Cerebral autoregulation and acute ischemic stroke.

Published

Journal Article (Review)

Cerebral autoregulation tightly controls blood flow to the brain by coupling cerebral metabolic demand to cerebral perfusion. In the setting of acute brain injury, such as that caused by ischemic stroke, the continued precise control of cerebral blood flow (CBF) is vital to prevent further injury. Chronic as well as acute elevations in blood pressure are frequently associated with stroke, therefore, understanding the physiological response of the brain to the treatment of hypertension is clinically important. Physiological data obtained in patients with acute ischemic stroke provide no clear evidence that there are alterations in the intrinsic autoregulatory capacity of cerebral blood vessels, except perhaps in infarcted tissue. While it is likely safe to modestly reduce blood pressure by 10-15 mm Hg in most patients with acute ischemic stroke, to date, there are no controlled trial data to indicate that reducing blood pressure is beneficial. There may be subgroups, such as those with persistent large vessel occlusion, large infarcts with edema causing increased intracranial pressure or local mass effect, or chronic hypertension, in which blood pressure reduction may lead to impaired cerebral perfusion in noninfarcted tissue.

Full Text

Duke Authors

Cited Authors

  • Jordan, JD; Powers, WJ

Published Date

  • September 2012

Published In

Volume / Issue

  • 25 / 9

Start / End Page

  • 946 - 950

PubMed ID

  • 22573015

Pubmed Central ID

  • 22573015

Electronic International Standard Serial Number (EISSN)

  • 1941-7225

Digital Object Identifier (DOI)

  • 10.1038/ajh.2012.53

Language

  • eng

Conference Location

  • United States