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Optimized System for Cerebral Perfusion Monitoring in the Rat Stroke Model of Intraluminal Middle Cerebral Artery Occlusion
Published on: February 17, 2013
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Cerebral hemodynamics in stroke thrombolysis (CHiST) study.
Man Y Lam1, Victoria J Haunton1,2, Ronney B Panerai1,2
1Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.
Plos One
|September 21, 2020
Summary
Intravenous thrombolysis for acute ischemic stroke alters cerebral autoregulation, affecting blood pressure and heart rate. These hemodynamic changes, particularly in the affected hemisphere, warrant further study for personalized patient management.
Area of Science:
- Neuroscience
- Cardiovascular Physiology
- Stroke Medicine
Background:
- Intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) has limited recanalization success (~50%).
- Understanding cerebral autoregulation (CA) changes post-IVT is crucial for managing physiological perturbations and reducing reperfusion injury risk.
Purpose of the Study:
- To investigate dynamic changes in CA during and after IVT in AIS patients.
- To assess the impact of IVT on hemodynamic parameters and CA indices.
Main Methods:
- Continuous monitoring of cerebral blood velocity (Transcranial Doppler), blood pressure (Finometer), and end-tidal CO2 (capnography).
- Measurements taken in 11 AIS patients at 4 time points: during IVT, and 23.9±2.6 hrs, 18.1±7.0 days, and 89.6±4.2 days post-IVT.
- Analysis included blood pressure, heart rate, critical closing pressure, end-tidal CO2, and CA parameters (phase, coherence, gain, Autoregulation Index).
Main Results:
- Significant reductions in blood pressure during IVT (p=0.04).
- Post-IVT, reductions in heart rate (p<0.005) and critical closing pressure in both hemispheres (p=0.02-0.005).
- Increased end-tidal CO2 in sub-acute/chronic stages (p=0.028) and reduced affected hemisphere phase during/after IVT (p=0.021-0.048). No changes in Autoregulation Index.
Conclusions:
- IVT in AIS induces significant changes in affected hemisphere phase and other hemodynamic parameters, but not the Autoregulation Index.
- These findings highlight dynamic CA alterations post-IVT.
- Further research in larger AIS cohorts is needed to explore CA's role in individualized management strategies.
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