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Loss of cerebrovascular autoregulation in experimental meningitis in rabbits
J H Tureen1, R J Dworkin, S L Kennedy
1Department of Pediatrics, University of California, San Francisco General Hospital 94110.
Abstract:
The present study was designed to determine whether cerebrovascular autoregulation is intact in experimental meningitis and to examine the relationship between fluctuations in cerebral blood flow (CBF) and increased intracranial pressure (ICP). Measurements of CBF were determined by the radionuclide microsphere technique in rabbits with experimental Streptococcus pneumoniae meningitis with simultaneous ICP monitoring via an implanted epidural catheter. CBF and ICP measurements were determined at baseline and when mean arterial blood pressure (MABP) was artificially manipulated by either pharmacologic or mechanical means. CBF was pressure passive with MABP through a range of 30-120 torr, and ICP directly correlated with CBF. These findings indicate that autoregulation of the cerebral circulation is lost during bacterial meningitis, resulting in a critical dependency of cerebral perfusion on systemic blood pressure, and that the parallel changes in ICP and in CBF suggest that fluctuations in CBF may influence intracranial hypertension in this disease.
Insights
Cerebrovascular autoregulation is lost in experimental meningitis, making cerebral blood flow (CBF) pressure-passive. This loss leads to increased intracranial pressure (ICP) and suggests CBF fluctuations may worsen intracranial hypertension.
Area of Science:
- Neurology
- Critical Care Medicine
- Physiology
Background:
- Bacterial meningitis can cause significant neurological complications.
- Cerebrovascular autoregulation is crucial for maintaining stable cerebral blood flow (CBF) despite changes in systemic blood pressure.
- The impact of meningitis on cerebrovascular autoregulation and its relationship with intracranial pressure (ICP) requires further elucidation.
Purpose of the Study:
- To investigate the integrity of cerebrovascular autoregulation in experimental meningitis.
- To explore the correlation between cerebral blood flow (CBF) dynamics and increased intracranial pressure (ICP) during meningitis.
Main Methods:
- Experimental meningitis was induced using Streptococcus pneumoniae in rabbits.
- Cerebral blood flow (CBF) was measured using the radionuclide microsphere technique.
- Intracranial pressure (ICP) and mean arterial blood pressure (MABP) were monitored simultaneously, with MABP artificially manipulated.
Main Results:
- Cerebral blood flow (CBF) demonstrated pressure-passive behavior with mean arterial blood pressure (MABP) ranging from 30-120 torr.
- Intracranial pressure (ICP) showed a direct correlation with cerebral blood flow (CBF).
Conclusions:
- Cerebrovascular autoregulation is impaired during bacterial meningitis.
- Cerebral perfusion becomes critically dependent on systemic blood pressure in meningitis.
- Parallel changes in ICP and CBF suggest CBF fluctuations may contribute to intracranial hypertension.
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