Increased ICP and Its Cerebral Haemodynamic Sequelae
OBJECTIVES: Increased intracranial pressure (ICP) is a pathological feature of many neurological diseases; however, the local and systemic sequelae of raised ICP are incompletely understood. Using an experimental paradigm, we aimed to describe the cerebrovascular consequences of acute increases in ICP.
MATERIALS AND METHODS: We assessed cerebral haemodynamics [mean arterial blood pressure (MAP), ICP, laser Doppler flowmetry (LDF), basilar artery Doppler flow velocity (Fv) and estimated vascular wall tension (WT)] in 27 basilar artery-dependent rabbits during experimental (artificial lumbar CSF infusion) intracranial hypertension. WT was estimated as the difference between critical closing pressure and ICP.
RESULTS: From baseline (~9 mmHg) to moderate increases in ICP (~41 mmHg), cortical LDF decreased (from 100 to 39.1%, p < 0.001), while mean global Fv was unchanged (from 47 to 45 cm/s, p = 0.38). In addition, MAP increased (from 88.8 to 94.2 mmHg, p < 0.01 and WT decreased (from 19.3 to 9.8 mmHg, p < 0.001). From moderate to high ICP (~75 mmHg), both global Fv and cortical LDF decreased (Fv, from 45 to 31.3 cm/s, p < 0.001; LDF, from 39.1 to 13.3%, p < 0.001) while MAP increased further (94.2 to 114.5 mmHg, p < 0.001) and estimated WT was unchanged (from 9.7 to 9.6 mmHg, p = 0.35).
CONCLUSION: In this analysis, we demonstrate a cortical vulnerability to increases in ICP and two ICP-dependent cerebro-protective mechanisms: with moderate increases in ICP, WT decreases and MAP increases to buffer cerebral perfusion, while with severe increases of ICP, an increased MAP predominates.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:126 |
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| Enthalten in: |
Acta neurochirurgica. Supplement - 126(2018) vom: 25., Seite 47-50 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Donnelly, Joseph [VerfasserIn] |
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| Links: |
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| Themen: |
Autoregulation |
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| Anmerkungen: |
Date Completed 12.07.2018 Date Revised 29.01.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.1007/978-3-319-65798-1_10 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM281500894 |
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| 100 | 1 | |a Donnelly, Joseph |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Increased ICP and Its Cerebral Haemodynamic Sequelae |
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| 500 | |a Date Revised 29.01.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: Increased intracranial pressure (ICP) is a pathological feature of many neurological diseases; however, the local and systemic sequelae of raised ICP are incompletely understood. Using an experimental paradigm, we aimed to describe the cerebrovascular consequences of acute increases in ICP | ||
| 520 | |a MATERIALS AND METHODS: We assessed cerebral haemodynamics [mean arterial blood pressure (MAP), ICP, laser Doppler flowmetry (LDF), basilar artery Doppler flow velocity (Fv) and estimated vascular wall tension (WT)] in 27 basilar artery-dependent rabbits during experimental (artificial lumbar CSF infusion) intracranial hypertension. WT was estimated as the difference between critical closing pressure and ICP | ||
| 520 | |a RESULTS: From baseline (~9 mmHg) to moderate increases in ICP (~41 mmHg), cortical LDF decreased (from 100 to 39.1%, p < 0.001), while mean global Fv was unchanged (from 47 to 45 cm/s, p = 0.38). In addition, MAP increased (from 88.8 to 94.2 mmHg, p < 0.01 and WT decreased (from 19.3 to 9.8 mmHg, p < 0.001). From moderate to high ICP (~75 mmHg), both global Fv and cortical LDF decreased (Fv, from 45 to 31.3 cm/s, p < 0.001; LDF, from 39.1 to 13.3%, p < 0.001) while MAP increased further (94.2 to 114.5 mmHg, p < 0.001) and estimated WT was unchanged (from 9.7 to 9.6 mmHg, p = 0.35) | ||
| 520 | |a CONCLUSION: In this analysis, we demonstrate a cortical vulnerability to increases in ICP and two ICP-dependent cerebro-protective mechanisms: with moderate increases in ICP, WT decreases and MAP increases to buffer cerebral perfusion, while with severe increases of ICP, an increased MAP predominates | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Autoregulation | |
| 650 | 4 | |a Cerebral haemodynamics | |
| 650 | 4 | |a Cerebral perfusion pressure | |
| 650 | 4 | |a Intracranial pressure | |
| 700 | 1 | |a Czosnyka, Marek |e verfasserin |4 aut | |
| 700 | 1 | |a Harland, Spencer |e verfasserin |4 aut | |
| 700 | 1 | |a Varsos, Georgios V |e verfasserin |4 aut | |
| 700 | 1 | |a Cardim, Danilo |e verfasserin |4 aut | |
| 700 | 1 | |a Robba, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Xiuyun |e verfasserin |4 aut | |
| 700 | 1 | |a Ainslie, Philip N |e verfasserin |4 aut | |
| 700 | 1 | |a Smielewski, Peter |e verfasserin |4 aut | |
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