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Cerebral autoregulation.

O B Paulson1, S Strandgaard, L Edvinsson

  • 1Department of Neurology, Rigshospitalet, Copenhagen, Denmark.

Cerebrovascular and Brain Metabolism Reviews
|January 1, 1990
PubMed
Summary
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Cerebral blood flow autoregulation maintains constant brain perfusion despite blood pressure changes. Disease can impair this vital protective mechanism, leaving the brain vulnerable to injury.

Area of Science:

  • Neuroscience
  • Physiology
  • Vascular Biology

Background:

  • Autoregulation of blood flow is the intrinsic ability of organs to maintain constant perfusion despite blood pressure fluctuations.
  • Cerebral blood flow (CBF) autoregulation is crucial for brain health, typically operating between 60-150 mm Hg mean arterial pressure.
  • Its precise mechanisms, involving myogenic, metabolic, neural, and endothelial factors, are under investigation.

Purpose of the Study:

  • To review the mechanisms of cerebral blood flow autoregulation.
  • To discuss the impact of various disease states on CBF autoregulation.
  • To explore potential therapeutic interventions for impaired autoregulation.

Main Methods:

  • Literature review of studies on cerebral blood flow autoregulation.

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  • Analysis of physiological mechanisms underlying autoregulation.
  • Examination of clinical data on diseases affecting CBF autoregulation.

    • Main Results:

    • CBF autoregulation is likely mediated by myogenic and metabolic factors, with contributions from nerves and endothelium.
    • Autoregulation limits can be modulated by factors like sympathetic activity and carbon dioxide levels.
    • Severe head injury, ischemic stroke, brain lesions, neonatal asphyxia, and chronic hypertension can impair or abolish CBF autoregulation.
    • Diabetes mellitus may lead to chronic impairment due to microangiopathy.

    Conclusions:

    • Cerebral blood flow autoregulation is a critical protective mechanism against blood pressure variations.
    • Impairment of autoregulation in various neurological conditions leaves brain tissue vulnerable.
    • Understanding and restoring autoregulation are key goals in managing cerebrovascular diseases.