doppler (TCD) and arterial blood pressure (ABP) monitoring enables assessment of cerebrovascular haemodynamics. Further indices describing cerebrovascular function can be calculated from ABP and CBFV, such as the mean index (Mxa) of cerebrovascular autoregulation, the 'time constant of the cerebral arterial bed' (tau), the 'critical closing pressure' (CrCP) and a 'non-invasive estimator of ICP' (nICP)...
December 2020: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Ian Seiller, Aude Pavilla, Julien Ognard, Nathalie Ozier-Lafontaine, Sylvie Colombani, Yamilet Cepeda Ibarra, Mehdi Mejdoubi
OBJECTIVE: Hypertension affects cerebrovascular autoregulation and increases the risk of cerebrovascular events and dementia. Notably, it is associated with cerebrovascular remodeling and lower resting cerebral blood flow (CBF). We wanted to determine, using arterial spin-labeling-MRI, the impact of a head-down tilt (HDT) dynamic maneuver on CBF in hypertensive patients. METHODS: The current prospective study measured 36 patients' CBFs (18 normotensive individuals; 18 hypertensive patients) on 1...
December 9, 2020: Journal of Hypertension
Yedan Liu, Huawei Zhang, Shaoxun Wang, Ya Guo, Xing Fang, Baoying Zheng, Wenjun Gao, Hongwei Yu, Zongbo Chen, Richard J Roman, Fan Fan
Diabetes mellitus (DM) is one of the primary pathological factors that contributes to aging-related cognitive impairments, but the underlying mechanisms remain unclear. We recently reported that old DM rats exhibited impaired myogenic responses of the cerebral arteries and arterioles, poor cerebral blood flow autoregulation, enhanced blood-brain barrier (BBB) leakage, and cognitive impairments. These changes were associated with diminished vascular smooth muscle cell contractile capability linked to elevated reactive oxygen species (ROS) and reduced ATP production...
December 11, 2020: American Journal of Physiology. Heart and Circulatory Physiology
Zongyu Xiao
BACKGROUND: Cranioplasty is a relatively simple neurosurgical procedure, and common complications of cranioplasty include dural tears, CSF leakage, infection, epilepsy, epidural hematoma and bone flap resorption. Intracerebral hemorrhage as a complication of cranioplasty is rare, and it is often fatal. The report describes one case of delayed severe intracerebral and intraventricular hemorrhage after an uneventful cranioplasty. CASE PRESENTATION: A previously healthy 29-year-old man was admitted to our hospital with a traumatic left frontotemporoparietal acute subdural hematoma, an emergency decompressive craniectomy with clot removal was performed...
December 11, 2020: British Journal of Neurosurgery
Alberto Porta, Angela Fantinato, Vlasta Bari, Francesca Gelpi, Beatrice Cairo, Beatrice De Maria, Enrico Giuseppe Bertoldo, Valentina Fiolo, Edward Callus, Carlo De Vincentiis, Marianna Volpe, Raffaella Molfetta, Marco Ranucci
We assessed the effect of surgical aortic valve replacement (SAVR) on cardiovascular and cerebrovascular controls via spontaneous variability analyses of heart period, approximated as the temporal distance between two consecutive R-wave peaks on the electrocardiogram (RR), systolic, diastolic and mean arterial pressure (SAP, DAP and MAP) and mean cerebral blood flow (MCBF). Powers in specific frequency bands, complexity, presence of nonlinear dynamics and markers of cardiac baroreflex and cerebral autoregulation were calculated...
2020: PloS One
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