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Impaired cerebral autoregulation after mild brain injury
S Strebel1, A M Lam, B F Matta
1Department of Anesthesiology, Harborview Medical Center, Seattle, WA 98104-2499, USA.
Surgical Neurology
|February 1, 1997
Summary
Mild head injury, like a concussion, can surprisingly cause a complete loss of cerebral autoregulation. This finding challenges the assumption that only severe head trauma impairs this critical brain function.
Area of Science:
- Neurology
- Neurophysiology
- Traumatic Brain Injury
Background:
- Cerebral autoregulation is crucial for maintaining stable brain blood flow.
- Impairment of cerebral autoregulation can lead to secondary neuronal injury.
- Mild head injuries, such as concussions, are generally assumed to have a low risk of autoregulation impairment.
Observation:
- A patient who sustained a concussion from a motor vehicle accident 6 days prior was evaluated.
- The patient underwent testing for cerebral autoregulation as part of a clinical study.
- Testing involved manipulating mean systemic blood pressure and monitoring middle cerebral artery blood flow velocity.
Findings:
- Complete absence of cerebral autoregulation was detected during baseline testing.
- The impairment of autoregulation persisted even after the patient awoke.
- The study was halted due to the unexpected and complete loss of this homeostatic mechanism.
Implications:
- Even seemingly trivial mild head injuries can lead to a significant loss of cerebral autoregulation.
- This challenges current assumptions about the effects of mild traumatic brain injury.
- Further research with larger patient cohorts is necessary to determine the incidence of this phenomenon.