Clinical relevance of cerebral autoregulation following subarachnoid haemorrhage.

Détails

ID Serval
serval:BIB_684BF6DC0CC2
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Clinical relevance of cerebral autoregulation following subarachnoid haemorrhage.
Périodique
Nature Reviews. Neurology
Auteur⸱e⸱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
Statut éditorial
Publié
Date de publication
2013
Volume
9
Numéro
3
Pages
152-163
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish. PDF type: Review
Résumé
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
Création de la notice
12/04/2013 18:23
Dernière modification de la notice
20/08/2019 15:23
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