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Open AccessJournal ArticleDOI

Cerebral blood flow is regulated by changes in blood pressure and in blood viscosity alike.

TLDR
The results show that viscosity changes must result in compensatory readjustments of vessel diameter, but that these adjustments do not occur where autoregulation to pressure changes is known to be defective.
Abstract
There is still considerable controversy regarding the influence of blood viscosity upon CBF. We have measured CBF with microspheres in 23 cats. Autoregulation was disturbed in the left caudate nucleus by microsurgical occlusion of the left middle cerebral artery. Induced hypertension or hypotension was used and i.v. mannitol (1 g/kg) administered. In all cats blood viscosity decreased an average of 16% at 15 minutes and, in 16 cats, increased 10% at 75 minutes post-mannitol. CBF in the right caudate was 79 +/- 6 ml/100g/min, in the left 38 +/- 6 (p less than 0.001). Only minor changes of CBF occurred in areas with presumed normal autoregulation, including the right caudate, in conjunction with pressure or viscosity changes. In the left caudate CBF decreased 21% with hypotension and 18% with higher viscosity, more than on the right (p less than 0.01 and p less than 0.2, respectively). CBF increased in the left caudate 56% with hypertension and 47% with lower viscosity, again much more than on the right (p less than 0.001 and p less than 0.01, respectively). In the other area which is (nearly) exclusively supplied by the middle cerebral artery of the cat, i.e., the ectosylvian cortex, results were similar to those in the caudate nucleus. These results show that viscosity changes must result in compensatory readjustments of vessel diameter, but that these adjustments do not occur where autoregulation to pressure changes is known to be defective. The adjustments to viscosity changes might be called blood viscosity autoregulation of CBF. We hypothesize that pressure autoregulation and blood viscosity autoregulation share the same mechanism.

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Citations
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Journal ArticleDOI

Cerebral perfusion pressure: management protocol and clinical results

TL;DR: These results are significantly better than other reported series across GCS categories in comparisons of death rates, survival versus dead or vegetative, or favorable versus nonfavorable outcome classifications.
Journal ArticleDOI

Integrative regulation of human brain blood flow

TL;DR: Mechanisms regulating cerebral blood flow (CBF), with specific focus on humans, are reviewed and the following four key theses are corroborated: that cerebral autoregulation does not maintain constant perfusion through a mean arterial pressure range of 60–150 mmHg; that there is important stimulatory synergism and regulatory interdependence of arterial blood gases and blood pressure on CBF regulation.
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Hematocrit and the risk of cardiovascular disease--the Framingham study: a 34-year follow-up.

TL;DR: The hypothesis that HCT is an important risk factor for some CVD events, an association that merits further investigation, is supported.
Journal ArticleDOI

Cerebral blood flow and metabolism in severely head-injured children. Part 1: Relationship with GCS score, outcome, ICP, and PVI.

TL;DR: No correlation could be established between the course of ICP or PVI and the occurrence of hyperemia, nor was there a correlation between the levels of CBF and ICP at the time of the measurements.
References
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Journal ArticleDOI

Responses of cerebral arteries and arterioles to acute hypotension and hypertension

TL;DR: The responses of cerebral precapillary vessels to changes in arterial blood pressure were studied in anesthetized cats equipped with cranial windows for the direct observation of the pial microcirculation of the parietal cortex and found to be size dependent.
Journal ArticleDOI

Mannitol causes compensatory cerebral vasoconstriction and vasodilation in response to blood viscosity changes.

TL;DR: An alternative explanation is offered for the effect of mannitol on ICP, the time course of ICP changes, "rebound effect," and the absence of influence on CBF, all with one mechanism.
Journal ArticleDOI

Effect of mannitol on ICP and CBF and correlation with pressure autoregulation in severely head-injured patients

TL;DR: The changes in intracranial pressure (ICP) and cerebral blood flow (CBF) after mannitol administration in a group of severely head-injured patients with intact or defective autoregulation is described.
Journal ArticleDOI

Effect of hæmatocrit on cerebral blood-flow in man

TL;DR: Cerebral blood-flow was measured in patients with haematocrit values in the range 0·47-0·53 and was found to be significantly lower than in 43 patients with Hct in a lower range, which suggests Hct around the generally accepted upper limit of normal may be an important factor in the causation of occlusive vascular disease.
Journal ArticleDOI

Whole blood viscosity parameters and cerebral blood flow.

TL;DR: It is concluded that heightened whole blood viscosity does correlate with decreased cerebral blood flow in the ranges measured in patients, that both fibrinogen and hematocrit must be taken into consideration in viscosities determinations, and that changes in viscolysis may have an important effect on CBF in regions of low flow.
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