Sympathetic regulation of cerebral blood flow in humans: a review
| Autor: | J M C van Dijk, Michiel J. Staal, Jan-Willem Elting, Anthony Absalom, M. ter Laan |
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| Rok vydání: | 2013 |
| Předmět: |
Sympathomimetics
Sympathetic nervous system NEAR-INFRARED SPECTROSCOPY Sympathetic Nervous System Subarachnoid hemorrhage Cerebral arteries SPINAL-CORD STIMULATION Cerebral autoregulation CARBON-DIOXIDE Cerebral circulation TRANSCRANIAL DOPPLER medicine Humans NERVE-STIMULATION STELLATE GANGLION BLOCK haemodynamics Vasomotor CEREBROVASCULAR SYSTEM business.industry REFRACTORY ANGINA-PECTORIS cerebrovascular disorders ANEURYSMAL SUBARACHNOID HEMORRHAGE Cerebral Arteries medicine.disease Anesthesiology and Pain Medicine medicine.anatomical_structure Cerebral blood flow AUTONOMIC NEURAL-CONTROL Cerebrovascular Circulation Anesthesia neurophysiology business Neuroscience circulatory and respiratory physiology |
| Zdroj: | British Journal of Anaesthesia. 111:361-367 |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/aet122 |
| Popis: | Summary Cerebral blood flow (CBF) is regulated by vasomotor, chemical, metabolic, and neurogenic mechanisms. Even though the innervation of cerebral arteries is quite extensively described and reviewed in the literature, its role in regulation of CBF in humans remains controversial. We believe that insufficient attention has so far been focused on the potential role of the innervation of the cerebral vasculature in cerebral autoregulation in humans. We have performed an extensive search and selection of available literature on electrical, chemical, and surgical manipulations of the sympathetic innervation of cerebral arteries, and the effects of circulation sympathetically active agents on CBF. Studies on (surgical) ganglion block show a role of sympathetic tone in preventing increases in CBF in humans, which are consistent with the view based on animal studies. Both direct innervation of the cerebral arteries from cervical ganglia and stimulation of adrenergic receptors by circulating sympathomimetics prevent sudden increases of CBF associated with hypertension and hypercapnia. We postulate that under normal physiological conditions neurogenic control has little influence on cerebral autoregulation as other methods of control (vasomotor, chemical, and metabolic) are dominant. In severely challenging circumstances, such as delayed cerebral ischaemia after subarachnoid haemorrhage, these methods might be overwhelmed, increasing the relative importance of neurogenic, sympathetic control of CBF. This insight might lead to future therapeutic possibilities. |
| Databáze: | OpenAIRE |
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