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Published on: December 10, 2014
Dynamic cerebral autoregulation after intracerebral hemorrhage: A case-control study
Kazuma Nakagawa1, Jorge M Serrador, Sarah L LaRose
1Neuroscience Institute, The Queen's Medical Center, Honolulu, Hawaii, USA. kazuma.nakagawa@hawaii.edu
BMC Neurology
|September 3, 2011
Summary
Intracerebral hemorrhage (ICH) patients show impaired dynamic cerebral autoregulation with higher resistance and gain compared to healthy individuals. This suggests reduced autoregulation effectiveness in the early stages following ICH.
Area of Science:
- Neurology
- Neuroscience
- Critical Care Medicine
Background:
- Cerebral autoregulation is crucial for maintaining stable brain blood flow.
- Understanding dynamic cerebral autoregulation post-intracerebral hemorrhage (ICH) is limited.
- This study compares dynamic autoregulation in ICH patients versus healthy controls.
Purpose of the Study:
- To investigate and compare dynamic cerebral autoregulation between patients with recent ICH and age-matched healthy controls.
- To assess the impact of ICH on cerebrovascular resistance and autoregulation efficiency.
Main Methods:
- A case-control study involving 21 ICH patients (within 72 hours of onset) and 23 healthy controls.
- Continuous monitoring of middle cerebral artery mean flow velocity (MFV) and mean arterial blood pressure (MAP).
- Transfer function analysis of spontaneous MAP and MFV oscillations to assess dynamic cerebral autoregulation in low and high frequency ranges.
Main Results:
- ICH patients exhibited significantly higher cerebrovascular resistance index (CVRi) compared to controls.
- Elevated gains in both low and high frequency ranges were observed in ICH patients, indicating poorer autoregulation.
- Increased coherence in the contralateral hemisphere was noted in the high-frequency range for the ICH group.
Conclusions:
- Patients with ICH demonstrate impaired dynamic cerebral autoregulation, characterized by higher resistance and gain across various frequencies.
- These findings suggest that dynamic cerebral autoregulation is less effective in the early period after ICH.
- Further research is required to correlate hematoma size with the severity of autoregulation impairment.
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