Relationships between Perfusion Pressure and Regional Cerebral Blood Flow in Patients with Intracranial Mass Lesions

1972 ◽  
Vol 8 (1-4) ◽  
pp. 111-117 ◽  
Author(s):  
M.P. Heilbrun ◽  
P.B. Jorgensen ◽  
G. Boysen
1992 ◽  
Vol 12 (4) ◽  
pp. 613-620 ◽  
Author(s):  
Naoki Koketsu ◽  
Michael A. Moskowitz ◽  
Hermes A. Kontos ◽  
Masayuki Yokota ◽  
Takeo Shimizu

Regional cerebral blood flow (rCBF) during controlled hemorrhagic hypotension (140–20 mm Hg) was assessed 10–14 days after chronic unilateral sectioning of parasympathetic and/or sensory fibers innervating pial vessels in spontaneously hypertensive rats (SHR). rCBF was measured in the cortical barrel fields bilaterally by laser Doppler blood flowmetry. Immunohistochemistry of middle cerebral artery (MCA) whole mount preparations was used to verify the surgical lesion. During hemorrhagic hypotension, rCBF was equivalent on the two sides in shams, after selective sensory denervation, or in parasympathetically sectioned animals exhibiting small decreases (≤30%) in immunoreactive vasoactive intestinal peptide (VIP)-containing fibers. After chronic parasympathetic denervation, decreases in perfusion pressure were accompanied by greater reductions in rCBF on the lesioned side; changes in vascular resistance were also attenuated on that side. The rCBF response to hypercapnia (Paco2 50 mm Hg), however, was symmetrical and robust. To examine the effects of impaired neurogenic vasodilation on the pathophysiology of cerebral ischemia, infarct size was measured 24 h following tandem MCA occlusion in denervated animals. Infarction volume was larger after selective parasympathetic sectioning (sham, 156 ± 27 vs. 196 ± 32 mm3, respectively) but only in those denervated animals demonstrating ≥40% decrease in immunoreactive VIP-containing fibers within the ipsilateral MCA. Lower than expected blood flow/perfusion pressure in the cortex distal to an occluded blood vessel may relate the observed blood flow responses to the occurrence of larger cortical infarcts in parasympathetically denervated animals. If true, the findings suggest a novel role for neurogenic vasodilation in the pathophysiology of cerebral ischemia and in rCBF regulation within the peri-infarction zone.


1977 ◽  
Vol 46 (3) ◽  
pp. 271-281 ◽  
Author(s):  
Hideo Endo ◽  
Bo Larsen ◽  
Niels A. Lassen

✓ Regional cerebral blood flow (rCBF) was investigated in 12 patients with brain tumors, using a 254-channel dynamic gamma camera. In nine of the 12 cases, hyperemic regions with loss of autoregulation were seen in sites remote from the tumor (the area around the tumor was in most cases also hyperemic). These remote rCBF abnormalities were found in the lower posterior part of the hemisphere in six cases, and in the frontal region in three. The location of the remote rCBF abnormality seemed to depend on the site of the tumor: cases with frontal and posterior fossa mass lesions had hyperemia in the lower part of the temporooccipital regions, cases with centroparietal mass lesions had hyperemia mostly in the frontal region. This may mean that the remote rCBF abnormality is due to local tissue compression against unyielding anatomical structures, namely, the tentorium and the falx. It is suggested that these abnormalities may constitute evidence of an early stage of a dangerous clinical condition: a state of preherniation.


2014 ◽  
Author(s):  
Scott Harcourt ◽  
Daniel G. Amen ◽  
Kristin C. Willeumier ◽  
Charles J. Golden

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