Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1975 Jul;38(7):657–665. doi: 10.1136/jnnp.38.7.657

Effects of increased arterial pressure on blood flow in the damaged brain.

J D Miller, J Garibi, J B North, G M Teasdale
PMCID: PMC1083244  PMID: 1159437

Abstract

The effect of induced arterial hypertension on cerebral blood flow and intracranial pressure was measured before and after the production of a standard cryogenic brain lesion in 10 anaesthetized, ventilated baboons. Before injury the animals were divided into a group with intact autoregulation, having more than 20% increase in cerebrovascular resistance during arterial hypertension, and a group with impaired autoregulation, in which the change in cerebrovascular resistance was much less. The cryogenic injury produced a rapid rise in intracranial pressure and a reduction of cerebral blood flow in the affected hemisphere. Despite this, there was an increase in cerebrovascular resistance during arterial hypertension in all animals after brain injury, accompanied by a further significant rise in intracranial pressure. It is suggested that this response is unlikely to represent normal physiological autoregulation and caution should be exercised in interpreting it as such in the course of studies of cerebral blood flow in patients with acute brain damage.

Full text

PDF
657

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bruce D. A., Langfitt T. W., Miller J. D., Schutz H., Vapalahti M. P., Stanek A., Goldberg H. I. Regional cerebral blood flow, intracranial pressure, and brain metabolism in comatose patients. J Neurosurg. 1973 Feb;38(2):131–144. doi: 10.3171/jns.1973.38.2.0131. [DOI] [PubMed] [Google Scholar]
  2. CLASEN R. A., BROWN D. V. L., LEAVITT S., HASS G. M. The production by liquid nitrogen of acute closed lesions. Surg Gynecol Obstet. 1953 May;96(5):605–616. [PubMed] [Google Scholar]
  3. Farrar J. K., Jr, Roach M. R. The effects of increased intracranial pressure on flow through major cerebral arteries in vitro. Stroke. 1973 Sep-Oct;4(5):795–806. doi: 10.1161/01.str.4.5.795. [DOI] [PubMed] [Google Scholar]
  4. Harper A. M. Autoregulation of cerebral blood flow: influence of the arterial blood pressure on the blood flow through the cerebral cortex. J Neurol Neurosurg Psychiatry. 1966 Oct;29(5):398–403. doi: 10.1136/jnnp.29.5.398. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Häggendal E., Löfgren J., Nilsson N. J., Zwetnow N. N. Effects of varied cerebrospinal fluid pressure on cerebral blood flow in dogs. Acta Physiol Scand. 1970 Jun;79(2):262–271. doi: 10.1111/j.1748-1716.1970.tb04725.x. [DOI] [PubMed] [Google Scholar]
  6. Johnston I. H., Johnston J. A., Jennett B. Intracranial-pressure changes following head injury. Lancet. 1970 Aug 29;2(7670):433–436. doi: 10.1016/s0140-6736(70)90054-1. [DOI] [PubMed] [Google Scholar]
  7. Johnston I. H., Rowan J. O., Harper A. M., Jennett W. B. Raised intracranial pressure and cerebral blood flow. 2. Supratentorial and infratentorial mass lesions in primates. J Neurol Neurosurg Psychiatry. 1973 Apr;36(2):161–170. doi: 10.1136/jnnp.36.2.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Johnston I. H., Rowan J. O., Harper A. M., Jennett W. B. Raised intracranial pressure and cerebral blood flow. I. Cisterna magna infusion in primates. J Neurol Neurosurg Psychiatry. 1972 Jun;35(3):285–296. doi: 10.1136/jnnp.35.3.285. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Johnston I. H., Rowan J. O. Raised intracranial pressure and cerebral blood flow. 3. Venous outflow tract pressures and vascular resistances in experimental intracranial hypertension. J Neurol Neurosurg Psychiatry. 1974 Apr;37(4):392–402. doi: 10.1136/jnnp.37.4.392. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kety S. S., Shenkin H. A., Schmidt C. F. THE EFFECTS OF INCREASED INTRACRANIAL PRESSURE ON CEREBRAL CIRCULATORY FUNCTIONS IN MAN. J Clin Invest. 1948 Jul;27(4):493–499. doi: 10.1172/JCI101996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Leech P., Miller J. D. Intracranial volume--pressure relationships during experimental brain compression in primates. 2. Effect of induced changes in systemic arterial pressure and cerebral blood flow. J Neurol Neurosurg Psychiatry. 1974 Oct;37(10):1099–1104. doi: 10.1136/jnnp.37.10.1099. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Meinig G., Reulen H. J., Magawly C. Regional cerebral blood flow and cerebral perfusion pressure in global brain oedema induced by water intoxication. Acta Neurochir (Wien) 1973;29(1):1–13. doi: 10.1007/BF01414612. [DOI] [PubMed] [Google Scholar]
  13. Miller J. D., Ledingham I. M., Jennett W. B. Effects of hyperbaric oxygen on intracranial pressure and cerebral blood flow in experimental cerebral oedema. J Neurol Neurosurg Psychiatry. 1970 Dec;33(6):745–755. doi: 10.1136/jnnp.33.6.745. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Miller J. D., Stanek A. E., Langfitt T. W. Cerebral blood flow regulation during experimental brain compression. J Neurosurg. 1973 Aug;39(2):186–196. doi: 10.3171/jns.1973.39.2.0186. [DOI] [PubMed] [Google Scholar]
  15. Miller J. D., Stanek A., Langfitt T. W. Concepts of cerebral perfusion pressure and vascular compression during intracranial hypertension. Prog Brain Res. 1972;35:411–432. doi: 10.1016/S0079-6123(08)60102-8. [DOI] [PubMed] [Google Scholar]
  16. Overgaard J., Tweed W. A. Cerebral circulation after head injury. 1. Cerebral blood flow and its regulation after closed head injury with emphasis on clinical correlations. J Neurosurg. 1974 Nov;41(5):531–541. doi: 10.3171/jns.1974.41.5.0531. [DOI] [PubMed] [Google Scholar]
  17. RAPELA C. E., GREEN H. D. AUTOREGULATION OF CANINE CEREBRAL BLOOD FLOW. Circ Res. 1964 Aug;15:SUPPL–SUPPL:212. [PubMed] [Google Scholar]
  18. Rowan J. O., Harper A. M., Miller J. D., Tedeschi G. M., Jennett W. B. Relationship between volume flow and velocity in the cerebral circulation. J Neurol Neurosurg Psychiatry. 1970 Dec;33(6):733–738. doi: 10.1136/jnnp.33.6.733. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. SHULMAN K. SMALL ARTERY AND VEIN PRESSURES IN THE SUBARACHNOID SPACE OF THE DOG. J Surg Res. 1965 Feb;5:56–61. doi: 10.1016/s0022-4804(65)80067-1. [DOI] [PubMed] [Google Scholar]
  20. Severinghaus J. W. Blood gas calculator. J Appl Physiol. 1966 May;21(3):1108–1116. doi: 10.1152/jappl.1966.21.3.1108. [DOI] [PubMed] [Google Scholar]
  21. Strandgaard S., MacKenzie E. T., Sengupta D., Rowan J. O., Lassen N. A., Harper A. M. Upper limit of autoregulation of cerebral blood flow in the baboon. Circ Res. 1974 Apr;34(4):435–440. doi: 10.1161/01.res.34.4.435. [DOI] [PubMed] [Google Scholar]
  22. Symon L., Pasztor E., Dorsch N. W., Branston N. M. Physiological responses of local areas of the cerebral circulation in experimental primates determined by the method of hydrogen clearance. Stroke. 1973 Jul-Aug;4(4):632–642. doi: 10.1161/01.str.4.4.632. [DOI] [PubMed] [Google Scholar]
  23. TROUPP J. INTRAVENTRICULAR PRESSURE IN PATIENTS WITH SEVERE BRAIN INJURIES. J Trauma. 1965 May;5:373–378. doi: 10.1097/00005373-196505000-00007. [DOI] [PubMed] [Google Scholar]
  24. Yada K., Nakagawa Y., Tsuru M. Circulatory disturbance of the venous system during experimental intracranial hypertension. J Neurosurg. 1973 Dec;39(6):723–729. doi: 10.3171/jns.1973.39.6.0723. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES