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Serial changes in static and dynamic cerebral autoregulation after acute ischaemic stroke
Suzanne L Dawson1, Ronney B Panerai, John F Potter
1University Division of Medicine for the Elderly, Leicester Warwick Medical School, University of Leicester, UK.
Cerebrovascular Diseases (Basel, Switzerland)
|May 27, 2003
Summary
Dynamic cerebral autoregulation (CA) is impaired after acute ischemic stroke for at least 1-2 weeks. Static CA remains unaffected in stroke patients compared to controls.
Area of Science:
- Neuroscience
- Cerebrovascular Physiology
Background:
- Cerebral autoregulation (CA) is crucial for maintaining stable brain blood flow.
- Longitudinal changes in CA following acute ischemic stroke are not well understood.
Purpose of the Study:
- To assess longitudinal changes in static and dynamic cerebral autoregulation (CA) after acute ischemic stroke.
Main Methods:
- Fifty-four ischemic stroke patients were evaluated within 96 hours and 7-14 days post-stroke.
- Transcranial Doppler was used to measure CA using static (thigh cuff inflation) and dynamic (thigh cuff release) stimuli.
- Results were compared to an age-, sex-, and blood pressure-matched control group.
Main Results:
- Dynamic CA was globally impaired in stroke patients at both initial and follow-up assessments compared to controls.
- Static CA was similar between stroke patients and controls and remained unchanged over time.
- Impaired dynamic CA was observed in both affected and non-affected hemispheres.
Conclusions:
- Dynamic, but not static, cerebral autoregulation is impaired following acute ischemic stroke.
- This impairment persists for at least 1-2 weeks post-stroke.
- The observed CA changes are independent of antihypertensive treatment, baseline BP, BP fluctuations, age, or stroke type.