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. 2020 Nov 24;11:564751. doi: 10.3389/fneur.2020.564751

Figure 1.

Figure 1

Cerebral autoregulation. Cerebral autoregulation in healthy people is reached at a MAP of 50–150 mmHg and ICP below 20–22 mmHg. After TBI, autoregulation is initially preserved, and compensatory mechanisms act to control ICP and to perfuse the brain (CT scan on the left). When these mechanisms are saturated, cerebral autoregulation is lost, ICP increases, and CBF reduces; if left untreated, this culminates in the worst-case scenario of cerebral herniation (CT scan on the right side). When autoregulation is preserved, pial arterioles dilate in response to ICP increase in order to maintain adequate CBF. When autoregulation is lost, arterioles constrict or dilate causing further reduction of CBF (ischemia) or unnecessary increase of perfusion (hyperemia and contusion evolution or malignant edema). MAP, mean arterial pressure; ICP, intracranial pressure; TBI, traumatic brain injury; CT, computed tomography; CBF, cerebral blood flow, DAD, diffuse axonal damage.