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[Cerebral vascular autoregulatory dysfunction. Neuroradiologic aspects].

G Sparacia1, N Nicastro, G Brancatelli

  • 1Istituto di Radiologia P. Cignolini, Università degli Studi, Palermo. sparacia@unipa.it

La Radiologia Medica
|July 22, 1999
PubMed
Summary

Systemic disorders can cause reversible brain lesions due to impaired cerebral vascular autoregulation. Prompt recognition of these neuroimaging findings is crucial for effective treatment and potential recovery.

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Area of Science:

  • Neurology
  • Radiology
  • Internal Medicine

Background:

  • Systemic disorders can manifest with neurological symptoms.
  • Cerebral vascular autoregulation plays a critical role in maintaining brain perfusion.
  • Derangements in autoregulation can lead to brain lesions.

Purpose of the Study:

  • To report neuroimaging findings in systemic disorders affecting cerebral vascular autoregulation.
  • To identify potentially reversible brain lesions caused by impaired autoregulation.
  • To differentiate these lesions from those caused by atherosclerosis or cardiogenic embolism.

Main Methods:

  • Review of brain CT and MR imaging in 14 patients.
  • Patients diagnosed with vasculopathy secondary to thrombotic thrombocytopenic purpura, uremic encephalopathy, eclampsia, lupus-related renal failure, or cyclosporine neurotoxicity.

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  • Neuroimaging follow-up after initiation of anti-edema therapy.

    • Main Results:

    • CT and MR revealed cortical-subcortical or deep brain edema.
    • Lesions were bilateral in 10 patients, symmetric in 4.
    • Edema resolution observed in 4 patients (eclampsia, TTP, uremic encephalopathy) after therapy; no regression in 10.

    Conclusions:

    • Brain lesions from impaired vascular autoregulation (non-atherosclerotic, non-cardiogenic) require prompt recognition.
    • These lesions are potentially reversible with appropriate treatment.
    • Early diagnosis and management can lead to improved patient outcomes.