Cerebral hemodynamics: concepts of clinical importance

Arquivos de Neuro-Psiquiatria

Edson Bor-seng-shu²  William S. Kita¹  Eberval G. Figueiredo²  Wellingson S. Paiva²  Erich T. Fonoff²  Manoel J. Teixeira²  Ronney B. Panerai¹ 

[1] ,University of São Paulo School of Medicine Hospital das Clínicas Division of Neurological SurgerySão Paulo SP ,Brazil

关键词: cerebral hemodynamics;    cerebral blood flow;    cerebral autoregulation;    neurovascular coupling;    brain injuries;    traumatic;    subarachnoid hemorrhage;    hemodinâmica cerebral;    fluxo sanguíneo cerebral;    autorregulação cerebral;    acoplamento neurovascular;    traumatismo encefálico;    hemorragia subaracnóidea;   

DOI  :  10.1590/S0004-282X2012000500010

来源: SciELO

【 摘 要 】

Cerebral hemodynamics and metabolism are frequently impaired in a wide range of neurological diseases, including traumatic brain injury and stroke, with several pathophysiological mechanisms of injury. The resultant uncoupling of cerebral blood flow and metabolism can trigger secondary brain lesions, particularly in early phases, consequently worsening the patient's outcome. Cerebral blood flow regulation is influenced by blood gas content, blood viscosity, body temperature, cardiac output, altitude, cerebrovascular autoregulation, and neurovascular coupling, mediated by chemical agents such as nitric oxide (NO), carbon monoxide (CO), eicosanoid products, oxygen-derived free radicals, endothelins, K+, H+, and adenosine. A better understanding of these factors is valuable for the management of neurocritical care patients. The assessment of both cerebral hemodynamics and metabolism in the acute phase of neurocritical care conditions may contribute to a more effective planning of therapeutic strategies for reducing secondary brain lesions. In this review, the authors have discussed concepts of cerebral hemodynamics, considering aspects of clinical importance.

【 授权许可】

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