Cerebral Autoregulation in Ischemic Stroke: From Pathophysiology to Clinical Concepts

Brain Sciences

Lucy Beishon¹  RonneyB. Panerai¹  ThompsonG. Robinson¹  Edson Bor-Seng-Shu²  RicardoC. Nogueira² 

[1] Cerebral Haemodynamics in Ageing and Stroke Medicine Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester LE2 7LX, UK;Neurology Department, School of Medicine, Hospital das Clinicas, University of São Paulo, São Paulo 01246−904, Brazil;

关键词: ischemic stroke;    dynamic cerebral autoregulation;    cerebral hemodynamics;   

DOI  :  10.3390/brainsci11040511

来源: DOAJ

【 摘 要 】

Ischemic stroke (IS) is one of the most impacting diseases in the world. In the last decades, new therapies have been introduced to improve outcomes after IS, most of them aiming for recanalization of the occluded vessel. However, despite this advance, there are still a large number of patients that remain disabled. One interesting possible therapeutic approach would be interventions guided by cerebral hemodynamic parameters such as dynamic cerebral autoregulation (dCA). Supportive hemodynamic therapies aiming to optimize perfusion in the ischemic area could protect the brain and may even extend the therapeutic window for reperfusion therapies. However, the knowledge of how to implement these therapies in the complex pathophysiology of brain ischemia is challenging and still not fully understood. This comprehensive review will focus on the state of the art in this promising area with emphasis on the following aspects: (1) pathophysiology of CA in the ischemic process; (2) methodology used to evaluate CA in IS; (3) CA studies in IS patients; (4) potential non-reperfusion therapies for IS patients based on the CA concept; and (5) the impact of common IS-associated comorbidities and phenotype on CA status. The review also points to the gaps existing in the current research to be further explored in future trials.

【 授权许可】

Unknown