Clinical relevance of cerebral autoregulation following subarachnoid haemorrhage.

Details

Serval ID
serval:BIB_684BF6DC0CC2
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Clinical relevance of cerebral autoregulation following subarachnoid haemorrhage.
Journal
Nature Reviews. Neurology
Author(s)
Budohoski K.P., Czosnyka M., Kirkpatrick P.J., Smielewski P., Steiner L.A., Pickard J.D.
ISSN
1759-4766 (Electronic)
ISSN-L
1759-4758
Publication state
Published
Issued date
2013
Volume
9
Number
3
Pages
152-163
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish. PDF type: Review
Abstract
Subarachnoid haemorrhage (SAH) is a form of stroke that is associated with substantial morbidity, often as a result of cerebral ischaemia that occurs in the following days. These delayed deficits in blood flow have been traditionally attributed to cerebral vasospasm (the narrowing of large arteries), which can lead to cerebral infarction and poor neurological outcome. Data from recent studies, however, show that treatment of vasospasm in patients with SAH, using targeted medication, does not translate to better neurological outcomes, and argue against vasospasm being the sole cause of the delayed ischaemic complications. Cerebral autoregulation-a mechanism that maintains stability of cerebral blood flow in response to changes in cerebral perfusion pressure-has been reported to fail after SAH, often before vasospasm becomes apparent. Failure of autoregulation, therefore, has been implicated in development of delayed cerebral ischaemia. In this Review, we summarize current knowledge about the clinical effect of disturbed cerebral autoregulation following aneurysmal SAH, with emphasis on development of delayed cerebral ischaemia and clinical outcome, and provide a critical assessment of studies of cerebral autoregulation in SAH with respect to the method of blood-flow measurement. Better understanding of cerebral autoregulation following SAH could reveal mechanisms of blood-flow regulation that could be therapeutically targeted to improve patient outcome.
Pubmed
Web of science
Create date
12/04/2013 17:23
Last modification date
20/08/2019 14:23
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