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Sample records for ct cerebral blood

  1. The effects of CT drift on xenon/CT measurement of regional cerebral blood flow.

    PubMed

    Kearfott, K J; Lu, H C; Rottenberg, D A; Deck, M D

    1984-01-01

    A systematic increase in computed tomography (CT) number of approximately 0.13 Hounsfield unit per scan (HU/scan) was observed when serial DeltaScan 2020 CT scans of a uniform water phantom were equally spaced at 0.5, 1.0, or 2.0 min and a shaped aluminum beam-hardening filter was employed. Much smaller drifts (less than 0.06 HU/scan) were observed with flat aluminum or shaped beryllium oxide filters. This machine drift, which was not associated with a rise in water phantom temperature and did not consistently correlate with estimated x-ray tube heat, could result in a significant overestimation of regional cerebral blood flow (rCBF) for a xenon/CT rCBF protocol involving 5-7 sequential scans obtained at 1-min interscan intervals.

  2. Increased blood-brain barrier permeability on perfusion CT might predict malignant middle cerebral artery infarction.

    PubMed

    Bektas, Hesna; Wu, Tzu-Ching; Kasam, Mallikarjunarao; Harun, Nusrat; Sitton, Clark W; Grotta, James C; Savitz, Sean I

    2010-11-01

    Perfusion CT has been used to assess the extent of blood-brain barrier breakdown. The purpose of this study was to determine the predictive value of blood-brain barrier permeability measured using perfusion CT for development of malignant middle cerebral artery infarction requiring hemicraniectomy (HC). We retrospectively identified patients from our stroke registry who had middle cerebral artery infarction and were evaluated with admission perfusion CT. Blood-brain barrier permeability and cerebral blood volume maps were generated and infarct volumes calculated. Clinical and radiographic characteristics were compared between those who underwent HC versus those who did not undergo HC. One hundred twenty-two patients (12 HC, 110 no HC) were identified. Twelve patients who underwent HC had developed edema, midline shift, or infarct expansion. Infarct permeability area, infarct cerebral blood volume area, and infarct volumes were significantly different (P < 0.018, P < 0.0211, P < 0.0001, P < 0.0014) between HC and no HC groups. Age (P = 0.03) and admission National Institutes of Health Stroke Scale (P = 0.0029) were found to be independent predictors for HC. Using logistic regression modeling, there was an association between increased infarct permeability area and HC. The OR for HC based on a 5-, 10-, 15-, or 20-cm² increase in infarct permeability area were 1.179, 1.390, 1.638, or 1.932, respectively (95% CI, 1.035 to 1.343, 1.071 to 1.804, 1.108 to 2.423, 1.146 to 3.255, respectively). Increased infarct permeability area is associated with an increased likelihood for undergoing HC. Because early HC for malignant middle cerebral artery infarction has been associated with better outcomes, the infarct permeability area on admission perfusion CT might be a useful tool to predict malignant middle cerebral artery infarction and need for HC.

  3. Comparison of near-infrared spectroscopy with CT cerebral blood flow measurements in newborn piglets

    NASA Astrophysics Data System (ADS)

    Brown, Derek W.; Picot, Paul A.; Springett, Roger; Delpy, David T.; Lee, Ting-Yim

    2001-05-01

    Severely premature infants are often at high risk of cerebral hemorrhage or ischemic injury due to their inability to properly regulate blood flow to the brain. If blood flow is too high, the infant is at risk of cerebral hemorrhage, while too little blood flow can result in ischemic injury. The purpose of this research is to design and develop a means of non-invasively measuring cerebral blood flow (CBF) with near infrared spectroscopy (NIRS). Such a device would greatly aid the diagnosis and monitoring of afflicted infants. Previous attempts to measure CBF with NIRS have achieved limited success. In this study we acquired high signal-to-noise NIR spectrum from 600 to 980 nm with a cooled CCD spectrometer. This spectrometer enables the differential path length factor (DPF) to be estimated with accuracy using a second derivative technique described by Matcher et al. The validity of our new approach is determined via direct comparison with a previously validated computed tomography (CT) method. Three newborn piglets were studied. CBF measurements were performed at various partial arterial CO2 tensions (PaCO2) using both the NIRS and CT methods. The results of the two methods correlate well with a relationship of CBFCT equals -4.30 + 1.05 CBFNIRS (r2 equals 0.96).

  4. Cerebral blood flow and brain atrophy correlated by xenon contrast CT scanning

    SciTech Connect

    Kitagawa, Y.; Meyer, J.S.; Tanahashi, N.; Rogers, R.L.; Tachibana, H.; Kandula, P.; Dowell, R.E.; Mortel, K.F.

    1985-11-01

    Correlations between cerebral blood flow (CBF) measured during stable xenon contrast CT scanning and standard CT indices of brain atrophy were investigated in the patients with senile dementia of Alzheimer type, multi-infarct dementia and idiopathic Parkinson's disease. Compared to age-matched normal volunteers, significant correlations were found in patients with idiopathic Parkinson's disease between cortical and subcortical gray matter blood flow and brain atrophy estimated by the ventricular body ratio, and mild to moderate brain atrophy were correlated with stepwise CBF reductions. However, in patients with senile dementia of Alzheimer type and multi-infarct dementia, brain atrophy was not associated with stepwise CBF reductions. Overall correlations between brain atrophy and reduced CBF were weak. Mild degrees of brain atrophy are not always associated with reduced CBF.

  5. Pharmacological control of head motion during cerebral blood flow imaging with CT or MRI.

    PubMed

    Sesay, M; Jeannin, A; Moonen, C T W; Dousset, V; Maurette, P

    2009-06-01

    Uncontrolled head motion during CT/MRI cerebral blood flow (CBF) imaging has been estimated between 3 and 15% of the cases. We present a pharmacological approach which permitted us to maintain the incident at 0.06% with few side effects. The protocol involves the systematic use of general anesthesia (sevoflurane) in children below five years and those with mental retardation. In anxious, claustrophobic or agitated adults, mild sedation with propofol, midazolam or hydroxyzine was used with mild effects on CBF. We strongly recommend the availability of basic cardiorespiratory resuscitation equipment and a recovery room before any sedation or general anesthesia is undertaken.

  6. Comparison of cerebral blood flow data obtained by computed tomography (CT) perfusion with that obtained by xenon CT using 320-row CT.

    PubMed

    Takahashi, Satoshi; Tanizaki, Yoshio; Kimura, Hiroaki; Akaji, Kazunori; Kano, Tadashige; Suzuki, Kentaro; Takayama, Youhei; Kanzawa, Takao; Shidoh, Satoka; Nakazawa, Masaki; Yoshida, Kazunari; Mihara, Ban

    2015-03-01

    Cerebral blood flow (CBF) data obtained by computed tomography perfusion (CTP) imaging have been shown to be qualitative data rather than quantitative, in contrast with data obtained by other imaging methods, such as xenon CT (XeCT) imaging. Thus, interpatient comparisons of CBF values themselves obtained by CTP may be inaccurate. In this study, we have compared CBF ratios as well as CBF values obtained from CTP-CBF data to those obtained from XeCT-CBF data for the same patients to determine CTP-CBF parameters that can be used for interpatient comparisons. The data used in the present study were obtained as volume data using 320-row CT. The volume data were applied to an automated region of interest-determining software (3DSRT, version 3.5.2 ) and converted to 59 slices of 2 mm interval standardized images. In the present study, we reviewed 10 patients with occlusive cerebrovascular diseases (CVDs) undergoing both CTP and XeCT in the same period. Our study shows that ratios of CBF measurements, such as hemodynamic stress distribution (perforator-to-cortical flow ratio of middle cerebral artery [MCA] region) or the left/right ratio for the region of the MCA, calculated using CTP data have been shown to correlate well with the same ratios calculated using XeCT data. These results suggest that such CBF ratios could be useful for generating interpatient comparisons of CTP-CBF data obtained by 320-row CT among patients with occlusive CVD.

  7. Cerebral blood volume imaging by flat detector computed tomography in comparison to conventional multislice perfusion CT.

    PubMed

    Struffert, Tobias; Deuerling-Zheng, Yu; Kloska, Stephan; Engelhorn, Tobias; Boese, Jan; Zellerhoff, Michael; Schwab, Stefan; Doerfler, Arnd

    2011-04-01

    We tested the hypothesis that Flat Detector computed tomography (FD-CT) with intravenous contrast medium would allow the calculation of whole brain cerebral blood volume (CBV) mapping (FD-CBV) and would correlate with multislice Perfusion CT (PCT). Twenty five patients were investigated with FD-CBV and PCT. Correlation of the CBV maps of both techniques was carried out with measurements from six anatomical regions from both sides of the brain. Mean values of each region and the correlation coefficient were calculated. Bland-Altman analysis was performed to compare the two different imaging techniques. The image and data quality of both PCT and FD-CBV were suitable for evaluation in all patients. The mean CBV values of FD-CBV and PCT showed only minimal differences with overlapping standard deviation. The correlation coefficient was 0.79 (p < 0.01). Bland-Altman analysis showed a mean difference of -0.077 ± 0.48 ml/100 g between FD-CBV and PCT CBV measurements, indicating that FD-CBV values were only slightly lower than those of PCT. CBV mapping with intravenous contrast medium using Flat Detector CT compared favourably with multislice PCT. The ability to assess cerebral perfusion within the angiographic suite may improve the management of ischaemic stroke and evaluation of the efficacy of dedicated therapies.

  8. Cerebral blood flow and brain shrinkage seen on CT during ACTH therapy.

    PubMed

    Futagi, Y; Abe, J; Kawahigashi, K

    1986-01-01

    By means of the Doppler ultrasound method, the cerebral blood flow (CBF) was assessed in 21 children with epilepsy undergoing treatment with adrenocorticotrophic hormone (ACTH). The maximum reduction in the internal carotid velocity, as an index of CBF during therapy, was about 35 percent compared with the values before therapy. Furthermore, sequential computed tomography (CT) examinations of the same subjects were performed to evaluate the change in the area of the intracranial brain parenchyma during therapy. The maximum reduction in the parenchymal area during therapy was about 10 percent. This corresponds to a 20 percent reduction in CBF according to Poiseuille's law, however, the remaining reduction in CBF demonstrated by velocity measurement cannot be explained only by that mechanical vascular factor. From these findings, it is concluded that in order to elucidate the mechanism of the CBF reduction, physiological factors such as changes in metabolism during therapy should also be evaluated in addition to the mechanical and physical causes.

  9. Simultaneous measurements of cerebral blood flow by the xenon/CT method and the microsphere method. A comparison

    SciTech Connect

    Gur, D.; Yonas, H.; Jackson, D.L.; Wolfson, S.K. Jr.; Rockette, H.; Good, W.F.; Cook, E.E.; Arena, V.C.; Willy, J.A.; Maitz, G.S.

    1985-10-01

    Simultaneous measurements of cerebral blood flow have been performed in baboons to assess the correlation between the acute and invasive nondiffusible microsphere technique and the noninvasive xenon-enhanced CT method. Blood flows in small tissue volumes (approximately 1 cm3) were directly compared. The results of these studies demonstrate a statistically significant association between the two methods (P less than .001). Similar correlations were obtained by both the Kendall tau (tau) and the Spearman (r) methods. The problems and limitations of such correlations are discussed.

  10. Dynamic contrast-enhanced x-ray CT measurement of cerebral blood volume in a rabbit tumor model

    NASA Astrophysics Data System (ADS)

    Cenic, Aleksa; Lee, Ting-Yim; Craen, Rosemary A.; Gelb, Adrian W.

    1998-07-01

    Cerebral blood volume (CBV) is a major determinant of intracranial pressure (ICP). Hyperventilation is commonly employed to reduce raised ICP (e.g. in brain tumour patients) presumably through its effect on CBV. With the advent of slip- ring CT scanners, dynamic contrast-enhanced imaging allows for the measurement of CBV with high spatial resolution. Using a two-compartment model to characterize the distribution of X- ray contrast agent in the brain, we have developed a non- equilibrium CT method to measure CBV in normal and pathological regions. We used our method to investigate the effect of hyperventilation on CBV during propofol anaesthesia in rabbits with implanted brain tumours. Eight New Zealand White rabbits with implanted VX2 carcinoma brain tumours were studied. For each rabbit, regional CBV measurements were initially made at normocapnia (PaCO2 40 mmHg) and then at hyperventilation (PaCO2 25 mmHg) during propofol anaesthesia. The head was positioned such that a coronal image through the brain incorporated a significant cross-section of the brain tumour as well as a radial artery in a forelimb. Images at the rate of 1 per second were acquired for 2 minutes as Omnipaque 300 (1.5 ml/kg rabbit weight) was injected via a peripheral vein. In these CT images, regions of interest in the brain tissue (e.g. tumour, contra-lateral normal, and peri-tumoural) and the radial artery were drawn. For each region, the mean CT number in pre-contrast images was subtracted from the mean CT number in post-contrast images to produce either the tissue contrast concentration curve, or the arterial contrast concentration curve. Using our non- equilibrium analysis method based on a two-compartment model, regional CBV values were determined from the measured contrast concentration curves. From our study, the mean CBV values [+/- SD] in the tumour, peri-tumoural, and contra-lateral normal regions during normocapnia were: 5.47 plus or minus 1.97, 3.28 plus or minus 1.01, and 1

  11. TIPS bilateral noise reduction in 4D CT perfusion scans produces high-quality cerebral blood flow maps

    NASA Astrophysics Data System (ADS)

    Mendrik, Adriënne M.; Vonken, Evert-jan; van Ginneken, Bram; de Jong, Hugo W.; Riordan, Alan; van Seeters, Tom; Smit, Ewoud J.; Viergever, Max A.; Prokop, Mathias

    2011-07-01

    Cerebral computed tomography perfusion (CTP) scans are acquired to detect areas of abnormal perfusion in patients with cerebrovascular diseases. These 4D CTP scans consist of multiple sequential 3D CT scans over time. Therefore, to reduce radiation exposure to the patient, the amount of x-ray radiation that can be used per sequential scan is limited, which results in a high level of noise. To detect areas of abnormal perfusion, perfusion parameters are derived from the CTP data, such as the cerebral blood flow (CBF). Algorithms to determine perfusion parameters, especially singular value decomposition, are very sensitive to noise. Therefore, noise reduction is an important preprocessing step for CTP analysis. In this paper, we propose a time-intensity profile similarity (TIPS) bilateral filter to reduce noise in 4D CTP scans, while preserving the time-intensity profiles (fourth dimension) that are essential for determining the perfusion parameters. The proposed TIPS bilateral filter is compared to standard Gaussian filtering, and 4D and 3D (applied separately to each sequential scan) bilateral filtering on both phantom and patient data. Results on the phantom data show that the TIPS bilateral filter is best able to approach the ground truth (noise-free phantom), compared to the other filtering methods (lowest root mean square error). An observer study is performed using CBF maps derived from fifteen CTP scans of acute stroke patients filtered with standard Gaussian, 3D, 4D and TIPS bilateral filtering. These CBF maps were blindly presented to two observers that indicated which map they preferred for (1) gray/white matter differentiation, (2) detectability of infarcted area and (3) overall image quality. Based on these results, the TIPS bilateral filter ranked best and its CBF maps were scored to have the best overall image quality in 100% of the cases by both observers. Furthermore, quantitative CBF and cerebral blood volume values in both the phantom and the

  12. TIPS bilateral noise reduction in 4D CT perfusion scans produces high-quality cerebral blood flow maps.

    PubMed

    Mendrik, Adriënne M; Vonken, Evert-jan; van Ginneken, Bram; de Jong, Hugo W; Riordan, Alan; van Seeters, Tom; Smit, Ewoud J; Viergever, Max A; Prokop, Mathias

    2011-07-07

    Cerebral computed tomography perfusion (CTP) scans are acquired to detect areas of abnormal perfusion in patients with cerebrovascular diseases. These 4D CTP scans consist of multiple sequential 3D CT scans over time. Therefore, to reduce radiation exposure to the patient, the amount of x-ray radiation that can be used per sequential scan is limited, which results in a high level of noise. To detect areas of abnormal perfusion, perfusion parameters are derived from the CTP data, such as the cerebral blood flow (CBF). Algorithms to determine perfusion parameters, especially singular value decomposition, are very sensitive to noise. Therefore, noise reduction is an important preprocessing step for CTP analysis. In this paper, we propose a time-intensity profile similarity (TIPS) bilateral filter to reduce noise in 4D CTP scans, while preserving the time-intensity profiles (fourth dimension) that are essential for determining the perfusion parameters. The proposed TIPS bilateral filter is compared to standard Gaussian filtering, and 4D and 3D (applied separately to each sequential scan) bilateral filtering on both phantom and patient data. Results on the phantom data show that the TIPS bilateral filter is best able to approach the ground truth (noise-free phantom), compared to the other filtering methods (lowest root mean square error). An observer study is performed using CBF maps derived from fifteen CTP scans of acute stroke patients filtered with standard Gaussian, 3D, 4D and TIPS bilateral filtering. These CBF maps were blindly presented to two observers that indicated which map they preferred for (1) gray/white matter differentiation, (2) detectability of infarcted area and (3) overall image quality. Based on these results, the TIPS bilateral filter ranked best and its CBF maps were scored to have the best overall image quality in 100% of the cases by both observers. Furthermore, quantitative CBF and cerebral blood volume values in both the phantom and the

  13. Brief Report: alterations in cerebral blood flow as assessed by PET/CT in adults with autism spectrum disorder with normal IQ.

    PubMed

    Pagani, Marco; Manouilenko, Irina; Stone-Elander, Sharon; Odh, Richard; Salmaso, Dario; Hatherly, Robert; Brolin, Fredrik; Jacobsson, Hans; Larsson, Stig A; Bejerot, Susanne

    2012-02-01

    Specific biological markers for autism spectrum disorder (ASD) have not yet been established. Functional studies have shown abnormalities in the anatomo-functional connectivity of the limbic-striatal "social" brain. This study aimed to investigate regional cerebral blood flow (rCBF) at rest. Thirteen patients with ASD of normal intelligence and ten IQ-, sex- and age-matched healthy controls (HC) underwent PET/CT using [1-(11)C]butanol, a perfusion tracer. As compared to HC, ASD showed significant CBF increases in the right parahippocampal, posterior cingulate, primary visual and temporal cortex, putamen, caudatus, substantia nigra and cerebellum. No statistically significant correlation between CBF and IQ was found. The limbic, posterior associative and cerebellar cortices showed increased blood flow in ASD, confirming previous findings about the neurobiology of ASD.

  14. Monitoring of Cerebral Blood Flow and Metabolism Bedside in Patients with Subarachnoid Hemorrhage – A Xenon-CT and Microdialysis Study

    PubMed Central

    Rostami, Elham; Engquist, Henrik; Johnson, Ulf; Howells, Timothy; Ronne-Engström, Elisabeth; Nilsson, Pelle; Hillered, Lars; Lewén, Anders; Enblad, Per

    2014-01-01

    Cerebral ischemia is the leading cause of morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH). Although 70% of the patients show angiographic vasospasm only 30% develop symptomatic vasospasm defined as delayed cerebral ischemia (DCI). Early detection and management of reversible ischemia is of critical importance in patients with SAH. Using a bedside Xenon enhanced computerized tomography (Xenon-CT) scanner makes it possible to measure quantitative regional Cerebral blood flow (CBF) bedside in the neurointensive care setting and intracerebral microdialysis (MD) is a method that offers the possibility to monitor the metabolic state of the brain continuously. Here, we present results from nine SAH patients with both MD monitoring and bedside Xenon-CT measurements. CBF measurements were performed within the first 72 h following bleeding. Six out of nine patients developed DCI at a later stage. Five out of six patients who developed DCI had initial global CBF below 26 ml/100 g/min whereas one had 53 ml/100 g/min. The three patients who did not develop clinical vasospasm all had initial global CBF above 27 ml/100 g/min. High lactate/pyruvate (L/P) ratio was associated with lower CBF values in the area surrounding the catheter. Five out of nine patients had L/P ratio ≥25 and four of these patients had CBF ≤ 22 ml/100 g/min. These preliminary results suggest that patients with initially low global CBF on Xenon-CT may be more likely to develop DCI. Initially low global CBF was accompanied with metabolic disturbances determined by the MD. Most importantly, pathological findings on the Xenon-CT and MD could be observed before any clinical signs of DCI. Combining bedside Xenon-CT and MD was found to be useful and feasible. Further studies are needed to evaluate if DCI can be detected before any other signs of DCI to prevent progress to infarction. PMID:24917850

  15. Resting cerebral blood flow

    PubMed Central

    Ances, B M.; Sisti, D; Vaida, F; Liang, C L.; Leontiev, O; Perthen, J E.; Buxton, R B.; Benson, D; Smith, D M.; Little, S J.; Richman, D D.; Moore, D J.; Ellis, R J.

    2009-01-01

    Objective: HIV enters the brain soon after infection causing neuronal damage and microglial/astrocyte dysfunction leading to neuropsychological impairment. We examined the impact of HIV on resting cerebral blood flow (rCBF) within the lenticular nuclei (LN) and visual cortex (VC). Methods: This cross-sectional study used arterial spin labeling MRI (ASL-MRI) to measure rCBF within 33 HIV+ and 26 HIV− subjects. Nonparametric Wilcoxon rank sum test assessed rCBF differences due to HIV serostatus. Classification and regression tree (CART) analysis determined optimal rCBF cutoffs for differentiating HIV serostatus. The effects of neuropsychological impairment and infection duration on rCBF were evaluated. Results: rCBF within the LN and VC were significantly reduced for HIV+ compared to HIV− subjects. A 2-tiered CART approach using either LN rCBF ≤50.09 mL/100 mL/min or LN rCBF >50.09 mL/100 mL/min but VC rCBF ≤37.05 mL/100 mL/min yielded an 88% (29/33) sensitivity and an 88% (23/26) specificity for differentiating by HIV serostatus. HIV+ subjects, including neuropsychologically unimpaired, had reduced rCBF within the LN (p = 0.02) and VC (p = 0.001) compared to HIV− controls. A temporal progression of brain involvement occurred with LN rCBF significantly reduced for both acute/early (<1 year of seroconversion) and chronic HIV-infected subjects, whereas rCBF in the VC was diminished for only chronic HIV-infected subjects. Conclusion: Resting cerebral blood flow (rCBF) using arterial spin labeling MRI has the potential to be a noninvasive neuroimaging biomarker for assessing HIV in the brain. rCBF reductions that occur soon after seroconversion possibly reflect neuronal or vascular injury among HIV+ individuals not yet expressing neuropsychological impairment. GLOSSARY AEH = acute/early HIV infection; ANOVA = analysis of variance; ASL-MRI = arterial spin labeling MRI; CART = classification and regression tree; CBF = cerebral blood flow; CH = chronic HIV

  16. Cerebral blood flow variations in CNS lupus

    SciTech Connect

    Kushner, M.J.; Tobin, M.; Fazekas, F.; Chawluk, J.; Jamieson, D.; Freundlich, B.; Grenell, S.; Freemen, L.; Reivich, M. )

    1990-01-01

    We studied the patterns of cerebral blood flow (CBF), over time, in patients with systemic lupus erythematosus and varying neurologic manifestations including headache, stroke, psychosis, and encephalopathy. For 20 paired xenon-133 CBF measurements, CBF was normal during CNS remissions, regardless of the symptoms. CBF was significantly depressed during CNS exacerbations. The magnitude of change in CBF varied with the neurologic syndrome. CBF was least affected in patients with nonspecific symptoms such as headache or malaise, whereas patients with encephalopathy or psychosis exhibited the greatest reductions in CBF. In 1 patient with affective psychosis, without clinical or CT evidence of cerebral ischemia, serial SPECT studies showed resolution of multifocal cerebral perfusion defects which paralleled clinical recovery.

  17. Comparison of xenon enhanced CT (XeCT) and I-123 iodoamphetamine (SPECT/IMP) techniques for measurement of regional cerebral blood flow (rCBF)

    SciTech Connect

    Hellman, R.S.; Collier, B.D.; Kilgor, D.P.; Walsh, P.R.; Daniels, D.L.; Haughton, V.M.; Williams, A.L.; Pojunas, K.W.; Tikofsky, R.S.; Isitman, A.T.

    1985-05-01

    An ongoing prospective study measuring rCBF by XeCT(20 patients) and SPECT/IMP (84 patients) to date includes 9 patients examined by both techniques. XeCT was done as 3 contiguous transaxial tomograms using a scanner (GE 9800) equipped with dynamic imaging capability and a gas delivery system for inspiring 30% Xenon. SPECT/IMP was done 20 minutes after injection of 3-5 mCi of IMP, obtaining 64 views over 360 degrees, 40 sec./view, with either a GE 400T or 400ACT. SPECT/IMP images obtained with the 400ACT camera (specially designed for head work) were superior to those obtained with the older camera. For all 9 cases, both techniques demonstrated flow abnormalities at all sites of infarction identified by conventional CT (TCT): 1 patient with normal TCT also had normal rCBF examinations. Furthermore, 8 of 9 cases showed evidence of ischemia (regions with normal TCT and abnormal rCBF measurements) by both techniques.

  18. Intracranial CT angiography obtained from a cerebral CT perfusion examination

    SciTech Connect

    Gratama van Andel, H. A. F.; Venema, H. W.; Majoie, C. B.; Den Heeten, G. J.; Grimbergen, C. A.; Streekstra, G. J.

    2009-04-15

    CT perfusion (CTP) examinations of the brain are performed increasingly for the evaluation of cerebral blood flow in patients with stroke and vasospasm after subarachnoid hemorrhage. Of the same patient often also a CT angiography (CTA) examination is performed. This study investigates the possibility to obtain CTA images from the CTP examination, thereby possibly obviating the CTA examination. This would save the patient exposure to radiation, contrast, and time. Each CTP frame is a CTA image with a varying amount of contrast enhancement and with high noise. To improve the contrast-to-noise ratio (CNR) we combined all 3D images into one 3D image after registration to correct for patient motion between time frames. Image combination consists of weighted averaging in which the weighting factor of each frame is proportional to the arterial contrast. It can be shown that the arterial CNR is maximized in this procedure. An additional advantage of the use of the time series of CTP images is that automatic differentiation between arteries and veins is possible. This feature was used to mask veins in the resulting 3D images to enhance visibility of arteries in maximum intensity projection (MIP) images. With a Philips Brilliance 64 CT scanner (64x0.625 mm) CTP examinations of eight patients were performed on 80 mm of brain using the toggling table technique. The CTP examination consisted of a time series of 15 3D images (2x64x0.625 mm; 80 kV; 150 mAs each) with an interval of 4 s. The authors measured the CNR in images obtained with weighted averaging, images obtained with plain averaging, and images with maximal arterial enhancement. The authors also compared CNR and quality of the images with that of regular CTA examinations and examined the effectiveness of automatic vein masking in MIP images. The CNR of the weighted averaged images is, on the average, 1.73 times the CNR of an image at maximal arterial enhancement in the CTP series, where the use of plain averaging

  19. Brief Report: Alterations in Cerebral Blood Flow as Assessed by PET/CT in Adults with Autism Spectrum Disorder with Normal IQ

    ERIC Educational Resources Information Center

    Pagani, Marco; Manouilenko, Irina; Stone-Elander, Sharon; Odh, Richard; Salmaso, Dario; Hatherly, Robert; Brolin, Fredrik; Jacobsson, Hans; Larsson, Stig A.; Bejerot, Susanne

    2012-01-01

    Specific biological markers for Autism Spectrum Disorder (ASD) have not yet been established. Functional studies have shown abnormalities in the anatomo-functional connectivity of the limbic-striatal "social" brain. This study aimed to investigate regional cerebral blood flow (rCBF) at rest. Thirteen patients with ASD of normal intelligence and…

  20. Brief Report: Alterations in Cerebral Blood Flow as Assessed by PET/CT in Adults with Autism Spectrum Disorder with Normal IQ

    ERIC Educational Resources Information Center

    Pagani, Marco; Manouilenko, Irina; Stone-Elander, Sharon; Odh, Richard; Salmaso, Dario; Hatherly, Robert; Brolin, Fredrik; Jacobsson, Hans; Larsson, Stig A.; Bejerot, Susanne

    2012-01-01

    Specific biological markers for Autism Spectrum Disorder (ASD) have not yet been established. Functional studies have shown abnormalities in the anatomo-functional connectivity of the limbic-striatal "social" brain. This study aimed to investigate regional cerebral blood flow (rCBF) at rest. Thirteen patients with ASD of normal intelligence and…

  1. Helical CT study of cerebral perfusion and related hemodynamic parameters

    NASA Astrophysics Data System (ADS)

    Cenic, Aleksa; Lee, Ting-Yim; Craen, Rosemary A.; Gelb, Adrian W.

    1997-05-01

    A convenient method for assessing cerebral perfusion and related functional parameters has been developed using a third generation slip-ring CT scanner. Dynamic contrast- enhanced scanning at the same level was employed to image the cerebral circulation at the rate of 1 image per second. Using data acquired with this non-helical mode of scanning, we have developed a method for the simultaneous in-vivo determination of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). These measurements are given in the same physiological units as positron emission tomography. In order to obtain accurate measurements of these parameters, methods were also developed to correct for recirculation and partial volume averaging in imaging small blood vessels. We have used 6 New Zealand white rabbits in our studies. For each rabbit, up to 3 CT measurements of CBF, CBV, and MTT were made at normocapnia under isoflurane anesthesia. Coronal sections through the brain were imaged while simultaneously imaging either a brain artery or the ear artery. Images were acquired for 1 minute as Isovue 300 was injected intravenously. In the acquired CT images, regions of interest in brain parenchyma and an artery were drawn. For each region of interest, the mean CT number in pre-contrast images was subtracted from the mean in post-contrast images to calculate the contrast concentration curves for the brain regions Q(t) and the arterial region Ca(t). Using a robust deconvolution method, the MTT was determined. CBV was then determined from the ratio of the areas of Q(t) and Ca(t). Finally, CBF was calculated from the Central Volume Principle. The mean regional CBF, CBV and MTT values were 73.3 +/- 5.1 ml/min/100g, 1.93 +/- 0.12 ml/100g and 1.80 +/- 0.18 s respectively. IN order to validate our CT CBF measurements, we also measured CBF using the well- established technique of microspheres with each CT study. The feasibility of our CT method to measure CBF accurately was

  2. In Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core?

    PubMed Central

    Copen, William A.; Morais, Livia T.; Wu, Ona; Schwamm, Lee H.; Schaefer, Pamela W.; González, R. Gilberto; Yoo, Albert J.

    2015-01-01

    Background and Purpose In the treatment of patients with suspected acute ischemic stroke, increasing evidence suggests the importance of measuring the volume of the irreversibly injured “ischemic core.” The gold standard method for doing this in the clinical setting is diffusion-weighted magnetic resonance imaging (DWI), but many authors suggest that maps of regional cerebral blood volume (CBV) derived from computed tomography perfusion imaging (CTP) can substitute for DWI. We sought to determine whether DWI and CTP-derived CBV maps are equivalent in measuring core volume. Methods 58 patients with suspected stroke underwent CTP and DWI within 6 hours of symptom onset. We measured low-CBV lesion volumes using three methods: “objective absolute,” i.e. the volume of tissue with CBV below each of six published absolute thresholds (0.9–2.5 mL/100 g), “objective relative,” whose six thresholds (51%-60%) were fractions of mean contralateral CBV, and “subjective,” in which two radiologists (R1, R2) outlined lesions subjectively. We assessed the sensitivity and specificity of each method, threshold, and radiologist in detecting infarction, and the degree to which each over- or underestimated the DWI core volume. Additionally, in the subset of 32 patients for whom follow-up CT or MRI was available, we measured the proportion of CBV- or DWI-defined core lesions that exceeded the follow-up infarct volume, and the maximum amount by which this occurred. Results DWI was positive in 72% (42/58) of patients. CBV maps’ sensitivity/specificity in identifying DWI-positive patients were 100%/0% for both objective methods with all thresholds, 43%/94% for R1, and 83%/44% for R2. Mean core overestimation was 156–699 mL for objective absolute thresholds, and 127–200 mL for objective relative thresholds. For R1 and R2, respectively, mean±SD subjective overestimation were -11±26 mL and -11±23 mL, but subjective volumes differed from DWI volumes by up to 117 and 124

  3. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.; Harper, A. M.; Jennett, W. B.

    1972-01-01

    Changes in cerebral blood flow during incremental increases of intracranial pressure produced by infusion of fluid into the cisterna magna were studied in anaesthetized baboons. Cerebral blood flow remained constant at intracranial pressure levels up to approximately 50 mm Hg. At intracranial pressure levels between 50-96 mm Hg a marked increase in cerebral blood flow occurred, associated with the development of systemic hypertension and changes in cerebrovascular resistance. Further increases of intracranial pressure led to a progressive fall in cerebral blood flow. Prior section of the cervical cord prevented both the increase in cerebral blood flow and the systemic hypertension. Alteration of cerebral perfusion pressure by bleeding during the hyperaemia in a further group of animals suggested that autoregulation was at least partially preserved during this phase. After maximum hyperaemia had occurred, however, autoregulation appeared to be lost. The clinical implications of these findings are discussed. PMID:4624687

  4. Correlation of CT cerebral vascular territories with function. 3. Middle cerebral artery

    SciTech Connect

    Berman, S.A.; Hayman, L.A.; Hinck, V.C.

    1984-05-01

    Schematic displays are presented of the cerebral territories supplied by branches of the middle cerebral artery as they would appear on axial and coronal computed tomographic (CT) scan sections. Companion diagrams of regional cortical function and a discussion of the fiber tracts are provided to simplify correlation of clinical deficits with coronal and axial CT abnormalities.

  5. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.; Harper, A. M.; Jennett, W. B.

    1973-01-01

    Changes in cerebral blood flow with increasing intracranial pressure were studied in anaesthetized baboons during expansion of a subdural balloon in one of two different sites. With an infratentorial balloon, cerebral blood flow bore no clear relation to intracranial pressure, but was linearly related to cerebral perfusion pressure. Apart from an initial change in some animals, cerebrovascular resistance remained constant with increasing intracranial pressure, and autoregulation appeared to be lost from the outset. With a supratentorial balloon, cerebral blood flow remained constant as intracranial pressure was increased to levels around 60 mm Hg, corresponding to a cerebral perfusion pressure range of approximately 100 to 40 mmHg. Cerebrovascular resistance fell progressively, and autoregulation appeared to be effective during this phase. At higher intracranial pressure levels (lower cerebral perfusion pressure levels), autoregulation was lost and cerebral blood flow became directly dependent on cerebral perfusion pressure. The importance of the cause of the increase in intracranial pressure on the response of the cerebral circulation and the relevance of these findings to the clinical situation are discussed. PMID:4196632

  6. Multifractality of cerebral blood flow

    NASA Astrophysics Data System (ADS)

    West, Bruce J.; Latka, Miroslaw; Glaubic-Latka, Marta; Latka, Dariusz

    2003-02-01

    Scale invariance, the property relating time series across multiple scales, has provided a new perspective of physiological phenomena and their underlying control systems. The traditional “signal plus noise” paradigm of the engineer was first replaced with a model in which biological time series have a fractal structure in time (Fractal Physiology, Oxford University Press, Oxford, 1994). This new paradigm was subsequently shown to be overly restrictive when certain physiological signals were found to be characterized by more than one scaling parameter and therefore to belong to a class of more complex processes known as multifractals (Fractals, Plenum Press, New York, 1988). Here we demonstrate that in addition to heart rate (Nature 399 (1999) 461) and human gait (Phys. Rev. E, submitted for publication), the nonlinear control system for cerebral blood flow (CBF) (Phys. Rev. Lett., submitted for publication; Phys. Rev. E 59 (1999) 3492) is multifractal. We also find that this multifractality is greatly reduced for subjects with “serious” migraine and we present a simple model for the underlying control process to describe this effect.

  7. Impaired cerebral vasoreactivity after embolization of arteriovenous malformations: assessment with serial acetazolamide challenge xenon CT

    SciTech Connect

    Tarr, R.W.; Johnson, D.W.; Horton, J.A.; Yonas, H.; Pentheny, S.; Durham, S.; Jungreis, C.A.; Hecht, S.T. )

    1991-05-01

    Embolization of a portion of the nidus of an arteriovenous malformation not only may alter hemodynamics within the nidus, but also may change blood flow dynamics in adjacent normal vessels. Sequential acetazolamide-challenge xenon CT cerebral blood flow studies were performed in eight patients before and after embolization of arteriovenous malformations to assess the hemodynamic effects on the major vascular territories supplying the malformation. Acetazolamide is a potent cerebral vasodilator, and its administration combined with cerebral blood flow studies allows assessment of cerebral vasoreactivity. In seven of the eight patients, one or more parenchymal areas exhibited a normal cerebral blood flow augmentation response to acetazolamide before embolization, but diminished acetazolamide flow augmentation was seen after embolization, indicating abnormal vasoreactivity. We found that the decrease in vasoreactivity peaked 6-10 days after embolization. In one of the eight patients, a temporary delayed neurologic deficit developed during a period of impaired cerebral vasoreactivity following embolization. Our results suggest that embolization of an arteriovenous malformation can induce vasoreactivity changes in adjacent normal vessels. Because these changes appear to be somewhat time-dependent, an appropriate interval should be observed between embolization stages or before surgical resection of an arteriovenous malformation following embolization to allow hemodynamic equilibration to occur. Acetazolamide challenge combined with serial cerebral blood flow studies following embolization enables determination of this hemodynamic equilibration.

  8. Early Cerebral Circulation Disturbance in Patients Suffering from Severe Traumatic Brain Injury (TBI): A Xenon CT and Perfusion CT Study.

    PubMed

    Honda, Mitsuru; Ichibayashi, Ryo; Yokomuro, Hiroki; Yoshihara, Katsunori; Masuda, Hiroyuki; Haga, Daisuke; Seiki, Yoshikatsu; Kudoh, Chiaki; Kishi, Taichi

    2016-08-15

    Traumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). Ischemia is a common and deleterious secondary injury following TBI. Detecting early ischemia in TBI patients is important to prevent further advancement and deterioration of the brain tissue. The purpose of this study was to clarify the cerebral circulatory disturbance during the early phase and whether it can be used to predict patient outcome. A total of 90 patients with TBI underwent a xenon-computed tomography (Xe-CT) and subsequently perfusion CT to evaluate the cerebral circulation on days 1-3. We measured CBF using Xe-CT and mean transit time (MTT: the width between two inflection points [maximum upward slope and maximum downward slope from inflow to outflow of the contrast agent]) using perfusion CT and calculated the cerebral blood volume (CBV) using the AZ-7000W98 computer system. The relationships of the hemodynamic parameters CBF, MTT, and CBV to the Glasgow Coma Scale (GCS) score and the Glasgow Outcome Scale (GOS) score were examined. There were no significant differences in CBF, MTT, and CBV among GCS3-4, GCS5-6, and GCS7-8 groups. The patients with a favorable outcome (GR and MD) had significantly higher CBF and lower MTT than those with an unfavorable one (SD, VS, or D). The discriminant analysis of these parameters could predict patient outcome with a probability of 70.6%. During the early phase, CBF reduction and MTT prolongation might influence the clinical outcome of TBI. These parameters are helpful for evaluating the severity of cerebral circulatory disturbance and predicting the outcome of TBI patients.

  9. Early Cerebral Circulation Disturbance in Patients Suffering from Severe Traumatic Brain Injury (TBI): A Xenon CT and Perfusion CT Study

    PubMed Central

    HONDA, Mitsuru; ICHIBAYASHI, Ryo; YOKOMURO, Hiroki; YOSHIHARA, Katsunori; MASUDA, Hiroyuki; HAGA, Daisuke; SEIKI, Yoshikatsu; KUDOH, Chiaki; KISHI, Taichi

    2016-01-01

    Traumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). Ischemia is a common and deleterious secondary injury following TBI. Detecting early ischemia in TBI patients is important to prevent further advancement and deterioration of the brain tissue. The purpose of this study was to clarify the cerebral circulatory disturbance during the early phase and whether it can be used to predict patient outcome. A total of 90 patients with TBI underwent a xenon-computed tomography (Xe-CT) and subsequently perfusion CT to evaluate the cerebral circulation on days 1–3. We measured CBF using Xe-CT and mean transit time (MTT: the width between two inflection points [maximum upward slope and maximum downward slope from inflow to outflow of the contrast agent]) using perfusion CT and calculated the cerebral blood volume (CBV) using the AZ-7000W98 computer system. The relationships of the hemodynamic parameters CBF, MTT, and CBV to the Glasgow Coma Scale (GCS) score and the Glasgow Outcome Scale (GOS) score were examined. There were no significant differences in CBF, MTT, and CBV among GCS3–4, GCS5–6, and GCS7–8 groups. The patients with a favorable outcome (GR and MD) had significantly higher CBF and lower MTT than those with an unfavorable one (SD, VS, or D). The discriminant analysis of these parameters could predict patient outcome with a probability of 70.6%. During the early phase, CBF reduction and MTT prolongation might influence the clinical outcome of TBI. These parameters are helpful for evaluating the severity of cerebral circulatory disturbance and predicting the outcome of TBI patients. PMID:27356957

  10. Postradiation regional cerebral blood flow in primates

    SciTech Connect

    Cockerham, L.G.; Cerveny, T.J.; Hampton, J.D.

    1986-06-01

    Early transient incapacitation (ETI) is the complete cessation of performance during the first 30 min after radiation exposure and performance decrement (PD) is a reduction in performance at the same time. Supralethal doses of radiation have been shown to produce a marked decrease in regional cerebral blood flow in primates concurrent with hypotension and a dramatic release of mast cell histamine. In an attempt to elucidate mechanisms underlying the radiation-induced ETI/PD phenomenon and the postradiation decrease in cerebral blood flow, primates were exposed to 100 Gy (1 Gy = 100 rads), whole-body, gamma radiation. Pontine and cortical blood flows were measured by hydrogen clearance, before and after radiation exposure. Systemic blood pressures were determined simultaneously. Systemic arterial histamine levels were determined preradiation and postradiation. Data obtained indicated that radiated animals showed a decrease in blood flow of 63% in the motor cortex and 51% in the pons by 10 min postradiation. Regional cerebral blood flow of radiated animals showed a slight recovery 20 min postradiation, followed by a fall to the 10 min nadir by 60 min postradiation. Immediately, postradiation systemic blood pressure fell 67% and remained at that level for the remainder of the experiment. Histamine levels in the radiated animals increased a hundredfold 2 min postradiation. This study indicates that regional cerebral blood flow decreases postradiation with the development of hypotension and may be associated temporally with the postradiation release of histamine.

  11. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.

    1974-01-01

    Intracranial pressure was raised by expansion of a supratentorial subdural ballon in anaesthetized baboons. Pressures were measured at several sites, both supratentorial and infratentorial, and cerebral blood flow was measured in each cerebral hemisphere separately. Pressures recorded from the right and left lateral ventricles corresponded closely throughout. Highly significant correlations were also obtained between the pressures in the right and left subdural spaces and the mean intraventricular pressure. There was, thus, no evidence of intracompartmental pressure gradients within the supratentorial space. Pressure gradients did, however, develop between the supratentorial and infratentorial compartments in the majority of experiments, although the level of supratentorial pressure at which this occurred, varied. Despite the presence of a large mass lesion over the right cerebral hemisphere, no significant differences developed between levels of cerebral blood flow in the two hemispheres, although flow in the right hemisphere remained consistently slightly lower than that in the left after the ballon was inserted. PMID:4836754

  12. Segmentation of brain blood vessels using projections in 3-D CT angiography images.

    PubMed

    Babin, Danilo; Vansteenkiste, Ewout; Pizurica, Aleksandra; Philips, Wilfried

    2011-01-01

    Segmenting cerebral blood vessels is of great importance in diagnostic and clinical applications, especially in quantitative diagnostics and surgery on aneurysms and arteriovenous malformations (AVM). Segmentation of CT angiography images requires algorithms robust to high intensity noise, while being able to segment low-contrast vessels. Because of this, most of the existing methods require user intervention. In this work we propose an automatic algorithm for efficient segmentation of 3-D CT angiography images of cerebral blood vessels. Our method is robust to high intensity noise and is able to accurately segment blood vessels with high range of luminance values, as well as low-contrast vessels.

  13. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.

    1974-01-01

    Pressure changes within the venous outflow tract from the brain were studied in anaesthetized baboons. Segmental vascular resistance changes were also calculated and the results correlated with the changes in cerebral blood flow, measured by the 133Xenon clearance method. Three different methods were used to raise intracranial pressure: cisterna magna infusion, a supratentorial subdural balloon, and an infratentorial subdural balloon. A close correlation was found between the cortical vein pressure and intracranial pressure with all methods of raising intracranial pressure: the overall correlation coefficient was 0·98. In the majority of animals sagittal sinus pressure showed little change through a wide range of intracranial pressure. In three of the six animals in the cisterna magna infusion group, however, sagittal sinus pressure increased to levels approaching the intracranial pressure during the later stages of intracranial hypertension. Jugular venous pressure showed little change with increasing intracranial pressure. The relationship between cerebral prefusion pressure and cerebral blood flow differed according to the method of increasing intracranial pressure. This was due to differing patterns of change in prevenous vascular resistance as venous resistance increased progressively with increasing pressure in all three groups. The present results confirm, therefore, the validity of the current definition of cerebral perfusion pressure—that is, cerebral perfusion pressure is equal to mean arterial pressure minus mean intracranial pressure—by demonstrating that intracranial pressure does represent the effective cerebral venous outflow pressure. Images PMID:4209160

  14. Substance abuse and cerebral blood flow.

    PubMed

    Mathew, R J; Wilson, W H

    1991-03-01

    This paper reviews acute and chronic effects of drugs of abuse on cerebral blood flow (CBF) and metabolism and their clinical significance. The most important source of information for the review is human research reports published in refereed journals. A few animal studies, book chapters, and abstracts that are especially relevant are also included. In humans, ethanol in small doses produces cerebral vasodilation; higher doses induce cerebral vasoconstriction. Chronic alcoholism is associated with reduced CBF and cerebral metabolism. Sedatives and antianxiety drugs lead to global reduction in CBF and cerebral metabolism. Caffeine, even in small doses, is a potent cerebral vasoconstrictor. Cerebral vasodilation is seen immediately after cigarette smoking, but chronic smokers show global reduction in CBF. Changes in CBF after marijuana smoking are variable; both increases and decreases are seen. Chronic marijuana smoking, however, seems to reduce CBF. Most inhalants and solvents are vasodilators; chronic abuse is accompanied by a decrease in CBF. A number of drugs of abuse, including ethanol, amphetamines, cocaine, nicotine, and caffeine-phenylpropanolamine combinations, increase the risk for stroke. Reduction in CBF associated with chronic use of ethanol, nicotine, inhalants, and solvents is at least partially reversible upon abstinence. Topics for future research include regional brain function, which mediates drug-induced mood changes (euphoria); CBF concomitants of psychological and physiological characteristics that increase addiction potential; changes in CBF that accompany withdrawal syndromes; mechanisms responsible for drug-induced stroke; and effects of functional and organic complications on CBF.

  15. Incidental Cerebral Microbleeds and Cerebral Blood Flow in Elderly Individuals.

    PubMed

    Gregg, Nicholas M; Kim, Albert E; Gurol, M Edip; Lopez, Oscar L; Aizenstein, Howard J; Price, Julie C; Mathis, Chester A; James, Jeffrey A; Snitz, Beth E; Cohen, Ann D; Kamboh, M Ilyas; Minhas, Davneet; Weissfeld, Lisa A; Tamburo, Erica L; Klunk, William E

    2015-09-01

    Cerebral microbleeds (CMBs) are collections of blood breakdown products that are a common incidental finding in magnetic resonance imaging of elderly individuals. Cerebral microbleeds are associated with cognitive deficits, but the mechanism is unclear. Studies show that individuals with CMBs related to symptomatic cerebral amyloid angiopathy have abnormal vascular reactivity and cerebral blood flow (CBF), but, to our knowledge, abnormalities in cerebral blood flow have not been reported for healthy individuals with incidental CMBs. To evaluate the association of incidental CMBs with resting-state CBF, cerebral metabolism, cerebrovascular disease, β-amyloid (Aβ), and cognition. A cross-sectional study of 55 cognitively normal individuals with a mean (SD) age of 86.8 (2.7) years was conducted from May 1, 2010, to May 1, 2013, in an academic medical center in Pittsburgh; data analysis was performed between June 10, 2013, and April 9, 2015. 3-Tesla magnetic resonance imaging was performed with susceptibility-weighted imaging or gradient-recalled echo to assess CMBs, arterial spin labeling for CBF, and T1- and T2-weighted imaging for atrophy, white matter hyperintensities, and infarcts. Positron emission tomography was conducted with fluorodeoxyglucose to measure cerebral metabolism and Pittsburgh compound B for fibrillar Aβ. Neuropsychological evaluation, including the Clinical Dementia Rating scale, was performed. Magnetic resonance images were rated for the presence and location of CMBs. Lobar CMBs were subclassified as cortical or subcortical. Measurements of CBF, metabolism, and Aβ were compared with the presence and number of CMBs with voxelwise and region-of-interest analyses. The presence of cortical CMBs was associated with significantly reduced CBF in multiple regions on voxelwise and region-of-interest analyses (percentage difference in global CBF, -25.3%; P = .0003), with the largest reductions in the parietal cortex (-37.6%; P < .0001) and

  16. Predicting stroke outcome using DCE-CT measured blood velocity

    NASA Astrophysics Data System (ADS)

    Oosterbroek, Jaap; Bennink, Edwin; Dankbaar, Jan Willem; Horsch, Alexander D.; Viergever, Max A.; Velthuis, Birgitta K.; de Jong, Hugo W. A. M.

    2015-03-01

    CT plays an important role in the diagnosis of acute stroke patients. Dynamic contrast enhanced CT (DCE-CT) can estimate local tissue perfusion and extent of ischemia. However, hemodynamic information of the large intracranial vessels may also be obtained from DCE-CT data and may contain valuable diagnostic information. We describe a novel method to estimate intravascular blood velocity (IBV) in large cerebral vessels using DCE-CT data, which may be useful to help predict stroke outcome. DCE-CT scans from 34 patients with isolated M1 occlusions were included from a large prospective multi-center cohort study of patients with acute ischemic stroke. Gaussians fitted to the intravascular data yielded the time-to-peak (TTP) and cerebral-blood-volume (CBV). IBV was computed by taking the inverse of the TTP gradient magnitude. Voxels with a CBV of at least 10% of the CBV found in the arterial input function were considered part of a vessel. Mid-sagittal planes were drawn manually and averages of the IBV over all vessel-voxels (arterial and venous) were computed for each hemisphere. Mean-hemisphere IBV differences, mean-hemisphere TTP differences, and hemisphere vessel volume differences were used to differentiate between patients with good and bad outcome (modified Rankin Scale score <3 versus ≥3 at 90 days) using ROC analysis. AUCs from the ROC for IBV, TTP, and vessel volume were 0.80, 0.67 and 0.62 respectively. In conclusion, IBV was found to be a better predictor of patient outcome than the parameters used to compute it and may be a promising new parameter for stroke outcome prediction.

  17. Regional cerebral blood flow in schizophrenia

    SciTech Connect

    Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

    1982-10-01

    Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions.

  18. Personality and regional cerebral blood flow.

    PubMed

    Mathew, R J; Weinman, M L; Barr, D L

    1984-05-01

    The extraversion-introversion dimension of personality is believed to have an inverse relationship with cortical arousal. Brain capillary perfusion is a well established index of brain function and arousal. Regional cerebral blood flow was measured in 51 right-handed females whose personality structure was examined with the Eysenck Personality Inventory (EPI). Significant inverse correlations were found between the brain blood flow and the extraversion-introversion score of EPI.

  19. The Reduction of Regional Cerebral Blood Flow in Normal-Appearing White Matter Is Associated with the Severity of White Matter Lesions in Elderly: A Xeon-CT Study

    PubMed Central

    Han, Jinghao; Hong, Zhen

    2014-01-01

    White matter lesions (WMLs) in normal elderly are related to chronic ischemia, and progression of WML occurs mostly in moderate to severe disease. However, the mechanism is uncertain. Thus, we enrolled fifty-six normal elderly patients without large artery disease. The severity of WML on MRI was graded as grade 0, I, II and III using the modified Fazekas scale. Cerebral blood flow (CBF) was measured by Xenon-CT. We found that CBF (mL/100 g/min) within periventricular lesions and in the right and left centrum semiovales were 20.33, 21.27 and 21.03, respectively, in group I; 16.33, 15.55 and 15.91, respectively, in group II; and 14.05, 14.46 and 14.23, respectively, in group III. CBF of normal-appearing white matter (NAWM) around periventricular areas and in the right and left centrum semiovales were 20.79, 22.26 and 22.15, respectively, in group 0; 21.12, 22.17 and 22.25, respectively, in group I; 18.02, 19.45 and 19.62, respectively, in group II; and 16.38, 18.18 and 16.74, respectively, in group III. Significant reductions in CBF were observed not only within lesions but also in NAWM surrounding the lesions. In addition, CBF was reduced significantly within lesions compared to NAWM of the same grade. Furthermore, CBF was reduced significantly in NAWM in grades II and III when compared to grades 0 and I. Our finding indicates that ischemia may play a role in the pathogenesis of WML. Additionally, our finding provides an alternative explanation for finding that the progression of WML occurred more commonly in patients with moderate to severe WML. PMID:25401786

  20. The reduction of regional cerebral blood flow in normal-appearing white matter is associated with the severity of white matter lesions in elderly: a Xeon-CT study.

    PubMed

    Fu, Jianhui; Tang, Jie; Han, Jinghao; Hong, Zhen

    2014-01-01

    White matter lesions (WMLs) in normal elderly are related to chronic ischemia, and progression of WML occurs mostly in moderate to severe disease. However, the mechanism is uncertain. Thus, we enrolled fifty-six normal elderly patients without large artery disease. The severity of WML on MRI was graded as grade 0, I, II and III using the modified Fazekas scale. Cerebral blood flow (CBF) was measured by Xenon-CT. We found that CBF (mL/100 g/min) within periventricular lesions and in the right and left centrum semiovales were 20.33, 21.27 and 21.03, respectively, in group I; 16.33, 15.55 and 15.91, respectively, in group II; and 14.05, 14.46 and 14.23, respectively, in group III. CBF of normal-appearing white matter (NAWM) around periventricular areas and in the right and left centrum semiovales were 20.79, 22.26 and 22.15, respectively, in group 0; 21.12, 22.17 and 22.25, respectively, in group I; 18.02, 19.45 and 19.62, respectively, in group II; and 16.38, 18.18 and 16.74, respectively, in group III. Significant reductions in CBF were observed not only within lesions but also in NAWM surrounding the lesions. In addition, CBF was reduced significantly within lesions compared to NAWM of the same grade. Furthermore, CBF was reduced significantly in NAWM in grades II and III when compared to grades 0 and I. Our finding indicates that ischemia may play a role in the pathogenesis of WML. Additionally, our finding provides an alternative explanation for finding that the progression of WML occurred more commonly in patients with moderate to severe WML.

  1. Application of Blood-Brain Barrier Permeability Imaging in Global Cerebral Edema.

    PubMed

    Ivanidze, J; Kallas, O N; Gupta, A; Weidman, E; Baradaran, H; Mir, D; Giambrone, A; Segal, A Z; Claassen, J; Sanelli, P C

    2016-09-01

    Blood-brain barrier permeability is not routinely evaluated in the clinical setting. Global cerebral edema occurs after SAH and is associated with BBB disruption. Detection of global cerebral edema using current imaging techniques is challenging. Our purpose was to apply blood-brain barrier permeability imaging in patients with global cerebral edema by using extended CT perfusion. Patients with SAH underwent CTP in the early phase after aneurysmal rupture (days 0-3) and were classified as having global cerebral edema or nonglobal cerebral edema using established noncontrast CT criteria. CTP data were postprocessed into blood-brain barrier permeability quantitative maps of PS (permeability surface-area product), K(trans) (volume transfer constant from blood plasma to extravascular extracellular space), Kep (washout rate constant of the contrast agent from extravascular extracellular space to intravascular space), VE (extravascular extracellular space volume per unit of tissue volume), VP (plasmatic volume per unit of tissue volume), and F (plasma flow) by using Olea Sphere software. Mean values were compared using t tests. Twenty-two patients were included in the analysis. Kep (1.32 versus 1.52, P < .0001), K(trans) (0.15 versus 0.19, P < .0001), VP (0.51 versus 0.57, P = .0007), and F (1176 versus 1329, P = .0001) were decreased in global cerebral edema compared with nonglobal cerebral edema while VE (0.81 versus 0.39, P < .0001) was increased. Extended CTP was used to evaluate blood-brain barrier permeability in patients with SAH with and without global cerebral edema. Kep is an important indicator of altered blood-brain barrier permeability in patients with decreased blood flow, as Kep is flow-independent. Further study of blood-brain barrier permeability is needed to improve diagnosis and monitoring of global cerebral edema. © 2016 by American Journal of Neuroradiology.

  2. Cerebral blood flow in humans following resuscitation from cardiac arrest

    SciTech Connect

    Cohan, S.L.; Mun, S.K.; Petite, J.; Correia, J.; Tavelra Da Silva, A.T.; Waldhorn, R.E.

    1989-06-01

    Cerebral blood flow was measured by xenon-133 washout in 13 patients 6-46 hours after being resuscitated from cardiac arrest. Patients regaining consciousness had relatively normal cerebral blood flow before regaining consciousness, but all patients who died without regaining consciousness had increased cerebral blood flow that appeared within 24 hours after resuscitation (except in one patient in whom the first measurement was delayed until 28 hours after resuscitation, by which time cerebral blood flow was increased). The cause of the delayed-onset increase in cerebral blood flow is not known, but the increase may have adverse effects on brain function and may indicate the onset of irreversible brain damage.

  3. Epilepsy, cerebral blood flow, and cerebral metabolic rate.

    PubMed

    Duncan, R

    1992-01-01

    Penfield's observations in the 1930s provided the first systematic evidence of changes in regional cerebral blood flow (rCBF) associated with focal seizures. Further studies in humans and animals confirmed increases in cerebral blood flow and metabolism during generalised seizures, but the interictal, ictal, and postictal changes in focal epilepsy have begun to be elucidated in the last decade with the advent of in vivo imaging techniques such as positron emission tomography (PET) and single photon emission computed tomography (SPECT) and, in the case of animal studies, of autoradiography. Most studies have been of temporal lobe epilepsy. Interictally, the characteristic finding has been reduced blood flow and/or metabolism in the affected temporal lobe, or more extensively in the ipsilateral hemisphere. The few studies to date of ictal or postictal changes have been of rCBF using SPECT. They show hyperperfusion of the whole temporal lobe ictally, hyperperfusion of the hippocampus, combined with hypoperfusion of lateral structures in the immediate postictal period. Later in the postictal period, hypoperfusion alone is seen. Studies of focal seizures in animals have shown hyperperfusion and hypermetabolism at the site of the focus often with widespread depression of both parameters in the ipsilateral neocortex. Limited studies of coupling between blood flow and metabolism in humans have suggested that flow during seizures is adequate for metabolic demand, although some animal studies have suggested localised areas of uncoupling. The results of modern in vivo imaging of ictal and postictal changes in blood flow and metabolism have correlated well with Penfield's observations, and these changes are now being used to help localise epileptic foci, allowing wider use of the surgical treatment he pioneered.

  4. Incidental Cerebral Microbleeds and Cerebral Blood Flow in Elderly Individuals

    PubMed Central

    Gregg, Nicholas M.; Kim, Albert E.; Gurol, M. Edip; Lopez, Oscar L.; Aizenstein, Howard J.; Price, Julie C.; Mathis, Chester A.; James, Jeffrey A.; Snitz, Beth E.; Cohen, Ann D.; Kamboh, M. Ilyas; Minhas, Davneet; Weissfeld, Lisa A.; Tamburo, Erica L.; Klunk, William E.

    2016-01-01

    IMPORTANCE Cerebral microbleeds (CMBs) are collections of blood breakdown products that are a common incidental finding in magnetic resonance imaging of elderly individuals. Cerebral microbleeds are associated with cognitive deficits, but the mechanism is unclear. Studies show that individuals with CMBs related to symptomatic cerebral amyloid angiopathy have abnormal vascular reactivity and cerebral blood flow (CBF), but, to our knowledge, abnormalities in cerebral blood flow have not been reported for healthy individuals with incidental CMBs. OBJECTIVE To evaluate the association of incidental CMBs with resting-state CBF, cerebral metabolism, cerebrovascular disease, β-amyloid (Aβ), and cognition. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study of 55 cognitively normal individuals with a mean (SD) age of 86.8 (2.7) years was conducted from May 1, 2010, to May 1, 2013, in an academic medical center in Pittsburgh; data analysis was performed between June 10, 2013, and April 9, 2015. INTERVENTIONS 3-Tesla magnetic resonance imaging was performed with susceptibility-weighted imaging or gradient-recalled echo to assess CMBs, arterial spin labeling for CBF, and T1- and T2-weighted imaging for atrophy, white matter hyperintensities, and infarcts. Positron emission tomography was conducted with fluorodeoxyglucose to measure cerebral metabolism and Pittsburgh compound B for fibrillar Aβ. Neuropsychological evaluation, including the Clinical Dementia Rating scale, was performed. MAIN OUTCOMES AND MEASURES Magnetic resonance images were rated for the presence and location of CMBs. Lobar CMBs were subclassified as cortical or subcortical. Measurements of CBF, metabolism, and Aβ were compared with the presence and number of CMBs with voxelwise and region-of-interest analyses. RESULTS The presence of cortical CMBs was associated with significantly reduced CBF in multiple regions on voxelwise and region-of-interest analyses (percentage difference in global CBF,

  5. Accuracy of the Alberta Stroke Program Early CT Score during the first 3 hours of middle cerebral artery stroke: comparison of noncontrast CT, CT angiography source images, and CT perfusion.

    PubMed

    Lin, K; Rapalino, O; Law, M; Babb, J S; Siller, K A; Pramanik, B K

    2008-05-01

    The Alberta Stroke Program Early CT Score (ASPECTS) is a reliable method of delineating the extent of middle cerebral artery (MCA) stroke. Our aim was to retrospectively compare the accuracy of ASPECTS on noncontrast CT, CT angiography (CTA) source images, and CT perfusion maps of cerebral blood volume (CBV) during the first 3 hours of middle cerebral artery (MCA) stroke. First-time patients with MCA stroke who presented <3 hours from symptom onset and were evaluated by noncontrast CT/CTA/CT perfusion, had confirmed acute nonlacunar MCA infarct on diffusion-weighted MR imaging (DWI) within 7 days, and had follow-up angiography were included. Patients were excluded for persistent MCA occlusion or stenosis. Two raters through consensus assigned an ASPECTS on the noncontrast CT, CTA source images, and the section-selective (2 x 12 mm coverage) CT perfusion CBV maps. ASPECTS on follow-up DWI served as the reference standard. For each CT technique, the detection rates of regional infarction, the mean ASPECTS, and the linear correlation to final ASPECTS were determined and compared. P values <.05 were considered significant. Twenty-eight patients satisfied the criteria with DWI performed at a mean of 50.3 hours (range, 22-125 hours) post-CT imaging. Of 280 ASPECTS regions, 100 were infarcted on DWI. The accuracy of noncontrast CT, CTA source images, and CT perfusion CBV for detecting regional infarct was 80.0%, 84.3%, and 96.8%, respectively (P < .0001). The mean ASPECTSs of noncontrast CT, CTA source images, CT perfusion CBV, and DWI were 8.4 +/- 1.8, 8.0 +/- 1.8, 6.8 +/- 1.9, and 6.5 +/- 1.8, respectively. The mean noncontrast CT and CTA source image ASPECTS was different from that of DWI (P < .05). Correlation of noncontrast CT, CTA source images, and CT perfusion CBV ASPECTS with final ASPECTS was r(2) = 0.34, r(2) = 0.42, and r(2) = 0.91, respectively. In a retrospective cohort of MCA infarcts imaged <3 hours from stroke onset, ASPECTS was most accurately determined

  6. Cerebral blood flow determination within the first 8 hours of cerebral infarction using stable xenon-enhanced computed tomography

    SciTech Connect

    Hughes, R.L.; Yonas, H.; Gur, D.; Latchaw, R.

    1989-06-01

    Cerebral blood flow mapping with stable xenon-enhanced computed tomography (Xe/CT) was performed in conjunction with conventional computed tomography (CT) within the first 8 hours after the onset of symptoms in seven patients with cerebral infarction. Six patients had hemispheric infarctions, and one had a progressive brainstem infarction. Three patients with very low (less than 10 ml/100 g/min) blood flow in an anatomic area appropriate for the neurologic deficit had no clinical improvement by the time of discharge from the hospital; follow-up CT scans of these three patients confirmed infarction in the area of very low blood flow. Three patients with moderate blood flow reductions (15-45 ml/100 g/min) in the appropriate anatomic area had significant clinical improvement from their initial deficits and had normal follow-up CT scans. One patient studied 8 hours after stroke had increased blood flow (hyperemia) in the appropriate anatomic area and made no clinical recovery.

  7. Spontaneous resolution of obstructive hydrocephalus from blood in the cerebral aqueduct.

    PubMed

    Yaghi, Shadi; Hinduja, Archana

    2011-03-29

    Obstructive hydrocephalus is a neurological emergency that needs to be immediately identified and treated. It very rarely resolves without treatment. We report about an 86-year-old man with right frontal stroke who developed obstructive hydrocephalus caused by blood in the cerebral aqueduct. The patient had sudden and immediate clinical improvement and a repeated head computed tomography (CT) scan showing spontaneous resolution of hydrocephalus. Spontaneous resolution of obstructive hydrocephalus is possible when the cause is minimal blood in the cerebral aqueduct without any blood in the fourth ventricle.

  8. Intraoperative cerebral blood flow imaging of rodents

    NASA Astrophysics Data System (ADS)

    Li, Hangdao; Li, Yao; Yuan, Lu; Wu, Caihong; Lu, Hongyang; Tong, Shanbao

    2014-09-01

    Intraoperative monitoring of cerebral blood flow (CBF) is of interest to neuroscience researchers, which offers the assessment of hemodynamic responses throughout the process of neurosurgery and provides an early biomarker for surgical guidance. However, intraoperative CBF imaging has been challenging due to animal's motion and position change during the surgery. In this paper, we presented a design of an operation bench integrated with laser speckle contrast imager which enables monitoring of the CBF intraoperatively. With a specially designed stereotaxic frame and imager, we were able to monitor the CBF changes in both hemispheres during the rodent surgery. The rotatable design of the operation plate and implementation of online image registration allow the technician to move the animal without disturbing the CBF imaging during surgery. The performance of the system was tested by middle cerebral artery occlusion model of rats.

  9. Cerebral blood flow in normal pressure hydrocephalus

    SciTech Connect

    Mamo, H.L.; Meric, P.C.; Ponsin, J.C.; Rey, A.C.; Luft, A.G.; Seylaz, J.A.

    1987-11-01

    A xenon-133 method was used to measure cerebral blood flow (CBF) before and after cerebrospinal fluid (CSF) removal in patients with normal pressure hydrocephalus (NPH). Preliminary results suggested that shunting should be performed on patients whose CBF increased after CSF removal. There was a significant increase in CBF in patients with NPH, which was confirmed by the favorable outcome of 88% of patients shunted. The majority of patients with senile and presenile dementia showed a decrease or no change in CBF after CSF removal. It is suggested that although changes in CBF and clinical symptoms of NPH may have the same cause, i.e., changes in the cerebral intraparenchymal pressure, there is no simple direct relation between these two events. The mechanism underlying the loss of autoregulation observed in NPH is also discussed.

  10. Cerebral blood flow and metabolism during sleep.

    PubMed

    Madsen, P L; Vorstrup, S

    1991-01-01

    A review of the current literature regarding sleep-induced changes in cerebral blood flow (CBF) and cerebral metabolic rate (CMR) is presented. Early investigations have led to the notion that dreamless sleep was characterized by global values of CBF and CMR practically at the level of wakefulness, while rapid eye movement (REM) sleep (dream sleep) was a state characterized by a dramatically increased level of CBF and possibly also of CMR. However, recent investigations firmly contradict this notion. Investigations on CBF and CMR performed during non-REM sleep, taking the effect of different levels of sleep into consideration, show that light sleep (stage II) is characterized by global levels of CBF and CMR only slightly reduced by 3-10% below the level associated with wakefulness, whereas CBF and CMR during deep sleep (stage III-IV) is dramatically reduced by 25-44%. Furthermore, recent data indicate that global levels of CBF and CMR are about the same during REM sleep as in wakefulness. On the regional level, deep sleep seems to be associated with a uniform decrease in regional CBF and CMR. Investigations concerning regional CBF and CMR during REM sleep are few but data from recent investigations seem to identify site-specific changes in regional CBF and CMR during REM sleep. CBF and CMR are reflections of cerebral synaptic activity and the magnitude of reduction in these variables associated with deep sleep indicates that overall cerebral synaptic activity is reduced to approximately one-half the level associated with wakefulness, while cerebral synaptic activity levels during REM sleep are similar to wakefulness. However, even though the new understanding of CBF and CMR during sleep provides significant and important information of the brain's mode of working during sleep, it does not at its current state identify the physiological processes involved in sleep or the physiological role of sleep.

  11. Cerebral blood flow response to functional activation

    PubMed Central

    Paulson, Olaf B; Hasselbalch, Steen G; Rostrup, Egill; Knudsen, Gitte Moos; Pelligrino, Dale

    2010-01-01

    Cerebral blood flow (CBF) and cerebral metabolic rate are normally coupled, that is an increase in metabolic demand will lead to an increase in flow. However, during functional activation, CBF and glucose metabolism remain coupled as they increase in proportion, whereas oxygen metabolism only increases to a minor degree—the so-called uncoupling of CBF and oxidative metabolism. Several studies have dealt with these issues, and theories have been forwarded regarding the underlying mechanisms. Some reports have speculated about the existence of a potentially deficient oxygen supply to the tissue most distant from the capillaries, whereas other studies point to a shift toward a higher degree of non-oxidative glucose consumption during activation. In this review, we argue that the key mechanism responsible for the regional CBF (rCBF) increase during functional activation is a tight coupling between rCBF and glucose metabolism. We assert that uncoupling of rCBF and oxidative metabolism is a consequence of a less pronounced increase in oxygen consumption. On the basis of earlier studies, we take into consideration the functional recruitment of capillaries and attempt to accommodate the cerebral tissue's increased demand for glucose supply during neural activation with recent evidence supporting a key function for astrocytes in rCBF regulation. PMID:19738630

  12. Multiple medullary venous malformations decreasing cerebral blood flow: Case report

    SciTech Connect

    Tomura, N.; Inugami, A.; Uemura, K.; Hadeishi, H.; Yasui, N. )

    1991-02-01

    A rare case of multiple medullary venous malformations in the right cerebral hemisphere is reported. The literature review yielded only one case of multiple medullary venous malformations. Computed tomography scan showed multiple calcified lesions with linear contrast enhancement representing abnormal dilated vessels and mild atrophic change of the right cerebral hemisphere. Single-photon emission computed tomography using N-isopropyl-p-({sup 123}I) iodoamphetamine demonstrated decreased cerebral blood flow in the right cerebral hemisphere.

  13. Volume perfusion CT imaging of cerebral vasospasm: diagnostic performance of different perfusion maps.

    PubMed

    Othman, Ahmed E; Afat, Saif; Nikoubashman, Omid; Müller, Marguerite; Schubert, Gerrit Alexander; Bier, Georg; Brockmann, Marc A; Wiesmann, Martin; Brockmann, Carolin

    2016-08-01

    In this study, we aimed to evaluate the diagnostic performance of different volume perfusion CT (VPCT) maps regarding the detection of cerebral vasospasm compared to angiographic findings. Forty-one datasets of 26 patients (57.5 ± 10.8 years, 18 F) with subarachnoid hemorrhage and suspected cerebral vasospasm, who underwent VPCT and angiography within 6 h, were included. Two neuroradiologists independently evaluated the presence and severity of vasospasm on perfusion maps on a 3-point Likert scale (0-no vasospasm, 1-vasospasm affecting <50 %, 2-vasospasm affecting >50 % of vascular territory). A third neuroradiologist independently assessed angiography for the presence and severity of vasospasm on a 3-point Likert scale (0-no vasospasm, 1-vasospasm affecting < 50 %, 2-vasospasm affecting > 50 % of vessel diameter). Perfusion maps of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and time to drain (TTD) were evaluated regarding diagnostic accuracy for cerebral vasospasm with angiography as reference standard. Correlation analysis of vasospasm severity on perfusion maps and angiographic images was performed. Furthermore, inter-reader agreement was assessed regarding findings on perfusion maps. Diagnostic accuracy for TTD and MTT was significantly higher than for all other perfusion maps (TTD, AUC = 0.832; MTT, AUC = 0.791; p < 0.001). TTD revealed higher sensitivity than MTT (p = 0.007). The severity of vasospasm on TTD maps showed significantly higher correlation levels with angiography than all other perfusion maps (p ≤ 0.048). Inter-reader agreement was (almost) perfect for all perfusion maps (kappa ≥ 0.927). The results of this study indicate that TTD maps have the highest sensitivity for the detection of cerebral vasospasm and highest correlation with angiography regarding the severity of vasospasm.

  14. Noninvasive optoacoustic monitoring of cerebral venous blood oxygenation in newborns

    NASA Astrophysics Data System (ADS)

    Petrov, Irene Y.; Wynne, Karon E.; Petrov, Yuriy; Esenaliev, Rinat O.; Richardson, C. Joan; Prough, Donald S.

    2012-02-01

    Cerebral ischemia after birth and during labor is a major cause of death and severe complications such as cerebral palsy. In the USA alone, cerebral palsy results in permanent disability of 10,000 newborns per year and approximately 500,000 of the total population. Currently, no technology is capable of direct monitoring of cerebral oxygenation in newborns. This study proposes the use of an optoacoustic technique for noninvasive cerebral ischemia monitoring by probing the superior sagittal sinus (SSS), a large central cerebral vein. We developed and built a multi-wavelength, near-infrared optoacoustic system suitable for noninvasive monitoring of cerebral ischemia in newborns with normal weight (NBW), low birth-weight (LBW, 1500 - 2499 g) and very low birth-weight (VLBW, < 1500 g). The system was capable of detecting SSS signals through the open anterior and posterior fontanelles as well as through the skull. We tested the system in NBW, LBW, and VLBW newborns (weight range: from 675 g to 3,000 g) admitted to the neonatal intensive care unit. We performed single and continuous measurements of the SSS blood oxygenation. The data acquisition, processing and analysis software developed by our group provided real-time, absolute SSS blood oxygenation measurements. The SSS blood oxygenation ranged from 60% to 80%. Optoacoustic monitoring of the SSS blood oxygenation provides valuable information because adequate cerebral oxygenation would suggest that no therapy was necessary; conversely, evidence of cerebral ischemia would prompt therapy to increase cerebral blood flow.

  15. Acute cerebral perfusion CT abnormalities associated with posttraumatic amnesia in mild head injury.

    PubMed

    Metting, Zwany; Rödiger, Lars A; de Jong, Bauke M; Stewart, Roy E; Kremer, Berry P; van der Naalt, Joukje

    2010-12-01

    Posttraumatic amnesia (PTA) is a common symptom following traumatic brain injury. Although this transient memory deficit implies specific impairment of higher brain function, the actual pathophysiology of PTA is not well understood. The aim of this study was to assess regional cerebral hemodynamics with perfusion computed tomography (CT) in patients during PTA following mild head injury compared to patients with resolved PTA. A total of 74 patients with mild head injury without structural abnormalities on a non-contrast CT scan were included and compared to 25 healthy controls. Two patient groups were defined: (1) a PTA group that was scanned during the episode of PTA (n = 34), and (2) a post-PTA group scanned after resolution of PTA (n = 40). The PTA group had significantly reduced cerebral blood flow (CBF) in the frontal grey matter (41.78 [SD 7.4] versus 44.44 [SD 6.2] mL • 100 g⁻¹ • min⁻¹, p = 0.023), and caudate nucleus (44.59 [SD 6.2] versus 47.85 [SD 7.7] mL • 100 g⁻¹ • min⁻¹, p = 0.021), compared to the post-PTA group. Thus in patients with mild head injury, PTA is associated with cerebral perfusion abnormalities in specific cortical and subcortical regions.

  16. Cerebral blood volume changes during brain activation

    PubMed Central

    Krieger, Steffen Norbert; Streicher, Markus Nikolar; Trampel, Robert; Turner, Robert

    2012-01-01

    Cerebral blood volume (CBV) changes significantly with brain activation, whether measured using positron emission tomography, functional magnetic resonance imaging (fMRI), or optical microscopy. If cerebral vessels are considered to be impermeable, the contents of the skull incompressible, and the skull itself inextensible, task- and hypercapnia-related changes of CBV could produce intolerable changes of intracranial pressure. Because it is becoming clear that CBV may be useful as a well-localized marker of neural activity changes, a resolution of this apparent paradox is needed. We have explored the idea that much of the change in CBV is facilitated by exchange of water between capillaries and surrounding tissue. To this end, we developed a novel hemodynamic boundary-value model and found approximate solutions using a numerical algorithm. We also constructed a macroscopic experimental model of a single capillary to provide biophysical insight. Both experiment and theory model capillary membranes as elastic and permeable. For a realistic change of input pressure, a relative pipe volume change of 21±5% was observed when using the experimental setup, compared with the value of approximately 17±1% when this quantity was calculated from the mathematical model. Volume, axial flow, and pressure changes are in the expected range. PMID:22569192

  17. Gender differences in regional cerebral blood flow

    SciTech Connect

    Gur, R.E.; Gur, R.C. )

    1990-01-01

    Gender differences have been noted in neurobehavioral studies. The 133xenon inhalation method for measuring regional cerebral blood flow (rCBF) can contribute to the understanding of the neural basis of gender differences in brain function. Few studies have examined gender differences in rCBF. In studies of normal subjects, women have higher rates of CBF than men, and this is related to age. Usually by the sixth decade men and women have similar flow rates. Fewer studies on rCBF in schizophrenia have examined sex differences. The pattern of higher flows for females maintains, but its correlates with gender differences in clinical as well as other parameters of brain function remain to be examined.

  18. Planning-free cerebral blood flow territory mapping in patients with intracranial arterial stenosis.

    PubMed

    Arteaga, Daniel F; Strother, Megan K; Davis, L Taylor; Fusco, Matthew R; Faraco, Carlos C; Roach, Brent A; Scott, Allison O; Donahue, Manus J

    2017-06-01

    A noninvasive method for quantifying cerebral blood flow and simultaneously visualizing cerebral blood flow territories is vessel-encoded pseudocontinuous arterial spin labeling MRI. However, obstacles to acquiring such information include limited access to the methodology in clinical centers and limited work on how clinically acquired vessel-encoded pseudocontinuous arterial spin labeling data correlate with gold-standard methods. The purpose of this work is to develop and validate a semiautomated pipeline for the online quantification of cerebral blood flow maps and cerebral blood flow territories from planning-free vessel-encoded pseudocontinuous arterial spin labeling MRI with gold-standard digital subtraction angiography. Healthy controls (n = 10) and intracranial atherosclerotic disease patients (n = 34) underwent 3.0 T MRI imaging including vascular (MR angiography) and hemodynamic (cerebral blood flow-weighted arterial spin labeling) MRI. Patients additionally underwent catheter and/or CT angiography. Variations in cross-territorial filling were grouped according to diameters of circle of Willis vessels in controls. In patients, Cohen's k-statistics were computed to quantify agreement in perfusion patterns between vessel-encoded pseudocontinuous arterial spin labeling and angiography. Cross-territorial filling patterns were consistent with circle of Willis anatomy. The intraobserver Cohen's k-statistics for cerebral blood flow territory and digital subtraction angiography perfusion agreement were 0.730 (95% CI = 0.593-0.867; reader one) and 0.708 (95% CI = 0.561-0.855; reader two). These results support the feasibility of a semiautomated pipeline for evaluating major neurovascular cerebral blood flow territories in patients with intracranial atherosclerotic disease.

  19. The Role of Neuronal Signaling in Controlling Cerebral Blood Flow

    ERIC Educational Resources Information Center

    Drake, Carrie T.; Iadecola, Costantino

    2007-01-01

    Well-regulated blood flow within the brain is vital to normal function. The brain's requirement for sufficient blood flow is ensured by a tight link between neural activity and blood flow. The link between regional synaptic activity and regional cerebral blood flow, termed functional hyperemia, is the basis for several modern imaging techniques…

  20. The Role of Neuronal Signaling in Controlling Cerebral Blood Flow

    ERIC Educational Resources Information Center

    Drake, Carrie T.; Iadecola, Costantino

    2007-01-01

    Well-regulated blood flow within the brain is vital to normal function. The brain's requirement for sufficient blood flow is ensured by a tight link between neural activity and blood flow. The link between regional synaptic activity and regional cerebral blood flow, termed functional hyperemia, is the basis for several modern imaging techniques…

  1. Regional cerebral blood flow changes associated with ethanol intoxication

    SciTech Connect

    Mathew, R.J.; Wilson, W.H.

    1986-11-01

    Regional cerebral blood flow (CBF) was measured via the 133Xenon inhalation technique in 26 healthy volunteers before and 60 minutes after the oral administration of ethyl alcohol or placebo on a double-blind basis. The cerebral blood flow values, corrected for test-retest differences in carbon dioxide showed a significant bilateral increase after ethanol administration. Blood levels of ethanol, estimated with a breath analyser, did not correlate with the CBF changes.

  2. Cerebral blood flow tomography with xenon-133

    SciTech Connect

    Lassen, N.A.

    1985-10-01

    Cerebral blood flow (CBF) can be measured tomographically by inhalation of Xenon-/sup 133/. The calculation is based on taking a sequence of tomograms during the wash-in and wash-out phase of the tracer. Due to the dynamic nature of the process, a highly sensitive and fast moving single photon emission computed tomograph (SPECT) is required. Two brain-dedicated SPECT systems designed for this purpose are mentioned, and the method is described with special reference to the limitations inherent in the soft energy of the 133Xe primary photons. CBF tomography can be used for a multitude of clinical and investigative purposes. This article discusses in particular its use for the selection of patients with carotid occlusion for extracranial/intracranial bypass surgery, for detection of severe arterial spasm after aneurysm bleeding, and for detection of low flow areas during severe migraine attacks. The use of other tracers for CBF tomography using SPECT is summarized with emphasis on the /sup 99m/Tc chelates that freely pass the intact blood-brain barrier. The highly sensitive brain-dedicated SPECT systems described are a prerequisite for achieving high resolution tomograms with such tracers.

  3. Postischemic cerebral blood flow and neuroeffector mechanisms.

    PubMed

    Macfarlane, R; Moskowitz, M A; Tasdemiroglu, E; Wei, E P; Kontos, H A

    1991-01-01

    The influence of neuroeffector mechanisms in the regulation of postischemic cerebral blood flow was investigated by microsphere determination in 8 cats after chronic unilateral vascular deafferentation by trigeminal ganglionectomy. The animals were subjected to 90 min of reperfusion following 10 min of global ischemia induced by 4-vessel occlusion and systemic hypotension. Cortical hyperemia 30 min after reperfusion was attenuated by up to 48% in cortical gray matter ipsilateral to the side of trigeminal ganglionectomy (p less than 0.01). Axon reflex mechanisms involving the release of neuropeptides from peripheral sensory nerve fibers, such as substance P (SP), calcitonin gene-related peptide (CGRP) and neurokinin A (NKA), mediate this response. SP and NKA cause vasodilation by endothelium-dependent mechanisms (endothelium-dependent relaxing factor), whereas CGRP relaxes vascular smooth muscle by direct receptor interactions. Studies were therefore undertaken to determine the extent to which endothelium-dependent mechanisms mediate the hyperemia following global cerebral ischemia. In 7 intact cats, the postischemic response of pial arterioles to the topical application of acetylcholine (ACh; 10(-7) M), an endothelial-dependent vasodilator, was measured using a closed cranial window technique. Although ACh increased pial arteriolar caliber by 17% under resting conditions, the same dose elicited a vasoconstrictor response (87% of pre-ACh diameter 30 min after reperfusion) for the first 60 min of reperfusion after 10 min of ischemia. ACh-induced vasodilation was restored by 75 min (105%), but was less than control even at 120 min (109 vs. 117%; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Optoacoustic mapping of cerebral blood oxygenation in humans

    NASA Astrophysics Data System (ADS)

    Petrov, Yuriy; Prough, Donald S.; Petrov, Irene Y.; Richardson, C. Joan; Fonseca, Rafael A.; Robertson, Claudia S.; Esenaliev, Rinat O.

    2017-03-01

    Noninvasive, transcranial mapping, monitoring, and imaging are highly important for detection and management of cerebral abnormalities and neuroscience research. Mapping, imaging, and monitoring of cerebral blood oxygenation are necessary for diagnostics and management of patients with traumatic brain injury, stroke, and other neurological conditions. We proposed to use optoacoustic technology for noninvasive, transcranial monitoring and imaging. In this work, we developed optoacoustic systems for mapping of cerebral blood oxygenation in humans and tested them in adults and neonates. The systems provide noninvasive, transcranial optoacoustic measurements in the transmission (forward) and reflection (backward) modes in the near infrared spectral range. Novel, ultra-sensitive probes were built for detection of optoacoustic signals and measurement of blood oxygenation in neonates and adults. Cerebral oxygenation was measured at different lateral sites from the superior sagittal sinus (SSS), a large central cerebral vein, located immediately beneath the midline of the human skull. In neonates, cerebral oxygenation was measured through open anterior and posterior fontanelles. Optoacoustic signal detection at different locations allowed for mapping of cerebral blood oxygenation. Our future studies will be focused on 3D mapping of cerebral blood oxygenation.

  5. Regional cerebral blood flow in childhood headache

    SciTech Connect

    Roach, E.S.; Stump, D.A.

    1989-06-01

    Regional cerebral blood flow (rCBF) was measured in 16 cranial regions in 23 children and adolescents with frequent headaches using the non-invasive Xenon-133 inhalation technique. Blood flow response to 5% carbon dioxide (CO2) was also determined in 21 patients, while response to 50% oxygen was measured in the two patients with hemoglobinopathy. Included were 10 patients with a clinical diagnosis of migraine, 4 with musculoskeletal headaches, and 3 with features of both types. Also studied were 2 patients with primary thrombocythemia, 2 patients with hemoglobinopathy and headaches, 1 patient with polycythemia, and 1 with headaches following trauma. With two exceptions, rCBF determinations were done during an asymptomatic period. Baseline rCBF values tended to be higher in these young patients than in young adults done in our laboratory. Localized reduction in the expected blood flow surge after CO2 inhalation, most often noted posteriorly, was seen in 8 of the 13 vascular headaches, but in none of the musculoskeletal headache group. Both patients with primary thrombocythemia had normal baseline flow values and altered responsiveness to CO2 similar to that seen in migraineurs; thus, the frequently reported headache and transient neurologic signs with primary thrombocythemia are probably not due to microvascular obstruction as previously suggested. These data support the concept of pediatric migraine as a disorder of vasomotor function and also add to our knowledge of normal rCBF values in younger patients. Demonstration of altered vasomotor reactivity to CO2 could prove helpful in children whose headache is atypical.

  6. Noninvasive method of estimating human newborn regional cerebral blood flow

    SciTech Connect

    Younkin, D.P.; Reivich, M.; Jaggi, J.; Obrist, W.; Delivoria-Papadopoulos, M.

    1982-12-01

    A noninvasive method of estimating regional cerebral blood flow (rCBF) in premature and full-term babies has been developed. Based on a modification of the /sup 133/Xe inhalation rCBF technique, this method uses eight extracranial NaI scintillation detectors and an i.v. bolus injection of /sup 133/Xe (approximately 0.5 mCi/kg). Arterial xenon concentration was estimated with an external chest detector. Cerebral blood flow was measured in 15 healthy, neurologically normal premature infants. Using Obrist's method of two-compartment analysis, normal values were calculated for flow in both compartments, relative weight and fractional flow in the first compartment (gray matter), initial slope of gray matter blood flow, mean cerebral blood flow, and initial slope index of mean cerebral blood flow. The application of this technique to newborns, its relative advantages, and its potential uses are discussed.

  7. Cerebral malaria: mysteries at the blood-brain barrier.

    PubMed

    Rénia, Laurent; Howland, Shanshan Wu; Claser, Carla; Charlotte Gruner, Anne; Suwanarusk, Rossarin; Hui Teo, Teck; Russell, Bruce; Ng, Lisa F P

    2012-01-01

    Cerebral malaria is the most severe pathology caused by the malaria parasite, Plasmodium falciparum. The pathogenic mechanisms leading to cerebral malaria are still poorly defined as studies have been hampered by limited accessibility to human tissues. Nevertheless, histopathology of post-mortem human tissues and mouse models of cerebral malaria have indicated involvement of the blood-brain barrier in cerebral malaria. In contrast to viruses and bacteria, malaria parasites do not infiltrate and infect the brain parenchyma. Instead, rupture of the blood-brain barrier occurs and may lead to hemorrhages resulting in neurological alterations. Here, we review the most recent findings from human studies and mouse models on the interactions of malaria parasites and the blood-brain barrier, shedding light on the pathogenesis of cerebral malaria, which may provide directions for possible interventions.

  8. Reversible cerebral vasoconstriction syndrome 3 months after blood transfusion.

    PubMed

    Braun, Charles N; Hughes, Richard L; Bosque, Patrick J

    2012-11-01

    Reversible cerebral vasoconstriction syndrome is characterized by the prolonged but reversible constriction of cerebral arteries accompanied by a sudden onset of severe headache, and is sometimes complicated by subarachnoid hemorrhage or cerebral infarction. It is associated with various clinical conditions and treatments, although the precise pathophysiology is not understood. In particular, several cases of this syndrome have been described to occur in middle-aged women within 1 week of a blood transfusion. We encountered a patient with a reversible cerebral vasoconstriction syndrome who became symptomatic 3 months after a blood transfusion. No other cause for the syndrome was found. This case suggests that the risk for the reversible cerebral vasoconstriction may persist for months after blood transfusion. Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. Cerebral embolism: local CBF and edema measured by CT scanning and Xe inhalation

    SciTech Connect

    Meyer, J.S.; Yamamoto, M.; Hayman, L.A.; Sakai, F.; Nakajima, S.; Armstrong, D.

    1980-01-01

    Serial CT scans were made in baboons after cerebral embolization during stable Xe inhalation for measuring local values for CBF and lambda (brain-blood partition or solubility coefficients), followed by iodine infusion for detecting blood-brain barrier (BBB) damage. Supplementary 133Xe CBF measurements were made at corresponding intervals. Persistent zones of zero flow surrounded by reduced flow were measured predominantly in subcortical regions, which showed gross and microscopic evidence of infarction at necropsy. Overylng cortex was relatively spared. Reduced lambda values attributed to edema appeared with in 3 to 5 minutes and progressed up to 60 minutes. Damage to BBB with visible transvascular seepage of iodine began to appear 1-11/2 hours after embolism. In chronic animals, lambda values were persistently reduced in areas showing histologic infarction. Contralateral hemispheric CBF increased for the first 15 minutes after embolism, followed by progressive reduction after 30 minutes (diaschisis).

  10. Cerebral embolism: local CFBF and edema measured by CT scanning and Xe inhalation. [Baboons

    SciTech Connect

    Meyer, J.S.; Yamamoto, M.; Hayman, L.A.; Sakai, F.; Nakajima, S.; Armstrong, D.

    1980-01-01

    Serial CT scans were made in baboons after cerebral embolization during stable Xe inhalation for measuring local values for CBF and lambda (brain-blood partition or solubility coefficients), followed by iodine infusion for detecting blood-brain barrier (BBB) damage. Persistent zones of zero flow surrounded by reduced flow were measured predominantly in subcortical regions, which showed gross and microscopic evidence of infarction at necropsy. Overlying cortex was relatively spared. Reduced lambda values attributed to edema appeared within 3 to 5 minutes and progressed up to 60 minutes. Damage to BBB with visible transvascular seepage of iodine began to appear 1 to 1 1/2 hours after embolism. In chronic animals, lambda values were persistently reduced in areas showing histologic infarction. Contralateral hemispheric CBF increased for the first 15 minutes after embolism, followed by progressive reduction after 30 minutes (diaschisis).

  11. Measurement of radiation dose in cerebral CT perfusion study.

    PubMed

    Hirata, Masaaki; Sugawara, Yoshifumi; Fukutomi, Yukimi; Oomoto, Kenji; Murase, Kenya; Miki, Hitoshi; Mochizuki, Teruhito

    2005-03-01

    To evaluate radiation dose in cerebral perfusion studies with a multi-detector row CT (MDCT) scanner on various voltage and current settings by using a human head phantom. Following the CT perfusion study protocol, continuous cine scans (1 sec/rotation x60 sec) consisting of four 5-mm-thick contiguous slices were performed three times at variable tube voltages of 80 kV, 100 kV, 120 kV, and 140 kV with the same tube current setting of 200 mA and on variable current settings of 50 mA, 100 mA, 150 mA, and 200 mA with the same tube voltage of 80 kV. Radiation doses were measured using a total of 41 theroluminescent dosimeters (TLDs) placed in the human head phantom. Thirty-six TLDs were inside and three were on the surface of the slice of the X-ray beam center, and two were placed on the surface 3 cm caudal assuming the lens position. Average radiation doses of surface, inside, and lens increased in proportion to the increases of tube voltage and tube current. The lowest inside dose was 87.6+/-15.3 mGy, and the lowest surface dose was 162.5+/-6.7 mGy at settings of 80 kV and 50 mA. The highest inside dose was 1,591.5+/-179.7 mGy, and the highest surface dose was 2,264.6+/-123.7 mGy at 140 kV-200 mA. At 80 kV-50 mA, the average radiation dose of lens was the lowest at 5.5+/-0.0 mGy. At 140 kV-200 mA the radiation dose of lens was the highest at 127.2+/-0.6 mGy. In cerebral CT perfusion study, radiation dose can vary considerably. Awareness of the patient's radiation dose is recommended.

  12. Accuracy of perfusion-CT in predicting malignant middle cerebral artery brain infarction.

    PubMed

    Dittrich, R; Kloska, S P; Fischer, T; Nam, E; Ritter, M A; Seidensticker, P; Heindel, W; Nabavi, D G; Ringelstein, E B

    2008-06-01

    We performed a prospective study on patients with middle cerebral artery(MCA) ischemic stroke to evaluate the accuracy of perfusion-CT imaging(PCT) to predict the development of malignant brain infarction (MBI). 106 patients(women 37 %, mean age 65 years)underwent native cranial computed tomography (CCT), CT angiography(CTA) and PCT after a median of 2 h after stroke onset. We assessed the patency of the MCA and the area of tissue ischemia (AIT)according to cerebral blood flow(CBF), cerebral blood volume (CBV) and time-to-peak (TTP)maps. Optimum sensitivity, specificity,positive (PPV) and negative predictive values (NPV) were calculated for the end-point MBI (= midline shift > 5 mm or decompressive surgery) by means of receiver operating characteristics(ROC). 20 patients (19 %)developed a MBI. In these patients,a larger AIT was found in all perfusion maps as compared to the remaining patients (p < 0.001). All perfusion maps had a very high NPV (95.4-98.4 %), a high sensitivity (85-95 %) and specificity (71.6-77.9 %) and only a moderate PPV (44-47.4 %). Best prediction was found for CBF maps with AIT of > 27.9 % of the hemisphere. PCT allows the discrimination of patients without a relevant risk for MBI from those having a 50 % risk of MBI development. Due to the high sensitivity and specificity, PCT is a reliable tool in detecting MBI. Because of PCT's better availability, it is the method of choice at present for an early risk stratification of acute stroke patients.

  13. Erythropoietin Pretreatment of Transplanted Endothelial Colony-Forming Cells Enhances Recovery in a Cerebral Ischemia Model by Increasing Their Homing Ability: A SPECT/CT Study.

    PubMed

    Garrigue, Philippe; Hache, Guillaume; Bennis, Youssef; Brige, Pauline; Stalin, Jimmy; Pellegrini, Lionel; Velly, Lionel; Orlandi, Francesca; Castaldi, Elena; Dignat-George, Françoise; Sabatier, Florence; Guillet, Benjamin

    2016-11-01

    Endothelial colony-forming cells (ECFCs) are promising candidates for cell therapy of ischemic diseases, as less than 10% of patients with an ischemic stroke are eligible for thrombolysis. We previously reported that erythropoietin priming of ECFCs increased their in vitro and in vivo angiogenic properties in mice with hindlimb ischemia. The present study used SPECT/CT to evaluate whether priming of ECFCs with erythropoietin could enhance their homing to the ischemic site after transient middle cerebral artery occlusion (MCAO) followed by reperfusion in rats and potentiate their protective or regenerative effect on blood-brain barrier (BBB) disruption, cerebral apoptosis, and cerebral blood flow (CBF).

  14. Augmentation of Regional Cerebral Blood Flow by Microvascular Anastomosis

    DTIC Science & Technology

    1974-06-01

    the Adult Foxhound after Middle Cerebral Root Occlusion 5 ABSTRACT Intracranial surgical procedures for cerebrovascular occlusive disease...11 I. INTRODUCTION Recent advances in stroke therapy have been highlighted by the development of direct intracraniai surgical approaches to...experimental acute stroke in dogs. J. Neurosurg. 38:26-31, 1973. 2. Fein, J, M. and Boulos, R, Local cerebral blood flow in experimental middle

  15. Interleaving cerebral CT perfusion with neck CT angiography part I. Proof of concept and accuracy of cerebral perfusion values.

    PubMed

    Oei, Marcel T H; Meijer, Frederick J A; van der Woude, Willem-Jan; Smit, Ewoud J; van Ginneken, Bram; Prokop, Mathias; Manniesing, Rashindra

    2017-06-01

    We present a novel One-Step-Stroke protocol for wide-detector CT scanners that interleaves cerebral CTP with volumetric neck CTA (vCTA). We evaluate whether the resulting time gap in CTP affects the accuracy of CTP values. Cerebral CTP maps were retrospectively obtained from 20 patients with suspicion of acute ischemic stroke and served as the reference standard. To simulate a 4 s gap for interleaving CTP with vCTA, we eliminated one acquisition at various time points of CTP starting from the bolus-arrival-time(BAT). Optimal timing of the vCTA was evaluated. At the time point with least errors, we evaluated elimination of a second time point (6 s gap). Mean absolute percentage errors of all perfusion values remained below 10 % in all patients when eliminating any one time point in the CTP sequence starting from the BAT. Acquiring the vCTA 2 s after reaching a threshold of 70HU resulted in the lowest errors (mean <3.0 %). Eliminating a second time point still resulted in mean errors <3.5 %. CBF/CBV showed no significant differences in perfusion values except MTT. However, the percentage errors were always below 10 % compared to the original protocol. Interleaving cerebral CTP with neck CTA is feasible with minor effects on the perfusion values. • Removing a single CTP acquisition has minor effects on calculated perfusion values • Calculated perfusion values errors depend on timing of skipping a CTP acquisition • Qualitative evaluation of CTP was not influenced by removing two time points • Neck CTA is optimally timed in the upslope of arterial enhancement.

  16. Sequential assessment of regional cerebral blood flow, regional cerebral blood volume, and blood-brain barrier in focal cerebral ischemia: a case report

    SciTech Connect

    Di Piero, V.; Perani, D.; Savi, A.; Gerundini, P.; Lenzi, G.L.; Fazio, F.

    1986-06-01

    Regional CBF (rCBF) and regional cerebral blood volume (rCBV) were evaluated by N,N,N'-trimethyl-N'-(2)-hydroxy-3-methyl-5-(123I)iodobenzyl-1, 3-propanediamine-2 HCl- and /sup 99m/TC-labeled red blood cells, respectively, and single-photon emission computerized tomography (SPECT) in a patient with focal cerebral ischemia. Sequential transmission computerized tomography (TCT) and SPECT functional data were compared with clinical findings to monitor the pathophysiological events occurring in stroke. A lack of correlation between rCBF-rCBV distributions and blood-brain barrier (BBB) breakdown was found in the acute phase. In the face of more prolonged alteration of BBB, as seen by TCT enhancement, a rapid evolution of transient phenomena such as luxury perfusion was shown by SPECT studies. Follow-up of the patient demonstrated a correlation between the neurological recovery and a parallel relative improvement of the cerebral perfusion.

  17. Autoregulation of cerebral blood circulation under orthostatic tests

    NASA Technical Reports Server (NTRS)

    Gayevyy, M. D.; Maltsev, V. G.; Pogorelyy, V. E.

    1980-01-01

    Autoregulation of cerebral blood flow (ACBF) under orthostatic tests (OT) was estimated in acute experiments on rabbits and cats under local anesthesia according to changes of perfusion pressure (PP) in carotid arteries, cerebral blood flow, pressure in the venous system of the brain, and resistance of cerebral vessels. The OT were conducted by turning a special table with the animal fastened to it from a horizontal to a vertical (head up or head down) position at 40 to 80 deg. In most experiments ACBF correlated with the changes of PP. Different variations of ACBF and its possible mechanisms are discussed.

  18. Cerebral artery evaluation of dual energy CT angiography with dual source CT.

    PubMed

    Ma, Rui; Liu, Cheng; Deng, Kai; Song, Shao-juan; Wang, Dao-ping; Huang, Ling

    2010-05-05

    Conventional computed tomography angiography (CTA) is time consuming, user-dependent and has poor image quality in skull base region. This study assessed the feasibility of a new method, dual energy CTA for depicting the cerebral artery. Phantom scan was done with head CTA sequences on dual source CT and 64 spiral CT for radiation dose calculation. Dual energy CTA was done with dual source CT on 36 patients who were suspected of having cerebral vascular disease. Three series axial images in 0.75 mm thick, 0.4 mm increment were acquired, which were named with 80 kV, 140 kV and merged images; 80 kV and 140 kV images were transferred into dual energy software, and maximum intensity projection (MIP) image was generated quickly by dual energy bone remove (DEBR group); merged images were transferred into In Space software to acquire MIP image through manual conventional bone remove (CoBR group). Post processing time and reading time were compared. Image qualities of the two groups were compared, mainly focusing on skull base segments of internal carotid artery and bone subtraction. ANOVA and SNK tests were applied for radiation dose comparison. Student's t test and Wilcoxon rank sum test were applied for assessing differences between data for significance. Cohen's kappa was used for interobserver agreement. Radiation dose of phantom scan showed dual energy CTA was between digital bone subtraction and conventional CTA. The post processing time and reading time were much shorter in DEBR than CoBR, and image quality in skull base was much higher in DEBR than CoBR (P < 0.01). There was no significant difference for suprasellar vessels between two groups (P > 0.5). Interobserver agreement for all vessel segments was excellent (kappa = 0.97). Dual energy CTA is a reliable, new modality for depicting cerebral artery, overcoming the limitation of conventional CTA in the skull base region. It can save much time in post processing and reading than conventional CTA.

  19. Mathematical Modelling of Cerebral Blood Circulation and Cerebral Autoregulation: Towards Preventing Intracranial Hemorrhages in Preterm Newborns

    PubMed Central

    Botkin, Nikolai; Alves-Pinto, Ana

    2014-01-01

    Impaired cerebral autoregulation leads to fluctuations in cerebral blood flow, which can be especially dangerous for immature brain of preterm newborns. In this paper, two mathematical models of cerebral autoregulation are discussed. The first one is an enhancement of a vascular model proposed by Piechnik et al. We extend this model by adding a polynomial dependence of the vascular radius on the arterial blood pressure and adjusting the polynomial coefficients to experimental data to gain the autoregulation behavior. Moreover, the inclusion of a Preisach hysteresis operator, simulating a hysteretic dependence of the cerebral blood flow on the arterial pressure, is tested. The second model couples the blood vessel system model by Piechnik et al. with an ordinary differential equation model of cerebral autoregulation by Ursino and Lodi. An optimal control setting is proposed for a simplified variant of this coupled model. The objective of the control is the maintenance of the autoregulatory function for a wider range of the arterial pressure. The control can be interpreted as the effect of a medicament changing the cerebral blood flow by, for example, dilation of blood vessels. Advanced numerical methods developed by the authors are applied for the numerical treatment of the control problem. PMID:25126111

  20. Mathematical modelling of cerebral blood circulation and cerebral autoregulation: towards preventing intracranial hemorrhages in preterm newborns.

    PubMed

    Lampe, Renée; Botkin, Nikolai; Turova, Varvara; Blumenstein, Tobias; Alves-Pinto, Ana

    2014-01-01

    Impaired cerebral autoregulation leads to fluctuations in cerebral blood flow, which can be especially dangerous for immature brain of preterm newborns. In this paper, two mathematical models of cerebral autoregulation are discussed. The first one is an enhancement of a vascular model proposed by Piechnik et al. We extend this model by adding a polynomial dependence of the vascular radius on the arterial blood pressure and adjusting the polynomial coefficients to experimental data to gain the autoregulation behavior. Moreover, the inclusion of a Preisach hysteresis operator, simulating a hysteretic dependence of the cerebral blood flow on the arterial pressure, is tested. The second model couples the blood vessel system model by Piechnik et al. with an ordinary differential equation model of cerebral autoregulation by Ursino and Lodi. An optimal control setting is proposed for a simplified variant of this coupled model. The objective of the control is the maintenance of the autoregulatory function for a wider range of the arterial pressure. The control can be interpreted as the effect of a medicament changing the cerebral blood flow by, for example, dilation of blood vessels. Advanced numerical methods developed by the authors are applied for the numerical treatment of the control problem.

  1. Effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies

    NASA Astrophysics Data System (ADS)

    Murase, Kenya; Nanjo, Takafumi; Satoshi, Ii; Miyazaki, Shohei; Hirata, Masaaki; Sugawara, Yoshifumi; Kudo, Masayuki; Sasaki, Kousuke; Mochizuki, Teruhito

    2005-11-01

    The purpose of this study was to investigate the effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies using multi-detector row CT (MDCT). Following the standard CT perfusion study protocol, continuous (cine) scans (1 s/rotation × 60 s) consisting of four 5 mm thick contiguous slices were performed using an MDCT scanner with a tube voltage of 80 kVp and a tube current of 200 mA. We generated the simulated images with tube currents of 50 mA, 100 mA and 150 mA by adding the corresponding noise to the raw scan data of the original image acquired above using a noise simulation tool. From the original and simulated images, we generated the functional images of cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) in seven patients with cerebrovascular disease, and compared the correlation coefficients (CCs) between the perfusion parameter values obtained from the original and simulated images. The coefficients of variation (CVs) in the white matter were also compared. The CC values deteriorated with decreasing tube current. There was a significant difference between 50 mA and 100 mA for all perfusion parameters. The CV values increased with decreasing tube current. There were significant differences between 50 mA and 100 mA and between 100 mA and 150 mA for CBF. For CBV and MTT, there was also a significant difference between 150 mA and 200 mA. This study will be useful for understanding the effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies using MDCT, and for selecting the tube current.

  2. Effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies.

    PubMed

    Murase, Kenya; Nanjo, Takafumi; Ii, Satoshi; Miyazaki, Shohei; Hirata, Masaaki; Sugawara, Yoshifumi; Kudo, Masayuki; Sasaki, Kousuke; Mochizuki, Teruhito

    2005-11-07

    The purpose of this study was to investigate the effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies using multi-detector row CT (MDCT). Following the standard CT perfusion study protocol, continuous (cine) scans (1 s/rotation x 60 s) consisting of four 5 mm thick contiguous slices were performed using an MDCT scanner with a tube voltage of 80 kVp and a tube current of 200 mA. We generated the simulated images with tube currents of 50 mA, 100 mA and 150 mA by adding the corresponding noise to the raw scan data of the original image acquired above using a noise simulation tool. From the original and simulated images, we generated the functional images of cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) in seven patients with cerebrovascular disease, and compared the correlation coefficients (CCs) between the perfusion parameter values obtained from the original and simulated images. The coefficients of variation (CVs) in the white matter were also compared. The CC values deteriorated with decreasing tube current. There was a significant difference between 50 mA and 100 mA for all perfusion parameters. The CV values increased with decreasing tube current. There were significant differences between 50 mA and 100 mA and between 100 mA and 150 mA for CBF. For CBV and MTT, there was also a significant difference between 150 mA and 200 mA. This study will be useful for understanding the effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies using MDCT, and for selecting the tube current.

  3. Cerebral glucose utilization and blood flow in Huntington's Disease (HD)

    SciTech Connect

    Phelps, M.E.; Mazziotta, J.C.; Wapenski, J.; Riege, W.; Baxter, L.R.

    1985-05-01

    Previous studies in the authors' Laboratory have been carried out on 13 patients symptomatic of HD (SHD) and 15 asymptomatic at-risk for HD (ARHD) with a ECAT II and identification of changes in caudate metabolism using an index technique. The authors report now studies of additional 28 subjects (11 SHD, 17 ARHD) studied drug free and compared to age/sex matched controls using the higher resolution NeuroECAT, FDG for glucose utilization (LCMRGlc) and 0-15 water for cerebral blood flow (CBF). Patients had neurological, psychiatric-tests, x-ray CT and were video taped to determine type, timing and amount of choreathetic movements during study. In SHD (disease duration 4.9 +- 2.7 yrs), significant decreases (30%) in LCMRGlc were found in striatum (SHD=19.3 +- 7.7, controls = 29.9 +- 5.8 ..mu.. moles/min/100g) despite no to moderate caudate atrophy on x-ray CT. Hemisphere and cortical CMRGlc were not significantly decreased. There was a significant correlation between disease duration and ratio of caudate to putamen (Cd/Put). Pattern of LCMRGlc and CBF matched in SHD. The caudate to hemisphere LCMRGlc ratio was not different between ARHD and controls except variance was about 4 times greater for ARHD (ARHD=1.21 +- 0.15, controls = 1.28 +- 0.04) indicating presence of subpopulations in ARHD group. Four ARHD subjects had a ratio of 1 Std. Dev. from mean of SHD (no normals had values in this range). The 2 ARHD subjects with lowest caudate LCMRGlc had Cd/Put ratios > 2 Std. Dev. from controls. Results show 1) LCMRGlc abnormalities in all SHD patients and subpopulations in ARHD, 2) metabolic alterations appear to begin in caudate and spread to putamen and that a Cd/Put value of 0.7 should be found at start of symptoms, and 3) cortex and thalamus are relatively spared in ARHD and early SHD.

  4. Cerebral blood flow: Physiologic and clinical aspects

    SciTech Connect

    Wood, J.H.

    1987-01-01

    This book contains 46 chapters divided among nine sections. The section titles are: Historical Perspectives; Cerebrovascular Anatomy; Cerebrovascular Physiology; Methods of Clinical Measurement; Experimental Methods; Imaging of Cerebral Circulation; Cerebrovascular Pathophysiology; Cerebrovascular Pharmacology; and Surgical and Interventional Augmentation.

  5. Correlation between cerebral blood flow and oxygen saturation in patients with subarachnoid hemorrhage and traumatic brain injury.

    PubMed

    Shafer, Robert; Brown, Alice; Taylor, Christopher

    2011-12-01

    The INVOS cerebral oximeter and portable xenon enhanced CT (Xe/CT) scan are two commonly used diagnostic devices in patients who have experienced neurologic insults such as traumatic brain injury and subarachnoid hemorrhage. While the INVOS device is a relatively inexpensive, non-invasive measure of cerebral blood oxygen saturation, Xe/CT is a more complex costly diagnostic test that is the current gold standard for assessing cerebral perfusion in patients in the neurosciences intensive care unit (NSI) at the University of New Mexico Hospital. The purpose of this research was to investigate a possible relationship between these two diagnostic devices that might enable clinicians to better determine the appropriate timing and necessity of Xe/CT scans by evaluating trends in cerebral oximetry. The research was conducted in the University of New Mexico Hospital NSI over 18 months, with 25 imaging studies being collected from among 22 patients. Computer generated cortical segments obtained from the Xe/CT scans were correlated to INVOS cerebral oximeter pad placement on each patient's forehead, and the values were then compared using Spearman correlation coefficients. In this study, no statistically significant relationship between the devices was found although expansion of the study to a greater number of patients may uncover such a relationship.

  6. Labetalol decreases cerebral perfusion pressure without negatively affecting cerebral blood flow in hypertensive gravidas.

    PubMed

    Belfort, Michael A; Tooke-Miller, Cathy; Allen, John C; Dizon-Townson, Donna; Varner, Michael A

    2002-01-01

    To research the cerebral hemodynamic effects of labetalol in pregnant women with hypertension. Prospective observational study. Tertiary Care Medical Center. Pregnant patients with hypertension. Transcranial Doppler (TCD) ultrasound was used to measure the blood velocity in the middle cerebral arteries (MCA) of eight pregnant patients with hypertension, before and after the administration of a 200 mg oral dose of labetalol. Five patients had severe preeclampsia, and three had chronic hypertension with superimposed preeclampsia. MCA blood velocity and systemic blood pressure were measured simultaneously at the baseline, and at 60 and 180 min after labetalol. Selected cerebral hemodynamic parameters were compared with normative curves. Values outside of the 5th and 95th percentiles were regarded as abnormal. Cerebral perfusion pressure (CPP), resistance area product (RAP), and cerebral flow index (CFI). Patient age, gestational age, and parity were similar to those of the normal women from whom the normative data were obtained. Women with hypertension had higher baseline CPP, MAP, and RAP than normal pregnant women, but their CFI was within the normal range. Labetalol reduced the CPP, as well as the systolic, diastolic, and mean BP significantly at 60 and 180 min without significantly affecting the heart rate, MCA velocities, RAP, or CFI. Labetalol effectively reduces CPP, without affecting cerebral perfusion, primarily by a decrease in systemic blood pressure. This makes it an ideal agent for blood pressure control in severely hypertensive pregnant women.

  7. Effect of plasma exchange on blood viscosity and cerebral blood flow.

    PubMed Central

    Brown, M M; Marshall, J

    1982-01-01

    The effects of plasma exchange using a low viscosity plasma substitute on blood viscosity and cerebral blood flow were investigated in eight subjects with normal cerebral vasculature. Plasma exchange resulted in significant reductions in plasma viscosity, whole blood viscosity, globulin and fibrinogen concentration without affecting packed cell volume. The reduction in whole blood viscosity was more pronounced at low shear rates suggesting an additional effect on red cell aggregation. Despite the fall in viscosity there was no significant change in cerebral blood flow. The results support the metabolic theory of autoregulation. Although changes in blood viscosity appear not to alter the level of cerebral blood flow under these circumstances, plasma exchange could still be of benefit in the management of acute cerebrovascular disease. PMID:6805689

  8. Cerebral blood flow measured by NMR indicator dilution in cats

    SciTech Connect

    Ewing, J.R.; Branch, C.A.; Helpern, J.A.; Smith, M.B.; Butt, S.M.; Welch, K.M.

    1989-02-01

    We developed techniques to assess the utility of a nuclear magnetic resonance (NMR) indicator for cerebral blood flow studies in cats, using Freon-22 for the first candidate. A PIN-diode-switched NMR experiment allowed the acquisition of an arterial as well as a cerebral fluorine-19 signal proportional to concentration vs. time in a 1.89 T magnet. Mean +/- SD blood:brain partition coefficients for Freon-22 were estimated at 0.93 +/- 0.08 for gray matter and 0.77 +/- 0.12 for white matter. Using maximum-likelihood curve fitting, estimates of mean +/- SD resting cerebral blood flow were 50 +/- 19 ml/100 g-min for gray matter and 5.0 +/- 2.0 ml/100 g-min for white matter. Hypercapnia produced the expected increases in gray and white matter blood flow. The physiologic effects of Freon-22, including an increase in cerebral blood flow itself with administration of 40% by volume, may limit its use as an indicator. Nevertheless, the NMR techniques described demonstrate the feasibility of fluorine-19-labeled compounds as cerebral blood flow indicators and the promise for their use in humans.

  9. The relationship of pineal calcification to cerebral atrophy on CT scan in multiple sclerosis.

    PubMed

    Sandyk, R; Awerbuch, G I

    1994-05-01

    Calcification is a known morphological feature of the pineal gland. The mechanisms underlying the development of pineal calcification (PC) are elusive although there is experimental evidence that calcification may be a marker of the past secretory activity of the gland and/or of degeneration. The increased incidence of PC with aging suggests that it may reflect cerebral degenerative changes as well. In a recent Editorial in this Journal it was proposed that the pineal gland is implicated in the pathogenesis of multiple sclerosis (MS). Cerebral atrophy, which can be demonstrated on CT scan, is a common feature of MS resulting from demyelination and gliosis. If PC is a marker of a cerebral degenerative process, then one would expect a higher incidence of calcification of the gland in patients with cerebral atrophy compared to those without cerebral atrophy. To test this hypothesis, we studied the incidence of PC on CT scan in a cohort of 48 MS patients, 21 of whom had cerebral atrophy. For the purpose of comparison, we also assessed the incidence of choroid plexus calcification (CPC) in relation to cerebral atrophy. PC was found in 42 patients (87.5%) and its incidence in patients with cerebral atrophy was significantly higher compared to the incidence in patients without cerebral atrophy (100% vs. 77.7%; p < .025). In contrast, CPC was unrelated to cerebral atrophy or to PC thus supporting the notion of a specific association between the pineal gland and the pathogenesis of MS.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. CT perfusion evidence of early global cerebral hypoperfusion after aneurysmal subarachnoid hemorrhage with cardiac arrest.

    PubMed

    Burns, Joseph D; Jacob, Jeffrey T; Luetmer, Patrick H; Wijdicks, Eelco F M

    2010-04-01

    Cardiac arrest and aneurysmal subarachnoid hemorrhage both cause sudden, severe cerebral hypoperfusion at ictus. Animal studies indicate that the resultant microvascular dysfunction and cerebral perfusion abnormalities are important determinants of the associated cerebral injury in both conditions. Although this suggests that perfusion imaging might be a useful tool for prognostication in patients with these conditions, this hypothesis has not been thoroughly investigated in humans. Case report. A 49-year-old man developed cardiac arrest upon rupture of an intracranial aneurysm. When he arrived at our institution 10 h later, he was comatose, had neurogenic hyperventilation, absent corneal reflexes, and continuous multifocal myoclonus. Despite normal intracranial pressure, normal cerebral perfusion pressure, normal flow in the proximal cerebral arteries on CT angiography, and a lack of diffuse cerebral edema, CT perfusion imaging performed 12 h after ictus showed severe, diffuse hypoperfusion. After the development of refractory intracranial hypertension, physiologic support was withdrawn and the patient died. Early global cerebral hypoperfusion can be demonstrated by CT perfusion imaging after cardiac arrest associated with high-grade aneurysmal subarachnoid hemorrhage and may be indicative of poor neurologic outcome. CT perfusion should be investigated as a prognostic tool in these conditions.

  11. Kidney Function and Cerebral Blood Flow: The Rotterdam Study.

    PubMed

    Sedaghat, Sanaz; Vernooij, Meike W; Loehrer, Elizabeth; Mattace-Raso, Francesco U S; Hofman, Albert; van der Lugt, Aad; Franco, Oscar H; Dehghan, Abbas; Ikram, M Arfan

    2016-03-01

    CKD is linked with various brain disorders. Whereas brain integrity is dependent on cerebral perfusion, the association between kidney function and cerebral blood flow has yet to be determined. This study was performed in the framework of the population-based Rotterdam Study and included 2645 participants with mean age of 56.6 years (45% men). We used eGFR and albumin-to-creatinine ratio to assess kidney function and performed phase-contrast magnetic resonance imaging of basilar and carotid arteries to measure cerebral blood flow. Participants had an average (SD) eGFR of 86.3 (13.4) ml/min per 1.73 m(2) and a median (interquartile range) albumin-to-creatinine ratio of 3.4 (2.2-6.1) mg/g. In age- and sex-adjusted models, a higher albumin-to-creatinine ratio was associated with lower cerebral blood flow level (difference in cerebral blood flow [milliliters per minute per 100 ml] per doubling of the albumin-to-creatinine ratio, -0.31; 95% confidence interval, -0.58 to -0.03). The association was not present after adjustment for cardiovascular risk factors (P=0.10). Each 1 SD lower eGFR was associated with 0.42 ml/min per 100 ml lower cerebral blood flow (95% confidence interval, 0.01 to 0.83) adjusted for cardiovascular risk factors. Thus, in this population-based study, we observed that lower eGFR is independently associated with lower cerebral blood flow.

  12. Frequency and patterns of abnormality detected by iodine-123 amine emission CT after cerebral infarction

    SciTech Connect

    Brott, T.G.; Gelfand, M.J.; Williams, C.C.; Spilker, J.A.; Hertzberg, V.S.

    1986-03-01

    Single photon emission computed tomography (SPECT) was performed in 31 patients with cerebral infarction and 13 who had had transient ischemic attacks, using iodine-123-labeled N,N,N'-trimethyl-N'-(2-hydroxyl-3-methyl-5-iodobenzyl)-1,3-propanediamin e (I-123-HIPDM) as the radiopharmaceutical. SPECT scans were compared with computed tomographic (CT) scans. SPECT was as sensitive as CT in detecting cerebral infarction (94% vs. 84%). The abnormalities were larger on the SPECT scans than on the CT scans in 19 cases, equal in seven, and smaller in five (SPECT abnormalities greater than or equal to CT abnormalities in 86% of cases). Fifteen of 30 patients with hemispheric infarction had decreased perfusion (decreased uptake of I-123-HIPDM) to the cerebellar hemisphere contralateral to the cerebral hemisphere involved by the infarction (crossed cerebellar diaschisis). Nine of these 15 patients had major motor deficits, while only one of the 15 without crossed cerebellar diaschisis had a major motor deficit.

  13. CT perfusion and delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.

    PubMed

    Cremers, Charlotte H P; van der Schaaf, Irene C; Wensink, Emerens; Greving, Jacoba P; Rinkel, Gabriel J E; Velthuis, Birgitta K; Vergouwen, Mervyn D I

    2014-02-01

    Delayed cerebral ischemia (DCI) is at presentation a diagnosis per exclusionem, and can only be confirmed with follow-up imaging. For treatment of DCI a diagnostic tool is needed. We performed a systematic review to evaluate the value of CT perfusion (CTP) in the prediction and diagnosis of DCI. We searched PubMed, Embase, and Cochrane databases to identify studies on the relationship between CTP and DCI. Eleven studies totaling 570 patients were included. On admission, cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time-to-peak (TTP) did not differ between patients who did and did not develop DCI. In the DCI time-window (4 to 14 days after subarachnoid hemorrhage (SAH)), DCI was associated with a decreased CBF (pooled mean difference -11.9 mL/100 g per minute (95% confidence interval (CI): -15.2 to -8.6)) and an increased MTT (pooled mean difference 1.5 seconds (0.9-2.2)). Cerebral blood volume did not differ and TTP was rarely reported. Perfusion thresholds reported in studies were comparable, although the corresponding test characteristics were moderate and differed between studies. We conclude that CTP can be used in the diagnosis but not in the prediction of DCI. A need exists to standardize the method for measuring perfusion with CTP after SAH, and optimize and validate perfusion thresholds.

  14. Hypothermia reduces cerebral metabolic rate and cerebral blood flow in newborn pigs

    SciTech Connect

    Busija, D.W.; Leffler, C.W. )

    1987-10-01

    The authors examined effects of hypothermia on cerebral metabolic rate and cerebral blood flow in anesthetized, newborn pigs (1-4 days old). Cerebral blood flow (CBF) was determined with 15-{mu}m radioactive microspheres. Regional CBF ranged from 44 to 66 ml{center dot}min{sup {minus}1}{center dot}100 g{sup {minus}1}, and cerebral metabolic rate was 1.94 {plus minus} 0.23 ml O{sub 2}{center dot}100 g{sup {minus}1}{center dot}min{sup {minus}1} during normothermia (39{degree}C). Reduction of rectal temperature to 34-35{degree}C decreased CBF and cerebral metabolic rate 40-50%. In another group of piglets, they examined responsiveness of the cerebral circulation to arterial hypercapnia during hypothermia. Although absolute values for normocapnic and hypercapnic CBF were reduced by hypothermia and absolute values for normocapnic and hypercapnic cerebrovascular resistance were increased, the percentage changes from control in these variables during hypercapnia were similar during normothermia and hypothermia. In another group of animals that were maintained normothermic and exposed to two episodes of hypercapnia, there was no attenuation of cerebrovascular dilation during the second episode. They conclude that hypothermia reduces CBF secondarily to a decrease in cerebral metabolic rate and that percent dilator responsiveness to arterial hypercapnia is unaltered when body temperature is reduced.

  15. Cerebral hemodynamics at altitude: effects of hyperventilation and acclimatization on cerebral blood flow and oxygenation.

    PubMed

    Sanborn, Matthew R; Edsell, Mark E; Kim, Meeri N; Mesquita, Rickson; Putt, Mary E; Imray, Chris; Yow, Heng; Wilson, Mark H; Yodh, Arjun G; Grocott, Mike; Martin, Daniel S

    2015-06-01

    Alterations in cerebral blood flow (CBF) and cerebral oxygenation are implicated in altitude-associated diseases. We assessed the dynamic changes in CBF and peripheral and cerebral oxygenation engendered by ascent to altitude with partial acclimatization and hyperventilation using a combination of near-infrared spectroscopy, transcranial Doppler ultrasound, and diffuse correlation spectroscopy. Peripheral (Spo2) and cerebral (Scto2) oxygenation, end-tidal carbon dioxide (ETCO2), and cerebral hemodynamics were studied in 12 subjects using transcranial Doppler and diffuse correlation spectroscopy (DCS) at 75 m and then 2 days and 7 days after ascending to 4559 m above sea level. After obtaining baseline measurements, subjects hyperventilated to reduce baseline ETCO2 by 50%, and a further set of measurements were obtained. Cerebral oxygenation and peripheral oxygenation showed a divergent response, with cerebral oxygenation decreasing at day 2 and decreasing further at day 7 at altitude, whereas peripheral oxygenation decreased on day 2 before partially rebounding on day 7. Cerebral oxygenation decreased after hyperventilation at sea level (Scto2 from 68.8% to 63.5%; P<.001), increased after hyperventilation after 2 days at altitude (Scto2 from 65.6% to 69.9%; P=.001), and did not change after hyperventilation after 7 days at altitude (Scto2 from 62.2% to 63.3%; P=.35). An intensification of the normal cerebral hypocapnic vasoconstrictive response occurred after partial acclimatization in the setting of divergent peripheral and cerebral oxygenation. This may help explain why hyperventilation fails to improve cerebral oxygenation after partial acclimatization as it does after initial ascent. The use of DCS is feasible at altitude and provides a direct measure of CBF indices with high temporal resolution. Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  16. Imaging of Cerebral Blood Flow in Patients with Severe Traumatic Brain Injury in the Neurointensive Care

    PubMed Central

    Rostami, Elham; Engquist, Henrik; Enblad, Per

    2014-01-01

    Ischemia is a common and deleterious secondary injury following traumatic brain injury (TBI). A great challenge for the treatment of TBI patients in the neurointensive care unit (NICU) is to detect early signs of ischemia in order to prevent further advancement and deterioration of the brain tissue. Today, several imaging techniques are available to monitor cerebral blood flow (CBF) in the injured brain such as positron emission tomography (PET), single-photon emission computed tomography, xenon computed tomography (Xenon-CT), perfusion-weighted magnetic resonance imaging (MRI), and CT perfusion scan. An ideal imaging technique would enable continuous non-invasive measurement of blood flow and metabolism across the whole brain. Unfortunately, no current imaging method meets all these criteria. These techniques offer snapshots of the CBF. MRI may also provide some information about the metabolic state of the brain. PET provides images with high resolution and quantitative measurements of CBF and metabolism; however, it is a complex and costly method limited to few TBI centers. All of these methods except mobile Xenon-CT require transfer of TBI patients to the radiological department. Mobile Xenon-CT emerges as a feasible technique to monitor CBF in the NICU, with lower risk of adverse effects. Promising results have been demonstrated with Xenon-CT in predicting outcome in TBI patients. This review covers available imaging methods used to monitor CBF in patients with severe TBI. PMID:25071702

  17. Dynamic analysis of blood pressure changes in progressive cerebral infarction.

    PubMed

    Zhao, Manli; Zhang, Lunzhong; Wang, Zeying; Wang, Xianglei; Wang, Yuyong; Wei, Hongyu; Li, Ruihua; Du, Yifeng

    2015-07-01

    Progressive cerebral infarction is one of the leading causes of high disability and lethality for stroke patients. However, the association between progression of BP changes and cerebral infarction is not currently well understood. We analyzed the dynamic changes in the BP of patients with acute ischemic stroke and explored the correlation between BP change and cerebral infarction progression. 30.9% (30/97) of the patients investigated developed to progressive cerebral infarction 17-141 h after admission. The percentage of patients with a long history of hypertension was significantly higher in the progressive group than in the non-progressive group. The mean systolic BP of the patients 16 h to 5 d after admission was also much higher in the progressive group. A greater abnormality of circadian blood pressure was also observed among patients in the progressive group. Hypertension history of more than 5 years is an important risk factor for progressive cerebral infarction. Both the elevation of systolic blood pressure 16 h to 5 d after admission and abnormal circadian blood pressure are associated with the disease progression. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Multiscale modeling of blood flow in cerebral malaria

    NASA Astrophysics Data System (ADS)

    Fedosov, Dmitry; Caswell, Bruce; Karniadakis, George

    2009-11-01

    The main characteristics of the malaria disease are progressing changes in red blood cell (RBC) mechanical properties and geometry, and its cytoadhesion to the vascular endothelium. Malaria-infected RBCs become considerably stiff compared to healthy ones, and may bind to the vascular endothelium of arterioles and venules. This leads to a significant reduction of blood flow, and eventual vessel obstruction. Due to a non-trivial malaria-infected RBC adhesive dynamics and obstruction formations the blood flow in cerebral malaria is extremely complex. Here, we employ multiscale modeling to couple nanometer scales at the binding level, micrometer scales at the cell level and millimeter scales at the arteriole level. Blood flow in cerebral malaria is modeled using a coarse-grained RBC model developed in our group. The RBC adhesion is simulated based on the stochastic bond formation/breakage model, which is validated against recent experiments.

  19. Cerebral oxygen metabolism and blood flow in human cerebral ischemic infarction

    SciTech Connect

    Lenzi, G.L.; Frackowiak, R.S.; Jones, T.

    1982-09-01

    Fifteen patients with acute cerebral hemispheric infarcts have been studied with positron emission tomography and the /sup 15/O steady-state inhalation technique. Thirteen follow-up studies were also performed. The values of cerebral oxygen metabolism (CMRO/sub 2/), cerebral blood flow (CBF), and oxygen extraction ration (OER) have been calculated for the infarcted regions, their borders, the symmetrical regions in contralateral cerebral hemispheres, and the cerebellar hemispheres. This study demonstrates that in the completed stroke there are thresholds for regional CMRO/sub 2/ and regional CBF below which the general clinical outcome of the patients is usually poor. The ischaemic lesions invariably produce an uncoupling between the greatly decreased metabolic demand and the less affected blood supply, with very frequent instances of relative hyperperfusion. Remote effects of the hemispheric infarcts have been demonstrated, such as crossed cerebellar diaschisis and contralateral transhemispheric depression. The level of consciousness correlates with oxygen uptake and blood flow both in the posterior fossa and in the contralateral cerebral hemispheres. The follow-up studies of individual patients underline the high variability of metabolism-to-flow balance during the acute phase of the illness, and stress the need for more studies focused on repeated assessments of homogeneous patient populations.

  20. Ozone Therapy on Cerebral Blood Flow: A Preliminary Report.

    PubMed

    Clavo, Bernardino; Catalá, Luis; Pérez, Juan L; Rodríguez, Victor; Robaina, Francisco

    2004-12-01

    Ozone therapy is currently being used in the treatment of ischemic disorders, but the underlying mechanisms that result in successful treatment are not well known. This study assesses the effect of ozone therapy on the blood flow in the middle cerebral and common carotid arteries. Seven subjects were recruited for the therapy that was performed by transfusing ozone-enriched autologous blood on 3 alternate days over 1 week. Blood flow quantification in the common carotid artery (n = 14) was performed using color Doppler. Systolic and diastolic velocities in the middle cerebral artery (n = 14) were estimated using transcranial Doppler. Ultrasound assessments were conducted at the following three time points: 1) basal (before ozone therapy), 2) after session #3 and 3) 1 week after session #3. The common carotid blood flow had increased by 75% in relation to the baseline after session #3 (P < 0.001) and by 29% 1 week later (P = 0.039). In the middle cerebral artery, the systolic velocity had increased by 22% after session #3 (P = 0.001) and by 15% 1 week later (P = 0.035), whereas the diastolic velocity had increased by 33% after session #3 (P < 0.001) and by 18% 1 week later (P = 0.023). This preliminary Doppler study supports the clinical experience of achieving improvement by using ozone therapy in peripheral ischemic syndromes. Its potential use as a complementary treatment in cerebral low perfusion syndromes merits further clinical evaluation.

  1. Ozone Therapy on Cerebral Blood Flow: A Preliminary Report

    PubMed Central

    2004-01-01

    Ozone therapy is currently being used in the treatment of ischemic disorders, but the underlying mechanisms that result in successful treatment are not well known. This study assesses the effect of ozone therapy on the blood flow in the middle cerebral and common carotid arteries. Seven subjects were recruited for the therapy that was performed by transfusing ozone-enriched autologous blood on 3 alternate days over 1 week. Blood flow quantification in the common carotid artery (n = 14) was performed using color Doppler. Systolic and diastolic velocities in the middle cerebral artery (n = 14) were estimated using transcranial Doppler. Ultrasound assessments were conducted at the following three time points: 1) basal (before ozone therapy), 2) after session #3 and 3) 1 week after session #3. The common carotid blood flow had increased by 75% in relation to the baseline after session #3 (P < 0.001) and by 29% 1 week later (P = 0.039). In the middle cerebral artery, the systolic velocity had increased by 22% after session #3 (P = 0.001) and by 15% 1 week later (P = 0.035), whereas the diastolic velocity had increased by 33% after session #3 (P < 0.001) and by 18% 1 week later (P = 0.023). This preliminary Doppler study supports the clinical experience of achieving improvement by using ozone therapy in peripheral ischemic syndromes. Its potential use as a complementary treatment in cerebral low perfusion syndromes merits further clinical evaluation. PMID:15841265

  2. Longitudinal Cerebral Blood Flow Changes during Speech in Hereditary Ataxia

    ERIC Educational Resources Information Center

    Sidtis, John J.; Strother, Stephen C.; Naoum, Ansam; Rottenberg, David A.; Gomez, Christopher

    2010-01-01

    The hereditary ataxias constitute a group of degenerative diseases that progress over years or decades. With principal pathology involving the cerebellum, dysarthria is an early feature of many of the ataxias. Positron emission tomography was used to study regional cerebral blood flow changes during speech production over a 21 month period in a…

  3. Longitudinal Cerebral Blood Flow Changes during Speech in Hereditary Ataxia

    ERIC Educational Resources Information Center

    Sidtis, John J.; Strother, Stephen C.; Naoum, Ansam; Rottenberg, David A.; Gomez, Christopher

    2010-01-01

    The hereditary ataxias constitute a group of degenerative diseases that progress over years or decades. With principal pathology involving the cerebellum, dysarthria is an early feature of many of the ataxias. Positron emission tomography was used to study regional cerebral blood flow changes during speech production over a 21 month period in a…

  4. Stable xenon CT blood flow mapping for evaluation of patients with extracranial-intracranial bypass surgery

    SciTech Connect

    Yonas, H.; Gur, D.; Good, B.C.; Latchaw, R.E.; Wolfson, S.K. Jr.; Good, W.F.; Maitz, G.S.; Colsher, J.G.; Barnes, J.E.; Colliander, K.G.

    1985-03-01

    Xenon computerized tomography (Xe CT) blood flow studies were conducted in 25 patients referred for a possible extracranial-intracranial bypass procedure for occlusive vascular disease in one or more extra- or intracranial vessels. These studies were helpful in selecting eight candidates for surgery. The Xe CT studies were performed at one or two brain levels using a prototype Xe CT system for measurement of cerebral blood flow which was designed in collaboration with the General Electric Co., and adapted for the GE 9800 scanner. In those patients selected to undergo operation, Xe CT demonstrated compromise of flow reserve regionally, globally, and/or in the watershed area. All eight patients who underwent the procedure showed a favorable clinical response postoperatively, and seven had a dramatic increase in flow. The 17 patients whose baseline CT studies showed no reduction of flow with the Xe CT method were not selected for surgery. All 25 patients have remained neurologically stable to date. Case studies of three of the eight patients undergoing bypass surgery are presented. This limited but consistent experience suggests that Xe CT blood flow mapping makes possible the recognition of brain regions in which flow reserves are compromised. This is due to the relatively high degree of spatial resolution that this technique provides and to the fact that mapping can be correlated directly with the anatomy. Used in combination with a careful clinical examination and an accurate medical history, this study method appears to be a useful guide in the selection of patients who are most at risk from hemodynamic instability and those who are most likely to benefit from flow-augmentation surgery.

  5. Comparable Cerebral Blood Flow in Both Hemispheres During Regional Cerebral Perfusion in Infant Aortic Arch Surgery.

    PubMed

    Rüffer, André; Tischer, Philip; Münch, Frank; Purbojo, Ariawan; Toka, Okan; Rascher, Wolfgang; Cesnjevar, Robert Anton; Jüngert, Jörg

    2017-01-01

    Cerebral protection during aortic arch repair can be provided by regional cerebral perfusion (RCP) through the innominate artery. This study addresses the question of an adequate bilateral blood flow in both hemispheres during RCP. Fourteen infants (median age 11 days [range, 3 to 108]; median weight, 3.6 kg [range, 2.8 to 6.0 kg]) undergoing RCP (flow rate 54 to 60 mL · kg(-1) · min(-1)) were prospectively included. Using combined transfontanellar/transtemporal two- and three-dimensional power/color Doppler sonography, cerebral blood flow intensity in the main cerebral vessels was displayed. Mean time average velocities were measured with combined pulse-wave Doppler in the basilar artery, and both sides of the internal carotid, anterior, and medial cerebral arteries. In addition, bifrontal regional cerebral oximetry (rSO2) was assessed. Comparing both hemispheres, measurements were performed at target temperature (28°C) during full-flow total body perfusion (TBP) and RCP. A regular circle of Willis with near-symmetric blood flow intensity to both hemispheres was visualized in all infants during both RCP and TBP. In the left internal carotid artery, blood flow direction was mixed (retrograde, n = 5; antegrade, n = 8) during TBP and retrograde during RCP. Comparison between sides showed comparable cerebral time average velocities and rSO2, except for higher time average velocities in the right internal carotid artery (TBP p = 0.019, RCP p = 0.09). Unilateral comparison between perfusion methods revealed significantly higher rSO2 in the right hemisphere during TBP (82% ± 9%) compared with RCP (74% ± 11%, p = 0.036). Bilateral assessment of cerebral rSO2 and time average velocity in the main great cerebral vessels suggests that RCP is associated with near-symmetric blood flow intensity to both hemispheres. Further neurodevelopmental studies are necessary to verify RCP for neuroprotection during aortic arch repair. Copyright © 2017 The Society of Thoracic

  6. Comparison of Cerebral Oxygen Saturation and Cerebral Perfusion Computed Tomography in Cerebral Blood Flow in Patients with Brain Injury.

    PubMed

    Trofimov, Alexey O; Kalentiev, George; Voennov, Oleg; Grigoryeva, Vera

    2016-01-01

    The purpose of this study was to determine the relationship between cerebral tissue oxygen saturation and cerebral blood volume in patients with traumatic brain injury. Perfusion computed tomography of the brain was performed in 25 patients with traumatic brain injury together with simultaneous SctO2 level measurement using cerebral near-infrared oxymetry. The mean age of the injured persons was 34.5±15.6 years (range 15-65); 14 men, 11 women. The Injury Severity Score (ISS) values were 44.4±9.7 (range 25-81). The Glasgow Coma Score (GCS) mean value before the study was 10.6±2.1 (range 5-13). SctO2 ranged from 51 to 89%, mean 62±8.2%. Cerebral blood volume (CBV) values were 2.1±0.67 ml/100 g (min 1.1; max 4.3 ml/100 g). Cerebral blood flow (CBF) was 31.99±13.6 ml/100 g×min. Mean transit time (MTT) values were 5.7±4.5 s (min 2.8; max 34.3 s). The time to peak (TTP) was 22.2±3.1 s. A statistically significant correlation was found between SctO2 level and cerebral blood volume (CBV) level (R=0.9; p<0.000001). No other significant correlations were found between brain tissue oxygenation and other parameters of brain perfusion.

  7. A computational model of rat cerebral blood flow using non-uniform rational B-splines.

    PubMed

    Pushkin, Sergey V; Podoprigora, Guennady I; Comas, Laurent; Boulahdour, Hatem; Cardot, Jean-Claude; Baud, Michel; Nartsissov, Yaroslav R; Blagosklonov, Oleg

    2007-01-01

    Non-Uniform Rational B-splines (NURBS) surfaces can be used for a computer simulation of shapes. Some anatomical models of human or animal structures have been recently developed on that basis. We used positron-emission tomography (PET) and computed tomography (CT) data for NURBS modeling of anatomical structures and isotope uptake in the rat brain. Our simplified model of the rat cerebral blood flow is the first step in a larger project aiming a simulation of PET scans in small animals followed by its validation in vivo.

  8. Pantothenate kinase-associated neurodegeneration with increased lentiform nuclei cerebral blood flow.

    PubMed

    Koyama, M; Yagishita, A

    2006-01-01

    We report a case of pantothenate kinase-associated neurodegeneration with increased regional cerebral blood flow (rCBF) in bilateral lentiform nuclei on technetium Tc-99m ethyl cysteinate dimer single-photon emission CT (ECD-SPECT). A 6-year-old boy presented with opisthotonus. T2*-weighted MR images revealed areas of marked hypointensity with a hyperintense focus in bilateral globus pallidus, creating the characteristic eye-of-the-tiger appearance. ECD-SPECT showed increased rCBF in bilateral lentiform nuclei.

  9. Cerebral infarction on 99mTc-MDP SPECT/CT imaging.

    PubMed

    Guo, Jia; Hu, Shuang; Wang, Haitao; Kuang, Anren

    2013-11-01

    A 70-year-old man with lung cancer underwent whole-body MDP bone scintigraphy to evaluate bone metastases that showed marked tracer uptake in the right side of the head, suggestive of skull metastasis. SPECT/CT imaging was performed for further evaluation. The SPECT images demonstrated increased MDP activity in the region of the brain perfused by the right middle cerebral artery. On CT images, there was a large hypoattenuation area corresponding to elevated MDP accumulation. At the same day, magnetic resonance angiography of the brain revealed occlusion of the right middle cerebral artery.

  10. [Assessment of maternal cerebral blood flow in patients with preeclampsia].

    PubMed

    Mandić, Vesna; Miković, Zeljko; Dukić, Milan; Vasiljević, Mladenko; Filimonović, Dejan; Bogavac, Mirjana

    2005-01-01

    Systemic vasoconstriction in preeclamptic patients increases vascular resistance, and is manifested by increased arterial blood flow velocity. The aim of the study is to evaluate if there is a change of Doppler indices in maternal medial cerbral artery (MCA) in severe preeclampsia due to: 1) severity of clinical symptoms, 2) the begining of eclamptic attack and 3) the application of anticonvulsive therapy. A prospective clinical study included 92 pregnant women, gestational age 28-36 weeks. They were divided into three groups: normotensive (n=30), mild preeclampsia (n=33), and severe preeclampsia (n=29). We investigated maternal cerebral circulation by assessing the MCA. We registrated: pulsatility index (Pi), resistance index (Ri), systolic/diastolic ratio (S/D), and the maximum systolic, end diastolic and medium velocity. Patients with severe preeclampsia were divided into two subgroups. subgroup 1 included patients without symptoms of threatening eclampsia (n=18; 62.06%); while subgroup 2 included those with symptoms of preeclampsia (n=11; 37.94%). All patients with severe preeclampsia were treated with magnesium sulfate (MgSO4), and cerebral blood flow was measured before and after the treatment. Statistical analysis was done by oneway ANOVA, Student t-test and t-paired sample test. The difference was considered to be significant if p<0.05. Significantly increased Pi, Ri and all velocities were established in the group of patients with severe preeclampsia compared with the other two groups. In the group with severe preeclamsia we registrated significantly increased values of all velocities (patients with signs of threatening eclampsia). After MgSO4 treatment in patients with severe preeclampsia significantly decreased values of Pi, Ri, S/D ratio and all velocities were registered. In the studied group of patients with severe preclampsia we found increased velocity values, Pi and Ri, especially in patients with signs of threatened eclampsia, suggesting that

  11. Cerebral Toxoplasmosis Masquerading Cns Lymphoma on FDG PET-CT in Post Renal Transplant Patient.

    PubMed

    Mukherjee, Anirban; Bal, Chandrasekhar; Tripathi, Madhavi; Das, Chandan Jyoti; Shamim, Shamim Ahmed

    2017-01-01

    20 year old post renal transplant patient developed recurrent episodes of seizure. MRI revealed focal lesion in right parieto-occipital lobe with perilesional edema. FDG PET-CT revealed multiple hypermetabolic lesions in bilateral cerebral hemisphere. Subsequent biopsy from the lesion demonstrated bradyzoites of Toxoplasma gondii with inflammatory cells and thereby, a confirmatory diagnosis of cerebral toxoplasmosis was made. This case demonstrates the fact that increased FDG uptake in cerebral lesions in post transplant patient should be interpreted with caution and confirmed with histopathological correlation.

  12. Cerebral Toxoplasmosis Masquerading Cns Lymphoma on FDG PET-CT in Post Renal Transplant Patient

    PubMed Central

    Mukherjee, Anirban; Bal, Chandrasekhar; Tripathi, Madhavi; Das, Chandan Jyoti; Shamim, Shamim Ahmed

    2017-01-01

    20 year old post renal transplant patient developed recurrent episodes of seizure. MRI revealed focal lesion in right parieto-occipital lobe with perilesional edema. FDG PET-CT revealed multiple hypermetabolic lesions in bilateral cerebral hemisphere. Subsequent biopsy from the lesion demonstrated bradyzoites of Toxoplasma gondii with inflammatory cells and thereby, a confirmatory diagnosis of cerebral toxoplasmosis was made. This case demonstrates the fact that increased FDG uptake in cerebral lesions in post transplant patient should be interpreted with caution and confirmed with histopathological correlation. PMID:28533649

  13. Cerebral blood flow response pattern during balloon test occlusion of the internal carotid artery

    SciTech Connect

    Witt, J.P.; Yonas, H.; Jungreis, C.

    1994-05-01

    To evaluate the risk of temporary or permanent internal carotid artery occlusion. In 156 patients intraarterial balloon test occlusion in combination with a stable xenon-enhanced CT cerebral blood flow study was performed before radiologic or surgical treatment. All 156 patients passed the clinical balloon test occlusion and underwent a xenon study in combination with a second balloon test. Quantitative flow data were analyzed for absolute changes as well as changes in symmetry. Fourteen patients exhibited reduced flow values between 20 and 30 mL/100 g per minute, an absolute decrease in flow, and significant asymmetry in the middle cerebral artery territory during balloon test occlusion. These patients would be considered at high risk for cerebral infarction if internal carotid artery occlusion were to be performed. With one exception they belonged to a group (class I) of 61 patients who showed bilateral or ipsilateral flow decrease and significant asymmetry with lower flow on the side of occlusion. The other 95 patients, who showed a variety of cerebral blood flow response patterns including ipsilateral or bilateral flow increase, were at moderate (class II) or low (class III) stroke risk. In contrast to these findings, exclusively qualitative flow analysis failed to identify the patients at high risk: a threshold with an asymmetry index of 10% revealed only 16% specificity whereas an asymmetry index of 45% showed only 61% sensitivity for detection of low flow areas (<30 mL/100 g per minute). For achieving a minimal hemodynamic related-stroke rate associated with permanent clinical internal carotid artery occlusion we suggest integration of a thorough analysis of quantitative cerebral blood flow data before and during balloon test occlusion. 68 refs., 5 figs., 2 tabs.

  14. Cerebral blood flow links insulin resistance and baroreflex sensitivity.

    PubMed

    Ryan, John P; Sheu, Lei K; Verstynen, Timothy D; Onyewuenyi, Ikechukwu C; Gianaros, Peter J

    2013-01-01

    Insulin resistance confers risk for diabetes mellitus and associates with a reduced capacity of the arterial baroreflex to regulate blood pressure. Importantly, several brain regions that comprise the central autonomic network, which controls the baroreflex, are also sensitive to the neuromodulatory effects of insulin. However, it is unknown whether peripheral insulin resistance relates to activity within central autonomic network regions, which may in turn relate to reduced baroreflex regulation. Accordingly, we tested whether resting cerebral blood flow within central autonomic regions statistically mediated the relationship between insulin resistance and an indirect indicator of baroreflex regulation; namely, baroreflex sensitivity. Subjects were 92 community-dwelling adults free of confounding medical illnesses (48 men, 30-50 years old) who completed protocols to assess fasting insulin and glucose levels, resting baroreflex sensitivity, and resting cerebral blood flow. Baroreflex sensitivity was quantified by measuring the magnitude of spontaneous and sequential associations between beat-by-beat systolic blood pressure and heart rate changes. Individuals with greater insulin resistance, as measured by the homeostatic model assessment, exhibited reduced baroreflex sensitivity (b = -0.16, p < .05). Moreover, the relationship between insulin resistance and baroreflex sensitivity was statistically mediated by cerebral blood flow in central autonomic regions, including the insula and cingulate cortex (mediation coefficients < -0.06, p-values < .01). Activity within the central autonomic network may link insulin resistance to reduced baroreflex sensitivity. Our observations may help to characterize the neural pathways by which insulin resistance, and possibly diabetes mellitus, relates to adverse cardiovascular outcomes.

  15. Cerebral Blood Flow Links Insulin Resistance and Baroreflex Sensitivity

    PubMed Central

    Ryan, John P.; Sheu, Lei K.; Verstynen, Timothy D.; Onyewuenyi, Ikechukwu C.; Gianaros, Peter J.

    2013-01-01

    Insulin resistance confers risk for diabetes mellitus and associates with a reduced capacity of the arterial baroreflex to regulate blood pressure. Importantly, several brain regions that comprise the central autonomic network, which controls the baroreflex, are also sensitive to the neuromodulatory effects of insulin. However, it is unknown whether peripheral insulin resistance relates to activity within central autonomic network regions, which may in turn relate to reduced baroreflex regulation. Accordingly, we tested whether resting cerebral blood flow within central autonomic regions statistically mediated the relationship between insulin resistance and an indirect indicator of baroreflex regulation; namely, baroreflex sensitivity. Subjects were 92 community-dwelling adults free of confounding medical illnesses (48 men, 30-50 years old) who completed protocols to assess fasting insulin and glucose levels, resting baroreflex sensitivity, and resting cerebral blood flow. Baroreflex sensitivity was quantified by measuring the magnitude of spontaneous and sequential associations between beat-by-beat systolic blood pressure and heart rate changes. Individuals with greater insulin resistance, as measured by the homeostatic model assessment, exhibited reduced baroreflex sensitivity (b = -0.16, p < .05). Moreover, the relationship between insulin resistance and baroreflex sensitivity was statistically mediated by cerebral blood flow in central autonomic regions, including the insula and cingulate cortex (mediation coefficients < -0.06, p-values < .01). Activity within the central autonomic network may link insulin resistance to reduced baroreflex sensitivity. Our observations may help to characterize the neural pathways by which insulin resistance, and possibly diabetes mellitus, relates to adverse cardiovascular outcomes. PMID:24358272

  16. Effects of midazolam on cerebral blood flow in human volunteers

    SciTech Connect

    Forster, A.; Juge, O.; Morel, D.

    1982-06-01

    The effects of intravenously administered midazolam on cerebral blood flow were evaluated in eight healthy volunteers using the /sup 133/Xe inhalation technique. Six minutes after an intravenous dose of 0.15 mg/kg midazolam, the cerebral blood flow decreased significantly (P less than 0.001) from a value of 40.6 +/- 3.3 to a value of 27.0 +/- 5.0 ml . 100 g-1 . min-1. Cerebrovascular resistance (CVR) increased from 2.8 +/- 0.2 to 3.9 to 0.6 mmHg/(ml . 100 g-1 . min-1)(P less than 0.001). Mean arterial blood pressure decreased significantly (P less than 0.05) from 117 +/- 8 to 109 +/- 9 mmHg and arterial carbon dioxide tension increased from 33.9 +/- 2.3 to 38.6 +/- 3.2 mmHg (P less than 0.05). Arterial oxygen tension remained stable throughout the study, 484 +/- 95 mmHg before the administration of midazolam and 453 +/- 76 mmHg after. All the subjects slept after the injection of the drug and had anterograde amnesia of 24.5 +/- 5 min. The decrease in mean arterial blood pressure was probably not important since it remained in the physiologic range for cerebral blood flow autoregulation. The increase in arterial carbon dioxide tension observed after the midazolam injection may have partially counteracted the effect of this new benzodiazepine on cerebral blood flow. Our data suggest that midazolam might be a safe agent to use for the induction of anethesia in neurosurgical patients with intracranial hypertension.

  17. Cerebral blood flow asymmetries in headache-free migraineurs

    SciTech Connect

    Levine, S.R.; Welch, K.M.; Ewing, J.R.; Joseph, R.; D'Andrea, G.

    1987-11-01

    Regional cerebral blood flow (rCBF) asymmetries were studied in controls and patients with common and classic/complicated migraine using /sup 133/Xe inhalation with 8 homologously situated external collimators over each cerebral hemisphere. Migraine patients as a group more frequently had posterior rCBF asymmetries than controls (p less than 0.03). Although there were no differences in the number of anterior rCBF asymmetries, migraine patients had 2 or more asymmetric probe pairs more often than controls (p less than 0.02). The posterior rCBF asymmetries, consistent with the site of activation of many migraine attacks, may be related to more labile control of the cerebral circulation.

  18. Cerebral blood flow during paroxysmal EEG activation induced by sleep in patients with complex partial seizures

    SciTech Connect

    Gozukirmizi, E.; Meyer, J.S.; Okabe, T.; Amano, T.; Mortel, K.; Karacan, I.

    1982-01-01

    Cerebral blood flow (CBF) measurements were combined with sleep polysomnography in nine patients with complex partial seizures. Two methods were used: the 133Xe method for measuring regional (rCBF) and the stable xenon CT method for local (LCBF). Compared to nonepileptic subjects, who show diffuse CBF decreases during stages I-II, non-REM sleep onset, patients with complex partial seizures show statistically significant increases in CBF which are maximal in regions where the EEG focus is localized and are predominantly seen in one temporal region but are also propagated to other cerebral areas. Both CBF methods gave comparable results, but greater statistical significance was achieved by stable xenon CT methodology. CBF increases are more diffuse than predicted by EEG paroxysmal activity recorded from scalp electrodes. An advantage of the 133Xe inhalation method was achievement of reliable data despite movement of the head. This was attributed to the use of a helmet which maintained the probes approximated to the scalp. Disadvantages were poor resolution (7 cm3) and two-dimensional information. The advantage of stable xenon CT method is excellent resolution (80 mm3) in three dimensions, but a disadvantage is that movement of the head in patients with seizure disorders may limit satisfactory measurements.

  19. Computed tomographic measurement of the xenon brain-blood partition coefficient and implications for regional cerebral blood flow: a preliminary report.

    PubMed

    Kelcz, F; Hilal, S K; Hartwell, P; Joseph, P M

    1978-05-01

    The calculation of regional cerebral blood flow requires, in addition to the measurement of the clearance, a knowledge of the regional brain-blood partition coefficient. The usual 133Xe washout techniques do not measure this latter parameter but use published values for normal brain tissue. This may lead to large errors in pathological tissue because the partition coefficient changes significantly in brain tumors. Investigations have begun into the use of CT and stable xenon to produce a cross sectional view of the brain in terms of its brain-blood partition coefficients. Results of experiments using an iodine phantom and xenon inhalation in animals are presented.

  20. Cerebral Toxoplasmosis in a Patient with AIDS on F-18 FDG PET/CT.

    PubMed

    Kim, Hae Won; Won, Kyoung Sook; Choi, Byung Wook; Zeon, Seok Kil

    2010-04-01

    The distinction between primary central nervous system (CNS) lymphoma and nonmalignant lesions due to opportunistic infections, in particular cerebral toxoplasmosis, is important because of the different treatments involved. A 32-year-old patient with AIDS was hospitalized for intermittent headaches. Brain magnetic resonance imaging (MRI) showed a small well-enhanced nodular lesion in the right frontal lobe. A fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET)/computed tomography (CT) scan showed moderate FDG uptake in the nodular lesion of the right frontal lobe. We present a case of cerebral toxoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS) and the usefulness of F-18 FDG PET/CT in the differential diagnosis of the cerebral toxoplasmosis will be discussed.

  1. Cerebral blood oxygenation measurements in neonates with optoacoustic technique

    NASA Astrophysics Data System (ADS)

    Herrmann, Stephen; Petrov, Irene Y.; Petrov, Yuriy; Richardson, C. Joan; Fonseca, Rafael A.; Prough, Donald S.; Esenaliev, Rinat O.

    2017-03-01

    Cerebral hypoxia is a major contributor to neonatal/infant mortality and morbidity including severe neurological complications such as mental retardation, cerebral palsy, motor impairment, and epilepsy. Currently, no technology is capable of accurate monitoring of neonatal cerebral oxygenation. We proposed to use optoacoustics for this application by probing the superior sagittal sinus (SSS), a large central cerebral vein. We developed and built a multi-wavelength, optical parametric oscillator (OPO) and laser diode optoacoustic systems for measurement of SSS blood oxygenation in the reflection mode through open anterior or posterior fontanelles and in the transmission mode through the skull in the occipital area. In this paper we present results of initial tests of the laser diode system for neonatal cerebral oxygenation measurements. First, the system was tested in phantoms simulating neonatal SSS. Then, using the data obtained in the phantoms, we optimized the system's hardware and software and tested it in neonates admitted in the Neonatal Intensive Care Unit. The laser diode system was capable of detecting SSS signals in the reflection mode through the open anterior and posterior fontanelles as well as in the transmission mode through the skull with high signal-to-noise ratio. Using the signals measured at different wavelengths and algorithms developed for oxygenation measurements, the laser diode system provided real-time, continuous oxygenation monitoring with high precision at all these locations.

  2. Cerebral blood flow autoregulation during intracranial hypertension in hypoxic lambs

    SciTech Connect

    Borel, C.O.; Backofen, J.E.; Koehler, R.C.; Jones, M.D. Jr.; Traystman, R.J. )

    1987-12-01

    The authors tested the hypothesis that hypoxic hypoxia interferes with cerebral blood flow (CBF) autoregulation when intracranial pressure (ICP) is elevated in pentobarbital-anesthetized lambs (3 to 9 days old). Cerebral perfusion pressure (CPP) was lowered stepwise from 73 to 23 mmHg in eight normoxic lambs and from 65 to 31 mmHg in eight other hypoxic lambs by ventricular infusion of artificial cerebrospinal fluid. In normoxic lambs, CBF measured by microspheres labeled with six different radioisotopes was not significantly changed over this range of CPP. In animals made hypoxic, base-line CBF was twice that of normoxic lambs. CBF was unchanged as CPP was reduced to 31 mmHg. Lower levels of CPP were not attained because a pressor response occurred with further elevations of ICP. No regional decrements in blood flow to cortical arterial watershed areas or to more caudal regions, such as cerebellum, brain stem, or thalamus, were detected with elevated ICP. Cerebral O{sub 2} uptake was similar in both groups and did not decrease when CPP was reduced. These results demonstrate that normoxic lambs have a considerable capacity for effective autoregulation of CBF when ICP is elevated. Moreover, cerebral vasodilation in response to a level of hypoxia approximating that normally seen prenatally does not abolish CBF autoregulation when ICP is elevated during the first postnatal week.

  3. CT detection of myocardial blood volume deficits: dual-energy CT compared with single-energy CT spectra.

    PubMed

    Arnoldi, Elisabeth; Lee, Yeong Shyan; Ruzsics, Balazs; Weininger, Markus; Spears, J Reid; Rowley, Christopher P; Chiaramida, Salvatore A; Costello, Philip; Reiser, Maximilian F; Schoepf, U Joseph

    2011-01-01

    The performance of dual-energy CT (DECT) for the detection of myocardial blood volume deficits has not systematically been compared with single-energy CT (SCT) spectra. We evaluated the accuracy for detection of myocardial blood volume deficits in DECT and SCT compared with 99m-Tc-Sestamibi-SPECT (single-photon emission CT) during rest and stress. 47 patients underwent rest/stress SPECT myocardial perfusion imaging and cardiac DECT on a dual-source CT scanner. The A- and B-tubes were operated with 140 kV and 80 kV/100 kV, respectively. DECT raw data were reconstructed by (1) only using high-energy (140 kV) CT spectra, (2) only using low-energy (80 kV/100 kV) CT spectra, (3) merging data (30% low- and 70% high-energy CT spectra), and (4) DECT-based iodine maps. Two independent, blinded observers analyzed all CT data according to each of the 4 reconstruction strategies for myocardial blood volume deficits. Specificity and positive predictive values were relatively similar between the 4 reconstruction strategies, with highest specificity (98%) of SCT datasets based on 140 kV for mixed perfusion deficits seen on SPECT. DECT iodine maps showed highest sensitivity, negative predictive value, and accuracy of 91%, 97%, and 93%, respectively, for mixed perfusion deficits. Analysis with receiver operating characteristics showed highest area under the curve values (0.84-0.93) with the use of DECT iodine maps in the detection of purely fixed and mixed perfusion deficits. DECT iodine maps show superior performance for the detection of fixed and mixed perfusion deficits compared with SCT spectra. Copyright © 2011 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  4. Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

    SciTech Connect

    Wagner, Marlies; Kyriakou, Yiannis; Mesnil de Rochemont, Richard du; Singer, Oliver C.; Berkefeld, Joachim

    2013-08-01

    PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy.

  5. Cerebral blood flow and metabolism associated with cerebral microbleeds in small vessel disease.

    PubMed

    Hashimoto, Tetsuya; Yokota, Chiaki; Koshino, Kazuhiro; Shimomura, Ryo; Hino, Tenyu; Moriguchi, Tetsuaki; Hori, Yuki; Uehara, Toshiyuki; Minematsu, Kazuo; Iida, Hidehiro; Toyoda, Kazunori

    2016-08-01

    Cerebral microbleeds (CMBs), probably reflecting microangiopathy, have not yet sufficiently been examined in association with cerebral blood flow (CBF) and metabolism. We investigated the relationships between CMBs, and CBF and metabolism in symptomatic small vessel disease. We enrolled 22 patients with symptomatic small vessel disease without severe stenosis (>50 %) in major cerebral arteries. Volumes of white matter lesions (WMLs) and number of CMBs were assessed on images of fluid-attenuated inversion recovery and gradient-echo T2*-weighted magnetic resonance imaging, respectively. Patients were divided into two groups according to the median number of CMBs (group I <5, n = 10; group II ≥5, n = 12). Parametric images of CBF, cerebral metabolic rate of oxygen (CMRO2), oxygen extraction fraction and cerebral blood volume were estimated using positron emission tomography and (15)O-labeled gases. The functional values in the cortex-subcortex, basal ganglia, and centrum semiovale were compared between the two groups. Volumes of WMLs of group II were larger than those of group I (median: 38.4; range: 25.1-91.5 mL vs. median: 11.3; range: 4.2-73.4 mL, p = 0.01). In the centrum semiovale, the mean CBF of group II was significantly lower than that of group I (12.6 ± 2.6 vs. 15.6 ± 3.3 mL/100 g/min, p = 0.04). In the other regions, there were no significant differences in either CBF or CMRO2 between the two groups. Our study indicated that increases in the number of CMBs with larger volumes of WMLs were associated with cerebral ischemia in the deep white matter in patients with symptomatic small vessel disease.

  6. Cerebral blood flow imaging with thallium-201 diethyldithiocarbamate SPECT

    SciTech Connect

    van Royen, E.A.; de Brune, J.F.H.; Hill, T.C.; Vyth, A.; Limburg, M.; Byse, B.L.; O'Leary, D.H.; de Jong, J.M.; Hijdra, A.; van der Schoot, J.B.

    1987-02-01

    Thallium-201 diethyldithiocarbamate ((/sup 201/TI)DDC) was studied in humans as an agent for cerebral blood flow imaging. Brain uptake proved to be complete 90 sec after injection with no appreciable washout or redistribution for hours. Intracarotid injection suggested an almost 100% extraction during the first passage. Whole-body distribution studies demonstrated a brain uptake of 4.3% of the dose compared with 0.9% for (/sup 201/TI)chloride. No differences were found in the distribution of (/sup 201/TI)DDC versus (/sup 201/TI)chloride in other organs. After the injection of 3 mCi /sup 201/TI, good quality single photon emission computed tomographic (SPECT) images of the brain were obtained with both a rotating gamma camera and a multidetector system. In ischemic brain disease, perfusion defects were easily demonstrated. We conclude that (/sup 201/TI)DDC is a suitable radiopharmaceutical for SPECT studies of cerebral blood flow.

  7. Regional cerebral blood flow and depersonalization after tetrahydrocannabinol administration.

    PubMed

    Mathew, R J; Wilson, W H; Chiu, N Y; Turkington, T G; Degrado, T R; Coleman, R E

    1999-07-01

    The aim of this study was to examine the relationship between depersonalization induced by tetrahydrocannabinol (THC), and regional brain activation. Cerebral blood flow (CBF) was measured by means of positron emission tomography (PET) in 59 normal right-handed volunteers before and following intravenous infusions of THC. After THC, CBF showed a global increase which was more marked in the right hemisphere, frontal lobes and anterior cingulate. Regression analyses showed positive correlations between the right frontal and anterior cingulate and depersonalization.

  8. [Effect of occlusal reconstruction on cerebral blood flow and cerebral oxygen saturation in patients with malocclusion].

    PubMed

    Lu, Xiao-Hui; Xie, Guang-Ping; Gu, Xin-Hua; Lu, Dong-Min

    2015-01-01

    To investigate the effect of occlusal reconstruction on blood flow velocity and cerebral oxygen saturation in patients with malocclusion. Thirty-three patients with malocclusion treated with occlusal reconstruction in Department of Stomatology, Medical School of Huzhou Normal College from Feb 2011 to Oct 2013 were enrolled in the study. The systolic peak flow velocity (vs), end-diastolic peak flow (vd) , mean peak flow velocity (vm) of middle cerebral artery and the oxygen saturation (rScO2) in the brain were detected at rest or chewing status by using transcranial Doppler color ultrasonography and near-infrared spectroscopy, respectively. In rest state, vm was significantly increased on 3 months after treatment, while vs and vd were significantly increased on 6 months after treatment and rScO2 were increased on 12 months after treatment (P<0.05). In chewing state, vs, vm, and rScO2 were increased on 3 months after treatment, and vd was increased on 6 months after treatment (P<0.05). Occlusal reconstruction can increase blood flow velocity of middle cerebral artery and cerebral oxygen saturation and improve oxygen supply of the brain in patients with malocclusion.

  9. Enhanced Cholinergic Activity Improves Cerebral Blood Flow during Orthostatic Stress

    PubMed Central

    Serrador, Jorge M.; Freeman, Roy

    2017-01-01

    Cerebral blood flow (CBF) and consequently orthostatic tolerance when upright depends on dilation of the cerebral vasculature in the face of reduced perfusion pressure associated with the hydrostatic gradient. However, it is still unclear if cholinergic activation plays a role in this dilation. To determine if enhancing central cholinergic activity with the centrally acting acetylcholinesterase inhibitor, physostigmine would increase CBF when upright compared to the peripherally acting acetylcholinesterase inhibitor, neostigmine, or saline. We performed a randomized double-blind dose-ranging study that took place over 3 days in a hospital-based research lab. Eight healthy controls (six women and two men, mean age, 26 years; range 21–33) were given infusions of physostigmine, neostigmine, or saline on three different days. Five-minute tilts were repeated at baseline (no infusion), Dose 1 (0.2 μg/kg/min physostigmine; 0.1 μg/kg/min neostigmine) and Dose 2 (0.6 μg/kg/min physostigmine or 0.3 μg/kg/min neostigmine), and placebo (0.9% NaCl). Cerebral blood velocity, beat-to-beat blood pressure, and end-tidal CO2 were continuously measured during tilts. Physostigmine (0.6 μg/kg/min) resulted in higher cerebral blood velocity during tilt (90.5 ± 1.5%) than the equivalent neostigmine (85.5 ± 2.6%) or saline (84.8 ± 1.7%) trials (P < 0.05). This increase occurred despite a greater postural hypocapnia, suggesting physostigmine had a direct vasodilatory effect on the cerebral vasculature. Cerebral hypoperfusion induced by repeated tilts was eliminated by infusion of physostigmine not neostigmine. In conclusion, this study provides the first evidence that enhancement of central, not peripheral, cholinergic activity attenuates the physiological decrease in CBF seen during upright tilt. These data support the need for further research to determine if enhancing central cholinergic activity may improve symptoms in patients with symptomatic

  10. [Blood gas analytical study on cerebral circulation under the influence of dihydroergotoxin (author's transl)].

    PubMed

    Liesegang, J; Bock, W J; Seibert, H; Schumacher, W

    1976-01-01

    The demand for sufficient blood supply and oxygenation of cerebral tissue after brain surgery or severe head injuries requires the clinical investigation of drugs which are supposed to improve cerebral blood flow and metabolism. We have therefore used the hydrogenated derivatives of the ergotoxin components of the secale alcaloids in the post-operative and posttraumatic period of neurosurgical patients, respectively, and studied their effect on cerebral metabolism by successive analysis of blood gases in the arterial and venous blood. A significant increase of cerebral venous CO2-concentration following the administration of dihydroergotoxin in these patients in all probability is attributable to an improved O2-utilisation in the cerebral tissue.

  11. Effects on regional cerebral blood flow of transcendental meditation.

    PubMed

    Jevning, R; Anand, R; Biedebach, M; Fernando, G

    1996-03-01

    Previous blood flow measurements in this laboratory have indicated increased nonrenal nonhepatic blood flow during behaviorally induced rest states, especially during the stylized mental technique of transcendental meditation (TM). We have hypothesized that increased cerebral blood flow (CBF) may account for most of the increased nonrenal nonhepatic blood flow during TM. In this report we describe increased frontal and occipital CBF in TM determined by the electrical impedance plethysmographic methodology known as rheoencephalography (REG), which allows noninvasive, nondisturbing, continuous CBF monitoring. We also report high correlation between increased CBF and decreased cerebrovascular resistance (CVR) during TM, suggesting that a contributing vascular mechanism to the increased CBF may be decreased CVR. Because only a small amount of stage 1 sleep was observed during TM and because stage 1 sleep has been reported to be accompanied by decreased CBF, we believe that sleep did not contribute to the CBF increase. The data of this study are consistent with the hypothesis that blood flow changes during TM comprise a patterned response subserving needs of increased cerebral activity.

  12. Spectral indices of human cerebral blood flow control: responses to augmented blood pressure oscillations.

    PubMed

    Hamner, J W; Cohen, Michael A; Mukai, Seiji; Lipsitz, Lewis A; Taylor, J Andrew

    2004-09-15

    We set out to fully examine the frequency domain relationship between arterial pressure and cerebral blood flow. Oscillatory lower body negative pressure (OLBNP) was used to create consistent blood pressure oscillations of varying frequency and amplitude to rigorously test for a frequency- and/or amplitude-dependent relationship between arterial pressure and cerebral flow. We also examined the predictions from OLBNP data for the cerebral flow response to the stepwise drop in pressure subsequent to deflation of ischaemic thigh cuffs. We measured spectral powers, cross-spectral coherence, and transfer function gains and phases in arterial pressure and cerebral flow during three amplitudes (0, 20, and 40 mmHg) and three frequencies (0.10, 0.05, and 0.03 Hz) of OLBNP in nine healthy young volunteers. Pressure fluctuations were directly related to OLBNP amplitude and inversely to OLBNP frequency. Although cerebral flow oscillations were increased, they did not demonstrate the same frequency dependence seen in pressure oscillations. The overall pattern of the pressure-flow relation was of decreasing coherence and gain and increasing phase with decreasing frequency, characteristic of a high-pass filter. Coherence between pressure and flow was increased at all frequencies by OLBNP, but was still significantly lower at frequencies below 0.07 Hz despite the augmented pressure input. In addition, predictions of thigh cuff data from spectral estimates were extremely inconsistent and highly variable, suggesting that cerebral autoregulation is a frequency-dependent mechanism that may not be fully characterized by linear methods.

  13. Visually evoked blood flow responses and interaction with dynamic cerebral autoregulation: correction for blood pressure variation.

    PubMed

    Gommer, Erik D; Bogaarts, Guy; Martens, Esther G H J; Mess, Werner H; Reulen, Jos P H

    2014-05-01

    Visually evoked flow responses recorded using transcranial Doppler ultrasonography are often quantified using a dynamic model of neurovascular coupling. The evoked flow response is seen as the model's response to a visual step input stimulus. However, the continuously active process of dynamic cerebral autoregulation (dCA) compensating cerebral blood flow for blood pressure fluctuations may induce changes of cerebral blood flow velocity (CBFV) as well. The effect of blood pressure variability on the flow response is evaluated by separately modeling the dCA-induced effects of beat-to-beat measured blood pressure related CBFV changes. Parameters of 71 subjects are estimated using an existing, well-known second order dynamic neurovascular coupling model proposed by Rosengarten et al., and a new model extending the existing model with a CBFV contributing component as the output of a dCA model driven by blood pressure as input. Both models were evaluated for mean and systolic CBFV responses. The model-to-data fit errors of mean and systolic blood pressure for the new model were significantly lower compared to the existing model: mean: 0.8%±0.6 vs. 2.4%±2.8, p<0.001; systolic: 1.5%±1.2 vs. 2.2%±2.6, p<0.001. The confidence bounds of all estimated neurovascular coupling model parameters were significantly (p<0.005) narrowed for the new model. In conclusion, blood pressure correction of visual evoked flow responses by including cerebral autoregulation in model fitting of averaged responses results in significantly lower fit errors and by that in more reliable model parameter estimation. Blood pressure correction is more effective when mean instead of systolic CBFV responses are used. Measurement and quantification of neurovascular coupling should include beat-to-beat blood pressure measurement.

  14. Comparison between Spontaneous Low-Frequency Oscillations in Regional Cerebral Blood Volume, and Cerebral and Plethysmographic Pulsations

    NASA Astrophysics Data System (ADS)

    Yamazaki, Kyoko; Uchida, Mariko; Obata, Akiko; Katura, Takusige; Sato, Hiroki; Tanaka, Naoki; Maki, Atsushi

    2007-07-01

    The brain plays a crucial role in maintaining systemic functions. Hence, the cerebral circulation is important because the tissue in the brain cannot store energy sources within it and has to constantly obtain them with oxygen from the blood flow. The mean cerebral blood flow is kept constant over a wide range of blood pressure levels by the regulation of the cerebral circulation. However, the regional cerebral blood flow (rCBF) and volume (rCBV) exhibit strong low-frequency oscillations (LFOs) such as arterial blood pressure and heart rate, which may reflect the interaction of the cerebral and systemic circulation. To gain an insight into the regulation of the cerebral circulation, we investigated LFOs in the rCBV, cerebral pulsation (CP) and plethysmographic pulsation (PP) particularly on their spectral properties. The rCBV and PP signals were simultaneously measured by optical topography (OT: multi-channel near infra-red spectroscopy) and plethysmography with the subject in a resting, seated state. The CP signals were obtained from the pulsatile component contained in the OT signals. When we compared the spectra of LFOs, we found that the spectral peak for LFOs tended to distinctly appear in the order of rCBV, PP, and CP. This distinctness might reflect the regulation of the cerebral circulation. OT signals are considered to contain a contribution from the skin tissue. We also demonstrate that CP is different from the pulsation observed from the skin tissue.

  15. History of International Society for Cerebral Blood Flow and Metabolism

    PubMed Central

    Paulson, Olaf B; Kanno, Iwao; Reivich, Martin; Sokoloff, Louis

    2012-01-01

    Interest in the brain's circulation dates back more than a century and has been steadily growing. Quantitative methods for measurements of cerebral blood flow (CBF) and energy metabolism became available in the middle of the 20th century and gave a new boost to the research. Scientific meetings dealing with CBF and metabolism were arranged, and the fast growing research led to a demand for a specialized journal. In this scientific environment, the International Society for Cerebral Blood Flow and Metabolism (ISCBFM) and its official Journal of Cerebral Metabolism were established in 1981 and has since then been a major success. The development of new brain imaging methods has had a major impact. Regulation of CBF and ischemia has been the main topics at the meetings. A new field of brain mapping research emerged and has now its own society and meetings. Brain emission tomography research has grown within the society and is now an integrated part. The ISCBFM is a sound society, and support of young scientists is among its goals. Several awards have been established. Other activities including summer schools, courses, satellite meetings, and Gordon conferences have contributed to the success of the society and strengthened the research. PMID:22186671

  16. History of International Society for Cerebral Blood Flow and Metabolism.

    PubMed

    Paulson, Olaf B; Kanno, Iwao; Reivich, Martin; Sokoloff, Louis

    2012-07-01

    Interest in the brain's circulation dates back more than a century and has been steadily growing. Quantitative methods for measurements of cerebral blood flow (CBF) and energy metabolism became available in the middle of the 20th century and gave a new boost to the research. Scientific meetings dealing with CBF and metabolism were arranged, and the fast growing research led to a demand for a specialized journal. In this scientific environment, the International Society for Cerebral Blood Flow and Metabolism (ISCBFM) and its official Journal of Cerebral Metabolism were established in 1981 and has since then been a major success. The development of new brain imaging methods has had a major impact. Regulation of CBF and ischemia has been the main topics at the meetings. A new field of brain mapping research emerged and has now its own society and meetings. Brain emission tomography research has grown within the society and is now an integrated part. The ISCBFM is a sound society, and support of young scientists is among its goals. Several awards have been established. Other activities including summer schools, courses, satellite meetings, and Gordon conferences have contributed to the success of the society and strengthened the research.

  17. Prostanoid synthesis in the cerebral blood vessels of asphyxiated piglets.

    PubMed

    Kis, B; Mezei, Z; Forgács, P; Gecse, A; Telegdy, G; Bari, F

    2001-01-01

    The aim of this study was to examine the effects of asphyxia-reventilation and hyperoxia on the cerebral blood perfusion and prostanoid production of the brain arteries and microvessels in piglets. After 10 min of asphyxia, animals were ventilated with room air, or with 100% O2. Following 4 hours of recovery, the brains were perfused, cerebral arteries were removed and microvessels were isolated from the cortex. The microvessels and the arteries were incubated with 1-14C-arachidonic acid, and the 1-14C-prostanoids were then separated by means of overpressure thin-layer chromatography and were quantitatively determined. Under control conditions, the synthesis of dilatory prostanoids dominated the arachidonate cascade both in the microvessels and in the arteries. Asphyxia and reventilation with room air did not modify the prostanoid production. O2 ventilation greatly affected the prostanoid synthesis of the microvessels, with an enhancement of PGD2 up to 247 +/- 27%. In the arteries, the production of PGI2 and of PGE2 was elevated to 272 +/- 15% and to 148 +/- 13%, respectively. These findings indicate that O2 ventilation after asphyxia substantially increases the extent of prostanoid synthesis in the cerebral blood vessels.

  18. Methamphetamine causes sustained depression in cerebral blood flow.

    PubMed

    Polesskaya, Oksana; Silva, Jharon; Sanfilippo, Christine; Desrosiers, Taylor; Sun, Anita; Shen, Jie; Feng, Changyong; Polesskiy, Aleksey; Deane, Rashid; Zlokovic, Berislav; Kasischke, Karl; Dewhurst, Stephen

    2011-02-10

    The use prevalence of the highly addictive psychostimulant methamphetamine (MA) has been steadily increasing over the past decade. MA abuse has been associated with both transient and permanent alterations in cerebral blood flow (CBF), hemorrhage, cerebrovascular accidents and death. To understand MA-induced changes in CBF, we exposed C56BL/6 mice to an acute bolus of MA (5mg/kg MA, delivered IP). This elicited a biphasic CBF response, characterized by an initial transient increase (~ 5 minutes) followed by a prolonged decrease (~ 30 minutes) of approximately 25% relative to baseline CBF--as measured by laser Doppler flowmetry over the somatosensory cortex. To assess if this was due to catecholamine derived vasoconstriction, phentolamine, an α-adrenergic antagonist was administered prior to MA treatment. This reduced the initial increase in CBF but failed to prevent the subsequent, sustained decrease in CBF. Consistent with prior reports, MA caused a transient increase in mean arterial blood pressure, body temperature and respiratory rate. Elevated respiratory rate resulted in hypocapnia. When respiratory rate was controlled by artificially ventilating mice, blood PaCO(2) levels after MA exposure remained unchanged from physiologic levels, and the MA-induced decrease in CBF was abolished. In vivo two-photon imaging of cerebral blood vessels revealed sustained MA-induced vasoconstriction of pial arterioles, consistent with laser Doppler flowmetry data. These findings show that even a single, acute exposure to MA can result in profound changes in CBF, with potentially deleterious consequences for brain function.

  19. Methamphetamine causes sustained depression in cerebral blood flow

    PubMed Central

    Polesskaya, Oksana; Silva, Jharon; Sanfilippo, Christine; Desrosiers, Taylor; Sun, Anita; Shen, Jie; Feng, Changyong; Polesskiy, Aleksey; Deane, Rashid; Zlokovic, Berislav; Kasischke, Karl; Dewhurst, Stephen

    2010-01-01

    The use prevalence of the highly addictive psychostimulant methamphetamine (MA) has been steadily increasing over the past decade. MA abuse has been associated with both transient and permanent alterations in cerebral blood flow (CBF), hemorrhage, cerebrovascular accidents and death. To understand MA-induced changes in CBF, we exposed C56BL/6 mice to an acute bolus of MA (5 mg/kg MA, delivered IP). This elicited a biphasic CBF response, characterized by an initial transient increase (~5 min) followed by a prolonged decrease (~30 min) of approximately 25% relative to baseline CBF – as measured by laser Doppler flowmetry over the somatosensory cortex. To assess if this was due to catecholamine derived vasoconstriction, phentolamine, an α-adrenergic antagonist was administered prior to MA treatment. This reduced the initial increase in CBF but failed to prevent the subsequent, sustained decrease in CBF. Consistent with prior reports, MA caused a transient increase in mean arterial blood pressure, body temperature and respiratory rate. Elevated respiratory rate resulted in hypocapnia. When respiratory rate was controlled by artificially ventilating mice, blood PaCO2 levels after MA exposure remained unchanged from physiologic levels, and the MA-induced decrease in CBF was abolished. In vivo two-photon imaging of cerebral blood vessels revealed sustained MA-induced vasoconstriction of pial arterioles, consistent with laser Doppler flowmetry data. These findings show that even a single, acute exposure to MA can result in profound changes in CBF, with potentially deleterious consequences for brain function. PMID:21156163

  20. [Measurement of cerebral blood flow using phase-contrast MRI].

    PubMed

    Obata, T; Shishido, F; Koga, M; Ikehira, H; Kimura, F; Yoshida, K

    1997-07-01

    The development of phase-contrast magnetic resonance imaging(P-C MRI) provides a noninvasive method for measurement of volumetric blood flow(VFR). The VFR of the left and right internal carotid arteries and basilar artery were measured using P-C MRI, and total cerebral blood flow(tCBF) was calculated by summing up the VFR values in three vessels. We investigated the changes in these blood flows as influenced from age, head size, height, weight, body surface area and handedness. Moreover, regional CBF(rCBF) was measured by combining with the single photon emission computed tomography(SPECT) of 123I. The blood flows were 142 +/- 58 mL/ min(mean +/- SD) in the basilar artery, 229 +/- 86 mL/min in the left, 223 +/- 58 mL/min in the right internal carotid artery, and tCBF was 617 +/- 128 mL/min(Ref. Magn Resn Imaging 14:P. 1143, 1996). Significant increases were observed in head-size-related change of VFR in the basilar artery and height-related change of tCBF. The value of rCBF was easily acquired in combination with SPECT. Phase-contrast MRI is useful for a noninvasive and rapid analysis of cerebral VFR and has potential for clinical use.

  1. Correlation between cerebral oxygen metabolism and cerebral blood flow simultaneously measured before and after acetazolamide administration

    NASA Astrophysics Data System (ADS)

    Yamaguchi, Hiroichiro; Yamauchi, Hideto; Hazama, Shiro; Hamamoto, Hirotsugu; Inoue, Nobuhiro

    1999-10-01

    The cerebral circulation and metabolism of ten preoperative cardiac surgery patients were assessed. Alterations in regional cerebral blood flow (rCBF), measured by 123I-N- isopropyl-p-iodo-amphetamine single-photon emission computed tomography, and in cerebral oxygen metabolism, simultaneously detected by near-infrared spectroscopy (NIRS) before and after acetazolamide administration, were investigated. The rCBF (ml/min/100 g) increased significantly from 40.21 +/- 7.65 to 56.24 +/- 13.69 (p equals 0.001), and a significant increase in oxyhemoglobin (Oxy-Hb) of 13.9% (p equals 0.0022) and total hemoglobin (Total-Hb) of 5.7% (0.0047) along with a significant decrease in deoxyhemoglobin (Deoxy-Hb) of 8.9% (p equals 0.0414) were observed concomitantly. Thus, the Oxy-Hb/Total- Hb ratio (%Oxy-Hb) rose significantly from 67.26 +/- 9.82% to 72.98 +/- 8.09% (p equals 0.0022). Examination of the relationships between individual parameters showed that the percentage changes in rCBF and Oxy-Hb were significantly correlated (r equals 0.758, p equals 0.011). The percentage changes in rCBF and %Oxy-Hb were also correlated significantly (r equals 0.740, p equals 0.014). In conclusion, this evidence suggested that NIRS is able to detect relative changes in cerebral hemodynamics and reflect luxury perfusion induced by acetazolamide.

  2. Effect of anxiety on cortical cerebral blood flow and metabolism

    SciTech Connect

    Gur, R.C.; Gur, R.E.; Resnick, S.M.; Skolnick, B.E.; Alavi, A.; Reivich, M.

    1987-04-01

    The relation between anxiety and cortical activity was compared in two samples of normal volunteers. One group was studied with the noninvasive xenon-133 inhalation technique for measuring cerebral blood flow (CBF) and the other with positron emission tomography (PET) using /sup 18/Flurodeoxyglucose (/sup 18/FDG) for measuring cerebral metabolic rates (CMR) for glucose. The inhalation technique produced less anxiety than the PET procedure, and for low anxiety subjects, there was a linear increase in CBF with anxiety. For higher anxiety subjects, however, there was a linear decrease in CBF with increased anxiety. The PET group manifested a linear decrease in CMR with increased anxiety. The results indicate that anxiety can have systematic effects on cortical activity, and this should be taken into consideration when comparing data from different procedures. They also suggest a physiologic explanation of a fundamental behavioral law that stipulates a curvilinear, inverted-U relationship between anxiety and performance.

  3. CEREBRAL BLOOD FLOW AND METABOLISM IN ANXIETY AND ANXIETY DISORDERS

    PubMed Central

    Mathew, Roy J.

    1994-01-01

    Anxiety disorders are some of the commonest psychiatric disorders and anxiety commonly co-exists with other psychiatric conditions. Anxiety can also be a normal emotion. Thus, study of the neurobiological effects of anxiety is of considerable significance. In the normal brain, cerebral blood flow (CBF) and metabolism (CMR) serve as indices of brain function. CBF/CMR research is expected to provide new insight into alterations in brain function in anxiety disorders and other psychiatric disorders. Possible associations between stress I anxiety I panic and cerebral ischemia I stroke give additional significance to the effects of anxiety on CBF. With the advent of non-invasive techniques, study of CBF/CMR in anxiety disorders became easier. A large numbers of research reports are available on the effects of stress, anxiety and panic on CBF/CMR in normals and anxiety disorder patients. This article reviews the available human research on this topic. PMID:21743685

  4. Laser Doppler flowmetry to measure changes in cerebral blood flow.

    PubMed

    Sutherland, Brad A; Rabie, Tamer; Buchan, Alastair M

    2014-01-01

    Laser Doppler flowmetry (LDF) is a method by which relative cerebral blood flow (CBF) of the cortex can be measured. Although the method is easy to employ, LDF only measures relative CBF, while absolute CBF cannot be quantified. LDF is useful for investigating CBF changes in a number of different applications including neurovascular and stroke research. This chapter will prepare the reader for rodent experiments using LDF with two preparations. The closed skull preparation can be used to monitor CBF with an intact skull, but in adult rats, thinning of the skull is required to obtain an accurate cortical CBF signal. The open skull preparation requires a craniotomy to expose the surface of the brain and the LDF probe is held close to the surface to measure cerebral perfusion.

  5. Cerebral hemodynamics in normal-pressure hydrocephalus. Evaluation by 133Xe inhalation method and dynamic CT study

    SciTech Connect

    Tamaki, N.; Kusunoki, T.; Wakabayashi, T.; Matsumoto, S.

    1984-09-01

    Cerebral hemodynamics in 31 patients with suspected normal-pressure hydrocephalus were studied by means of the xenon-133 (133Xe) inhalation method and on dynamic computerized tomography (CT) scanning. Cerebral blood flow (CBF) is reduced in all patients with dementia. Hypoperfusion was noted in a frontal distribution in these patients compared with normal individuals. There was no difference in CBF patterns between patients with good and those with poor outcome. The CBF was increased following cerebrospinal fluid (CSF) shunting in patients who responded to that procedure: increase in flow correlated with clinical improvement, frontal and temporal lobe CBF was most markedly increased, and the CBF pattern became normal. In contrast, CBF was decreased after shunt placement in patients who were considered to have suffered from degenerative dementia, as evidenced by non-response to shunting. Dynamic computerized tomography studies demonstrated that patients with a good outcome showed a postoperative reduction in mean transit time of contrast material, most prominent in the frontal and temporal gray matter, and slight in the deep frontal structures, but not in the major cerebral vessels. Patients with poor outcome after shunting, however, had an increase in transit time in all regions. This corresponded well with the results as determined by the 133Xe inhalation method.

  6. Changes in chorioretinal blood flow velocity and cerebral blood flow after carotid endarterectomy.

    PubMed

    Enaida, Hiroshi; Nagata, Shinji; Takeda, Atsunobu; Nakao, Shintaro; Ikeda, Yasuhiro; Ishibashi, Tatsuro

    2016-11-01

    To investigate the changes in chorioretinal blood flow velocity and cerebral blood after carotid endarterectomy (CEA). Nine patients with moderate to severe internal carotid artery stenosis underwent CEA. Chorioretinal blood flow velocity was measured by laser speckle flowgraphy (LSFG), while cerebral blood flow (CBF) was measured by single-photon emission computed tomography (SPECT), on the affected side both before and after CEA. LSFG was evaluated in five areas to determine mean blur rate, while CBF was calculated from regional CBF and cerebrovascular reactivity (CVR), at the middle cerebral artery (MCA) region of each patient. Five cases showed an increase (mean 3.49 %, range -29.82 to 35.59 %) of average chorioretinal blood flow velocity using LSFG after CEA. A particularly averaged increase in chorioretinal blood flow was observed in the macular area compared with other areas. Similarly, there was an increase in CBF at rest (mean 11.46 %, range -14.51 to 74.14 %) observed using SPECT after surgery. Improvement of CVR was confirmed in four cases. All general and visual symptoms disappeared after CEA. Severe adverse effects, including hyperperfusion syndrome, were not observed in any cases. LSFG may be useful for the analysis of chorioretinal blood flow changes after CEA.

  7. [Intraoperative monitoring of cerebral blood-flow and condition of cerebral at open and endovascular interventions in carotid system].

    PubMed

    Kuntsevich, G I; Tanashian, M M; Skrylev, S I; Krotenkova, M V; Shchipakin, V L; Koshcheev, A Iu; Lagoda, O V; Gemdzhian, E G; Medvedev, R B; Kulikova, S N

    2011-01-01

    The aim of our research is to study hemodynamic and embolic situation during the carotid endarterectomy (CEA), carotid angioplastic and stenting (CAS), and to reveal the prognostic significance of the data provided by intraoperative monitoring of the brain blood flow in exposing acute ischemic lesions in brain. Intraoperative monitoring of blood flow in artery ophthalmic vas carried out with 60% of patients, in the middle cerebral artery-with 40% during the main stages of CEA, and with 64 patients in the middle cerebral artery during CAS. The comparison of the data of intraoperative monitoring of blood flow in middle cerebral artery with the result of brain diffusion-weighted magnetic resonance imaging (DW-MRI) 24 hours after the operation shows, that solid microembolic signals and vasospasm are prognostic signals (sensibility and specifics make up 95%) in the development of acute ischemic cerebral lesions. The monitoring of blood flow in artery ophthalmic is of the greatest diagnostic value in estimation of the hemodynamic situation, but it is of the lowest practical value in detecting microembolic signals. According to the data of the intraoperative blood flow monitoring in middle cerebral artery in group CEA the development of acute ischemic cerebral lesions were predicted with 11,1% of patients and the cause of postoperative stroke, developed by 2,9% of the patients, was specified. According to the result of DW-MRI, acute ischemic cerebral lesions were diagnosed with 21% of patients, that is, 18% of ischemic cerebral lesions were asymptomatic. In group CAS ischemic cerebral lesions were prognosed with 30% of patients, actually they were later detected with 40,6% of cases by means of DW-MRI. According to the data of intraoperative of blood flow monitoring the cause of the development of postoperative stroke was specified in 6,2% of cause; in 34,4% of cause the acute ischemic cerebral lesions were asymptomatic.

  8. Capillary pericytes regulate cerebral blood flow in health and disease

    PubMed Central

    Sutherland, Brad A.; O’Farrell, Fergus M.; Buchan, Alastair M.; Lauritzen, Martin; Attwell, David

    2014-01-01

    Brain blood flow increases, evoked by neuronal activity, power neural computation and are the basis of BOLD functional imaging. It is controversial whether blood flow is controlled solely by arteriole smooth muscle, or also by capillary pericytes. We demonstrate that neuronal activity and the neurotransmitter glutamate evoke the release of messengers that dilate capillaries by actively relaxing pericytes. Dilation is mediated by prostaglandin E2, but requires nitric oxide release to suppress vasoconstricting 20-HETE synthesis. In vivo, when sensory input increases blood flow, capillaries dilate before arterioles and are estimated to produce 84% of the blood flow increase. In pathology, ischaemia evokes capillary constriction by pericytes. We show that this is followed by pericyte death in rigor, which may irreversibly constrict capillaries and damage the blood-brain barrier. Thus, pericytes are major regulators of cerebral blood flow and initiators of functional imaging signals. Prevention of pericyte constriction and death may reduce the long-lasting blood flow decrease which damages neurons after stroke. PMID:24670647

  9. Regional cerebral blood flow during comprehension and speech (in cerebrally healthy subjects)

    SciTech Connect

    Lechevalier, B.; Petit, M.C.; Eustache, F.; Lambert, J.; Chapon, F.; Viader, F. )

    1989-07-01

    Regional cerebral blood flow (rCBF) was measured by the xenon-133 inhalation method in 10 cerebrally healthy subjects at rest and during linguistic activation tests. These consisted of a comprehension test (binaural listening to a narrative text) and a speech test (making sentences from a list of words presented orally at 30-s intervals). The comprehension task induced a moderate increase in the mean right CBF and in both inferior parietal areas, whereas the speech test resulted in a diffuse increase in the mean CBF of both hemispheres, predominating regionally in both inferior parietal, left operculary, and right upper motor and premotor areas. It is proposed that the activation pattern induced by linguistic stimulation depends on not only specific factors, such as syntactic and semantic aspects of language, but also the contents of the material proposed and the attention required by the test situation.

  10. Influence of aortic blood flow velocity on changes of middle cerebral artery blood flow velocity during isoflurane and sevoflurane anaesthesia.

    PubMed

    Holzer, A; Greher, M; Hetz, H; Standhardt, H; Donner, A; Heinzl, H; Zimpfer, M; Illievich, U M

    2001-04-01

    We studied the influence of systemic (aortic) blood flow velocity on changes of cerebral blood flow velocity under isoflurane or sevoflurane anaesthesia. Forty patients (age: isoflurane 24-62 years; sevoflurane 24-61 years; ASA I-III) requiring general anaesthesia undergoing routine spinal surgery were randomly assigned to either group. Cerebral blood flow velocity was measured in the middle cerebral artery by transcranial Doppler sonography (depth: 50-60 mm). Systemic blood flow velocity was determined by transthoracic Doppler sonography at the aortic valve. Heart rate, arterial pressure, arterial oxygen saturation and body temperature were monitored. After standardized anaesthesia induction (propofol, remifentanil, vecuronium) sevoflurane or isoflurane were used as single agent anaesthetics. Cerebral blood flow velocity and systemic blood flow velocity were measured in the awake patient (baseline) and repeated 5 min after reaching a steady state of inspiratory and end-expiratory concentrations of 0.75, 1.00, and 1.25 mean alveolar concentrations of either anaesthetic. To calculate the influence of systemic blood flow velocity on cerebral blood flow velocity, we defined the cerebral-systemic blood flow velocity index (CSvI). CSvI of 100% indicates a 1:1 relationship of changes of cerebral blood flow velocity and systemic blood flow velocity. Isoflurane and sevoflurane reduced both cerebral blood flow velocity and systemic blood flow velocity. The CSvI decreased significantly at all three concentrations vs. 100% (isoflurane/sevoflurane: 0.75 MAC: 85 +/- 25%/81 +/- 23%, 1.0 MAC: 79 +/- 19%/74 +/- 16%, 1.25 MAC: 71 +/- 16%/79 +/- 21%; [mean +/- SD] P = 0.0001). The reduction of the CSvI vs. 100% indicates a direct reduction of cerebral blood flow velocity caused by isoflurane/sevoflurane, independently of systemic blood flow velocity.

  11. Intraoperative multi-exposure speckle imaging of cerebral blood flow.

    PubMed

    Richards, Lisa M; Kazmi, Sm Shams; Olin, Katherine E; Waldron, James S; Fox, Douglas J; Dunn, Andrew K

    2017-01-01

    Multiple studies have demonstrated that laser speckle contrast imaging (LSCI) has high potential to be a valuable cerebral blood flow monitoring technique during neurosurgery. However, the quantitative accuracy and sensitivity of LSCI is limited, and highly dependent on the exposure time. An extension to LSCI called multi-exposure speckle imaging (MESI) overcomes these limitations, and was evaluated intraoperatively in patients undergoing brain tumor resection. This clinical study ( n = 8) recorded multiple exposure times from the same cortical tissue area spanning 0.5-20 ms, and evaluated images individually as single-exposure LSCI and jointly using the MESI model. This study demonstrated that the MESI estimates provided the broadest flow sensitivity for sampling the flow magnitude in the human brain, closely followed by the shorter exposure times. Conservation of flow analysis on vascular bifurcations was used to validate physiological accuracy, with highly conserved flow estimates (<10%) from both MESI and 1 ms LSCI ( n = 14 branches). The MESI model had high goodness-of-fit with proper image calibration and acquisition, and was used to monitor blood flow changes after tissue cautery. Results from this study demonstrate that intraoperative MESI can be performed with high quantitative accuracy and sensitivity for cerebral blood flow monitoring.

  12. Coupling between arterial pressure, cerebral blood velocity, and cerebral tissue oxygenation with spontaneous and forced oscillations.

    PubMed

    Rickards, Caroline A; Sprick, Justin D; Colby, Hannah B; Kay, Victoria L; Tzeng, Yu-Chieh

    2015-04-01

    We tested the hypothesis that transmission of arterial pressure to brain tissue oxygenation is low under conditions of arterial pressure instability. Two experimental models of hemodynamic instability were used in healthy human volunteers; (1) oscillatory lower body negative pressure (OLBNP) (N = 8; 5 male, 3 female), and; (2) maximal LBNP to presyncope (N = 21; 13 male, 8 female). Mean arterial pressure (MAP), middle cerebral artery velocity (MCAv), and cerebral tissue oxygen saturation (ScO2) were measured non-invasively. For the OLBNP protocol, between 0 and -60 mmHg negative pressure was applied for 20 cycles at 0.05 Hz, then 20 cycles at 0.1 Hz. For the maximal LBNP protocol, progressive 5 min stages of chamber decompression were applied until the onset of presyncope. Spectral power of MAP, mean MCAv, and ScO2 were calculated within the VLF (0.04-0.07 Hz), and LF (0.07-0.2 Hz) ranges, and cross-spectral coherence was calculated for MAP-mean MCAv, MAP-ScO2, and mean MCAv-ScO2 at baseline, during each OLBNP protocol, and at the level prior to pre-syncope during maximal LBNP (sub-max). The key findings are (1) both 0.1 Hz OLBNP and sub-max LBNP elicited increases in LF power for MAP, mean MCAv, and ScO2 (p ≤ 0.08); (2) 0.05 Hz OLBNP increased VLF power in MAP and ScO2 only (p ≤ 0.06); (3) coherence between MAP-mean MCAv was consistently higher (≥0.71) compared with MAP-ScO2, and mean MCAv-ScO2 (≤0.43) during both OLBNP protocols, and sub-max LBNP (p ≤ 0.04). These data indicate high linearity between pressure and cerebral blood flow variations, but reduced linearity between cerebral tissue oxygenation and both arterial pressure and cerebral blood flow. Measuring arterial pressure variability may not always provide adequate information about the downstream effects on cerebral tissue oxygenation, the key end-point of interest for neuronal viability.

  13. Acute cerebral infarction: effect of JPEG compression on detection at CT.

    PubMed

    Ohgiya, Yoshimitsu; Gokan, Takehiko; Nobusawa, Hiroshi; Hirose, Masanori; Seino, Noritaka; Fujisawa, Hidefumi; Baba, Maiko; Nagai, Kyoko; Tanno, Keisuke; Takeyama, Nobuyuki; Munechika, Hirotsugu

    2003-04-01

    To evaluate the effect of Joint Photographic Experts Group (JPEG) compression ratios of 10:1 and 20:1 on detection of acute cerebral infarction at computed tomography (CT). CT images obtained in 25 patients with acute cerebral infarction and 25 patients with no lesions were compressed by means of a JPEG algorithm at ratios of 10:1 and 20:1. Normal and abnormal sections (on original and compressed images) were reviewed by using a color soft-copy computed monochrome cathode ray tube monitor. Five observers rated the presence or absence of a lesion with a 50-point scale (0, definitely absent; 25, equivocal; and 50, definitely present). Diagnostic accuracy was evaluated with receiver operating characteristic (ROC) curve analysis. Significant difference was defined as a P value less than.05 for the area tested with a two-tailed paired Student t test. At ROC analysis, no statistically significant difference was detected for all cases considered together (Az [area under the ROC curve] = 0.887 +/- 0.038 [mean +/- SD] on noncompressed images, Az = 0.897 +/- 0.038 on 10:1 compressed images, and Az = 0.842 +/- 0.073 on 20:1 compressed images; P >.05). JPEG compression at ratios of 10:1 and 20:1 was tolerated in the detection of acute cerebral infarction at CT.

  14. Cerebral CT perfusion in patients with perimesencephalic and those with aneurysmal subarachnoid hemorrhage.

    PubMed

    Cremers, Charlotte H P; van der Schaaf, Irene C; Dankbaar, Jan Willem; Velthuis, Birgitta K; Rinkel, Gabriel J E

    2014-02-01

    The cause of perimesencephalic hemorrhage is unknown, but a venous source is suggested. If perimesencephalic hemorrhage is of venous origin, less elevation of the intracranial pressure and less perfusion deficits are expected than after aneurysmal subarachnoid hemorrhage. We compared perfusion in the acute stage after perimesencephalic hemorrhage and aneurysmal subarachnoid hemorrhage. We included 45 perimesencephalic hemorrhage patients and 45 aneurysmal subarachnoid hemorrhage patients, who were matched on clinical condition at admission and underwent computerized tomographic scanning <72 h after subarachnoid hemorrhage. Cerebral blood flow was assessed in 12 predefined regions of interest. Differences in cerebral blood flow values with corresponding 95% confidence intervals were calculated. Sub-group analyses were performed stratified on comparable amounts of blood and location of blood (posterior circulation aneurysms and additionally in infratentorial and supratentorial aneurysms). Cerebral blood flow was higher in perimesencephalic hemorrhage patients (mean: 63·8) than in aneurysmal sub-arachnoid hemorrhage patients (mean: 55·9; difference of means: -7·9 [95% confidence interval: -10·7 to -5·2]) and also in the sub-group with comparable amounts of blood (mean cerebral blood flow: 56·4; difference of means: -7·4 [95% confidence interval: -10·4 to -4·3]). Cerebral blood flow was comparable with perimesencephalic hemorrhage patients for the sub-group with posterior circulation aneurysms (difference of means: -0·7 [95% confidence interval: -5·2 to 3·8]); however, differences diverged after stratifying posterior circulation aneurysms into supratentorial (difference of means -3·9 [95% confidence interval: -9·3 to 1·4]) and infratentorial aneurysms (difference of means 3·0 [95% confidence interval: -2·8 to 8·8]). Perimesencephalic hemorrhage patients have a higher cerebral blood flow than aneurysmal subarachnoid hemorrhage patients. The findings

  15. Quantifying cerebral blood flow: regional regulation with global implications.

    PubMed

    Small, Scott A

    2004-10-01

    In 1948, Seymour S. Kety and Carl F. Schmidt published back-to-back papers in the JCI that are widely acknowledged as landmarks. Upon publication, the studies resolved a century-old debate, irrefutably demonstrating that cerebral blood flow is regionally regulated. The reported findings turned out to be so powerful in their implications that they provided the inspirational spark that illuminated a brand-new field: functional brain imaging. Thus these papers are landmarks of the rarest kind, not only ending a controversy, but also giving birth to one of the most exciting fields within modern day neuroscience.

  16. Cerebral blood flow regulation and neurovascular dysfunction in Alzheimer disease.

    PubMed

    Kisler, Kassandra; Nelson, Amy R; Montagne, Axel; Zlokovic, Berislav V

    2017-07-01

    Cerebral blood flow (CBF) regulation is essential for normal brain function. The mammalian brain has evolved a unique mechanism for CBF control known as neurovascular coupling. This mechanism ensures a rapid increase in the rate of CBF and oxygen delivery to activated brain structures. The neurovascular unit is composed of astrocytes, mural vascular smooth muscle cells and pericytes, and endothelia, and regulates neurovascular coupling. This Review article examines the cellular and molecular mechanisms within the neurovascular unit that contribute to CBF control, and neurovascular dysfunction in neurodegenerative disorders such as Alzheimer disease.

  17. The Non-Invasive Measurement of Regional Cerebral Blood Flow

    PubMed Central

    Wilson, Edwin M.; Wills, Edward L.

    1977-01-01

    The non-invasive, repeatable measurement of bilateral, regional cerebral blood flow in man is achieved through the application of the 133xenon inhalation method. The clinical utility of the methodology is enhanced by integrating the method into a computer system which combines on-line data acquisition with rapid data analysis and display. The subsequent statistical analysis of the results from specific patient categories and normal populations is facilitated by a computerized data base coupled with the primary computer system. ImagesFig. 2

  18. Relationship between cerebral blood flow and blood pressure in long-term heart transplant recipients.

    PubMed

    Smirl, Jonathan D; Haykowsky, Mark J; Nelson, Michael D; Tzeng, Yu-Chieh; Marsden, Katelyn R; Jones, Helen; Ainslie, Philip N

    2014-12-01

    Heart transplant recipients are at an increased risk for cerebral hemorrhage and ischemic stroke; yet, the exact mechanism for this derangement remains unclear. We hypothesized that alterations in cerebrovascular regulation is principally involved. To test this hypothesis, we studied cerebral pressure-flow dynamics in 8 clinically stable male heart transplant recipients (62±8 years of age and 9±7 years post transplant, mean±SD), 9 male age-matched controls (63±8 years), and 10 male donor controls (27±5 years). To increase blood pressure variability and improve assessment of the pressure-flow dynamics, subjects performed squat-stand maneuvers at 0.05 and 0.10 Hz. Beat-to-beat blood pressure, middle cerebral artery velocity, and end-tidal carbon dioxide were continuously measured during 5 minutes of seated rest and throughout the squat-stand maneuvers. Cardiac baroreceptor sensitivity gain and cerebral pressure-flow responses were assessed with linear transfer function analysis. Heart transplant recipients had reductions in R-R interval power and baroreceptor sensitivity low frequency gain (P<0.01) compared with both control groups; however, these changes were unrelated to transfer function metrics. Thus, in contrast to our hypothesis, the increased risk of cerebrovascular complication after heart transplantation does not seem to be related to alterations in cerebral pressure-flow dynamics. Future research is, therefore, warranted. © 2014 American Heart Association, Inc.

  19. In vivo cerebral blood flow autoregulation studies using rheoencephalography

    NASA Astrophysics Data System (ADS)

    Bodo, M.; Pearce, F.; Garcia, A.; Van Albert, S.; Settle, T.; Szebeni, J.; Baranyi, L.; Hartings, J.; Armonda, R.

    2010-04-01

    Acute management of patients with traumatic brain/blast injury is a challenge. To minimize secondary injury and improve outcome, it is critical to detect neurological deterioration early, when it is potentially reversible. One potential monitoring method is cerebral electrical impedance (rheoencephalography-REG) because of its non-invasiveness and good time resolution. Reported here are the results of cerebral blood flow (CBF) manipulations comparing electroencephalogram (EEG) with REG (both intra-cerebral) and measuring with surface and skull REG electrodes. Our hypothesis was that REG would reflect spreading depression and CBF autoregulation. Animal experiments were performed using one rat (four trials with intracerebral electrodes), monkeys (n=8, with surface electrodes) and pigs (n = 24 pigs with skull electrodes; 57 trials, 19 types of liposomes). Challenges included intracranial pressure (ICP) elevation, liposome infusion, and hemorrhage. Data were stored on a PC and evaluated off line. CBF autoregulation was evaluated both by visual inspection and by a Matlab script. These studies confirmed that REG reflects CBF autoregulation and that REG is useful for detecting spreading depression (SD), vasospasm and the lower limit of CBF autoregulation. These findings have clinical relevance for use in noninvasive neuro-monitoring in the neurosurgery intensive care and during transportation of patients with brain injury.

  20. Regional cerebral blood flow in essential hypertension: data evaluation by a mapping system

    SciTech Connect

    Rodriguez, G.; Arvigo, F.; Marenco, S.; Nobili, F.; Romano, P.; Sandini, G.; Rosadini, G.

    1987-01-01

    Regional cerebral blood flow was studied by means of the 133Xe inhalation method in 26 untreated and 10 treated patients with essential hypertension. The untreated subjects were divided into newly and previously diagnosed groups to assess the relation between regional cerebral blood flow and the duration of hypertension. The overall flow reduction was more marked in the frontal and temporal regions in the previously diagnosed group, and this was attributed to pathological changes in the district served by the middle cerebral artery. Regional temporal lobe impairment was also noted in the newly diagnosed and treated subjects. A significant correlation was found between regional cerebral blood flow and mean arterial blood pressure.

  1. Trigeminal Cardiac Reflex and Cerebral Blood Flow Regulation

    PubMed Central

    Lapi, Dominga; Scuri, Rossana; Colantuoni, Antonio

    2016-01-01

    The stimulation of some facial regions is known to trigger the trigemino-cardiac reflex: the main stimulus is represented by the contact of the face with water. This phenomenon called diving reflex induces a set of reactions in the cardiovascular and respiratory systems occurring in all mammals, especially marine (whales, seals). During the immersion of the face in the water, the main responses are aimed at reducing the oxygen consumption of the organism. Accordingly reduction in heart rate, peripheral vasoconstriction, blood pooling in certain organs, especially the heart, and brain and an increase in blood pressure have been reported. Moreover, the speed and intensity of the reflex is inversely proportional to the temperature of the water: more cold the water, more reactions as described are strong. In the case of deep diving an additional effect, such as blood deviation, has been reported: the blood is sequestered within the lungs, to compensate for the increase in the external pressure, preventing them from collapsing. The trigeminal-cardiac reflex is not just confined to the diving reflex; recently it has been shown that a brief proprioceptive stimulation (10 min) by jaw extension in rats produces interesting effects both at systemic and cerebral levels, reducing the arterial blood pressure, and vasodilating the pial arterioles. The arteriolar dilation is associated with rhythmic diameter changes characterized by an increase in the endothelial activity. Fascinating the stimulation of trigeminal nerve is able to activate the nitric oxide release by vascular endothelial cells. Therefore, the aim of this review was to highlight the effects due to trigeminal cardiac reflex induced by a simple mandibular extension. Opposite effects, such as hypotension, and modulation of cerebral arteriolar tone, were observed, when these responses were compared to those elicited by the diving reflex. PMID:27812317

  2. Neuroimmunological Blood Brain Barrier Opening in Experimental Cerebral Malaria

    PubMed Central

    Baer, Kerstin; Mikolajczak, Sebastian A.; Kappe, Stefan H. I.; Frevert, Ute

    2012-01-01

    Plasmodium falciparum malaria is responsible for nearly one million annual deaths worldwide. Because of the difficulty in monitoring the pathogenesis of cerebral malaria in humans, we conducted a study in various mouse models to better understand disease progression in experimental cerebral malaria (ECM). We compared the effect on the integrity of the blood brain barrier (BBB) and the histopathology of the brain of P. berghei ANKA, a known ECM model, P. berghei NK65, generally thought not to induce ECM, P. yoelii 17XL, originally reported to induce human cerebral malaria-like histopathology, and P. yoelii YM. As expected, P. berghei ANKA infection caused neurological signs, cerebral hemorrhages, and BBB dysfunction in CBA/CaJ and Swiss Webster mice, while Balb/c and A/J mice were resistant. Surprisingly, PbNK induced ECM in CBA/CaJ mice, while all other mice were resistant. P. yoelii 17XL and P. yoelii YM caused lethal hyperparasitemia in all mouse strains; histopathological alterations, BBB dysfunction, or neurological signs were not observed. Intravital imaging revealed that infected erythrocytes containing mature parasites passed slowly through capillaries making intimate contact with the endothelium, but did not arrest. Except for relatively rare microhemorrhages, mice with ECM presented no obvious histopathological alterations that would explain the widespread disruption of the BBB. Intravital imaging did reveal, however, that postcapillary venules, but not capillaries or arterioles, from mice with ECM, but not hyperparasitemia, exhibit platelet marginalization, extravascular fibrin deposition, CD14 expression, and extensive vascular leakage. Blockage of LFA-1 mediated cellular interactions prevented leukocyte adhesion, vascular leakage, neurological signs, and death from ECM. The endothelial barrier-stabilizing mediators imatinib and FTY720 inhibited vascular leakage and neurological signs and prolonged survival to ECM. Thus, it appears that neurological

  3. Neuroimmunological blood brain barrier opening in experimental cerebral malaria.

    PubMed

    Nacer, Adela; Movila, Alexandru; Baer, Kerstin; Mikolajczak, Sebastian A; Kappe, Stefan H I; Frevert, Ute

    2012-01-01

    Plasmodium falciparum malaria is responsible for nearly one million annual deaths worldwide. Because of the difficulty in monitoring the pathogenesis of cerebral malaria in humans, we conducted a study in various mouse models to better understand disease progression in experimental cerebral malaria (ECM). We compared the effect on the integrity of the blood brain barrier (BBB) and the histopathology of the brain of P. berghei ANKA, a known ECM model, P. berghei NK65, generally thought not to induce ECM, P. yoelii 17XL, originally reported to induce human cerebral malaria-like histopathology, and P. yoelii YM. As expected, P. berghei ANKA infection caused neurological signs, cerebral hemorrhages, and BBB dysfunction in CBA/CaJ and Swiss Webster mice, while Balb/c and A/J mice were resistant. Surprisingly, PbNK induced ECM in CBA/CaJ mice, while all other mice were resistant. P. yoelii 17XL and P. yoelii YM caused lethal hyperparasitemia in all mouse strains; histopathological alterations, BBB dysfunction, or neurological signs were not observed. Intravital imaging revealed that infected erythrocytes containing mature parasites passed slowly through capillaries making intimate contact with the endothelium, but did not arrest. Except for relatively rare microhemorrhages, mice with ECM presented no obvious histopathological alterations that would explain the widespread disruption of the BBB. Intravital imaging did reveal, however, that postcapillary venules, but not capillaries or arterioles, from mice with ECM, but not hyperparasitemia, exhibit platelet marginalization, extravascular fibrin deposition, CD14 expression, and extensive vascular leakage. Blockage of LFA-1 mediated cellular interactions prevented leukocyte adhesion, vascular leakage, neurological signs, and death from ECM. The endothelial barrier-stabilizing mediators imatinib and FTY720 inhibited vascular leakage and neurological signs and prolonged survival to ECM. Thus, it appears that neurological

  4. Radioactive microsphere study of cerebral blood flow under acceleration. Technical report

    SciTech Connect

    Greenlees, K.J.; Yoder, J.E.; Toth, D.M.; Oloff, C.M.; Karl, A.

    1980-11-01

    A study using radioactive microspheres for the investigation of cerebral blood flow during acceleration is described. Details of a technique for the blunt dissection of cerebral tissues are included. Results of flow studies at 3 and 5 G sub z acceleration stress indicate there is no selective regional preservation of cerebral tissue. (Author)

  5. CT perfusion during delayed cerebral ischemia after subarachnoid hemorrhage: distinction between reversible ischemia and ischemia progressing to infarction.

    PubMed

    Cremers, Charlotte H P; Vos, Pieter C; van der Schaaf, Irene C; Velthuis, Birgitta K; Vergouwen, Mervyn D I; Rinkel, Gabriel J E; Dankbaar, Jan Willem

    2015-09-01

    Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) can be reversible or progress to cerebral infarction. In patients with a deterioration clinically diagnosed as DCI, we investigated whether CT perfusion (CTP) can distinguish between reversible ischemia and ischemia progressing to cerebral infarction. From a prospectively collected series of aSAH patients, we included those with DCI, CTP on the day of clinical deterioration, and follow-up imaging. In qualitative CTP analyses (visual assessment), we calculated positive and negative predictive value (PPV and NPV) with 95% confidence intervals (95%CI) of a perfusion deficit for infarction on follow-up imaging. In quantitative analyses, we compared perfusion values of the least perfused brain tissue between patients with and without infarction by using receiver-operator characteristic curves and calculated a threshold value with PPV and NPV for the perfusion parameter with the highest area under the curve. In qualitative analyses of 33 included patients, 15 of 17 patients (88%) with and 6 of 16 patients (38%) without infarction on follow-up imaging had a perfusion deficit during clinical deterioration (p = 0.002). Presence of a perfusion deficit had a PPV of 71% (95%CI: 48-89%) and NPV of 83% (95%CI: 52-98%) for infarction on follow-up. Quantitative analyses showed that an absolute minimal cerebral blood flow (CBF) threshold of 17.7 mL/100 g/min had a PPV of 63% (95%CI: 41-81%) and a NPV of 78% (95%CI: 40-97%) for infarction. CTP may differ between patients with DCI who develop infarction and those who do not. For this purpose, qualitative evaluation may perform marginally better than quantitative evaluation.

  6. Increased Pulsatile Cerebral Blood Flow, Cerebral Vasodilation, and Post-syncopal Headache in Adolescents

    PubMed Central

    Ocon, Anthony J.; Messer, Zachary; Medow, Marvin S.; Stewart, Julian M.

    2011-01-01

    Objective We hypothesize that following a sudden decrease in cerebral blood flow velocity (CBFV) in adolescents at faint, rapid hyperemic pulsatile CBFV occurs upon the return to the supine position, and is associated with post-syncopal headache. Study design This case-control study involved 16 adolescent subjects with history of fainting and headaches. We induced faint during 70° tilt-table testing and measured mean arterial pressure (MAP), heart rate (HR), end-tidal CO2, and CBFV. Fifteen control subjects were similarly evaluated with a tilt but did not faint, and comparisons with fainters were made at equivalent defined time points. Results Baseline values were similar between groups. Upon fainting, MAP decreased 49% in fainters vs. 6% in controls (P<0.001). HR decreased 15% in fainters and increased 35% in controls (P<0.001). In fainters, cerebrovascular critical closing pressure increased markedly resulting in reduced diastolic (-66%) and mean CBFV (-46%) at faint; systolic CBFV was similar to controls. Pulsatile CBFV (systolic – diastolic CBFV) increased 38% in fainters, driving flow-mediated dilation of cerebral vessels. Returning to supine, fainters’ CBFV exhibited increased systolic and decreased diastolic flows compared with controls (P<0.02). Conclusion Increased pulsatile CBFV during and following faint may cause post-syncopal cerebral vasodilation and headache. PMID:21596391

  7. Outcome prediction within twelve hours after severe traumatic brain injury by quantitative cerebral blood flow.

    PubMed

    Kaloostian, Paul; Robertson, Claudia; Gopinath, Shankar P; Stippler, Martina; King, C Christopher; Qualls, Clifford; Yonas, Howard; Nemoto, Edwin M

    2012-03-20

    We measured quantitative cortical mantle cerebral blood flow (CBF) by stable xenon computed tomography (CT) within the first 12 h after severe traumatic brain injury (TBI) to determine whether neurologic outcome can be predicted by CBF stratification early after injury. Stable xenon CT was used for quantitative measurement of CBF (mL/100 g/min) in 22 cortical mantle regions stratified as follows: low (0-8), intermediate (9-30), normal (31-70), and hyperemic (>70) in 120 patients suffering severe (Glasgow Coma Scale [GCS] score ≤8) TBI. For each of these CBF strata, percentages of total cortical mantle volume were calculated. Outcomes were assessed by Glasgow Outcome Scale (GOS) score at discharge (DC), and 1, 3, and 6 months after discharge. Quantitative cortical mantle CBF differentiated GOS 1 and GOS 2 (dead or vegetative state) from GOS 3-5 (severely disabled to good recovery; p<0.001). Receiver operating characteristic (ROC) curve analysis for percent total normal plus hyperemic flow volume (TNHV) predicting GOS 3-5 outcome at 6 months for CBF measured <6 and <12 h after injury showed ROC area under the curve (AUC) cut-scores of 0.92 and 0.77, respectively. In multivariate analysis, percent TNHV is an independent predictor of GOS 3-5, with an odds ratio of 1.460 per 10 percentage point increase, as is initial GCS score (OR=1.090). The binary version of the Marshall CT score was an independent predictor of 6-month outcome, whereas age was not. These results suggest that quantitative cerebral cortical CBF measured within the first 6 and 12 h after TBI predicts 6-month outcome, which may be useful in guiding patient care and identifying patients for randomized clinical trials. A larger multicenter randomized clinical trial is indicated.

  8. Cerebral blood flow and personality: a positron emission tomography study.

    PubMed

    Johnson, D L; Wiebe, J S; Gold, S M; Andreasen, N C; Hichwa, R D; Watkins, G L; Boles Ponto, L L

    1999-02-01

    This study sought to describe brain regions associated with the personality dimension of introversion/extraversion. Measures of cerebral blood flow (CBF) were obtained from 18 healthy subjects by means of [150]H20 positron emission tomography. Correlations of regional CBF with introversion/extraversion were calculated, and a three-dimensional map of those correlations was generated. Overall, introversion was associated with increased blood flow in the frontal lobes and in the anterior thalamus. Regions in the anterior cingulate gyrus, the temporal lobes, and the posterior thalamus were found to be correlated with extraversion. The findings of the study lend support to the notion that introversion is associated with increased activity in frontal lobe regions. Moreover, the study suggests that individual differences in introversion and extraversion are related to differences in a fronto-striato-thalamic circuit.

  9. SPECT study of regional cerebral blood flow in Alzheimer disease

    SciTech Connect

    Bonte, F.J.; Ross, E.D.; Chehabi, H.H.; Devous, M.D. Sr.

    1986-07-01

    A common cause of dementia in late midlife and old age is Alzheimer disease (AD), which affects more than one in 20 individuals over the age of 65. Past studies of regional cerebral blood flow (rCBF) in patients with AD here suggested blood flow abnormalities, but findings have differed. We have studied 37 patients diagnosed as having AD with inhalation and washout of /sup 133/Xe and single-photon emission computed tomography (SPECT), obtaining evidence of abnormal rCBF patterns in 19. Flow reductions were most common in the temporoparietal regions and were occasionally found in the frontal areas. Investigators using positron-emission tomography (PET) have identified similar findings with respect to rCBF and regional oxygen, glucose, and protein metabolism. The SPECT determination of rCBF, which gives information similar to that provided by PET, may assume importance in the diagnosis of AD and in the differential diagnosis of the dementias.

  10. Autoregulation of cerebral blood flow in orthostatic hypotension

    NASA Technical Reports Server (NTRS)

    Novak, V.; Novak, P.; Spies, J. M.; Low, P. A.

    1998-01-01

    BACKGROUND AND PURPOSE: We sought to evaluate cerebral autoregulation in patients with orthostatic hypotension (OH). METHODS: We studied 21 patients (aged 52 to 78 years) with neurogenic OH during 80 degrees head-up tilt. Blood flow velocities (BFV) from the middle cerebral artery were continuously monitored with transcranial Doppler sonography, as were heart rate, blood pressure (BP), cardiac output, stroke volume, CO2, total peripheral resistance, and cerebrovascular resistance. RESULTS: All OH patients had lower BP (P<.0001), BFV_diastolic (P<.05), CVR (P<.007), and TPR (P<.02) during head-up tilt than control subjects. In control subjects, no correlations between BFV and BP were found during head-up tilt, suggesting normal autoregulation. OH patients could be separated into those with normal or expanded autoregulation (OH_NA; n=16) and those with autoregulatory failure (OH_AF; n=5). The OH_NA group showed either no correlation between BFV and BP (n=8) or had a positive BFV/BP correlation (R2>.75) but with a flat slope. An expansion of the "autoregulated" range was seen in some patients. The OH_AF group was characterized by a profound fall in BFV in response to a small reduction in BP (mean deltaBP <40 mm Hg; R2>.75). CONCLUSIONS: The most common patterns of cerebral response to OH are autoregulatory failure with a flat flow-pressure relationship or intact autoregulation with an expanded autoregulated range. The least common pattern is autoregulatory failure with a steep flow-pressure relationship. Patients with patterns 1 and 2 have an enhanced capacity to cope with OH, while those with pattern 3 have reduced capacity.

  11. Autoregulation of cerebral blood flow in orthostatic hypotension

    NASA Technical Reports Server (NTRS)

    Novak, V.; Novak, P.; Spies, J. M.; Low, P. A.

    1998-01-01

    BACKGROUND AND PURPOSE: We sought to evaluate cerebral autoregulation in patients with orthostatic hypotension (OH). METHODS: We studied 21 patients (aged 52 to 78 years) with neurogenic OH during 80 degrees head-up tilt. Blood flow velocities (BFV) from the middle cerebral artery were continuously monitored with transcranial Doppler sonography, as were heart rate, blood pressure (BP), cardiac output, stroke volume, CO2, total peripheral resistance, and cerebrovascular resistance. RESULTS: All OH patients had lower BP (P<.0001), BFV_diastolic (P<.05), CVR (P<.007), and TPR (P<.02) during head-up tilt than control subjects. In control subjects, no correlations between BFV and BP were found during head-up tilt, suggesting normal autoregulation. OH patients could be separated into those with normal or expanded autoregulation (OH_NA; n=16) and those with autoregulatory failure (OH_AF; n=5). The OH_NA group showed either no correlation between BFV and BP (n=8) or had a positive BFV/BP correlation (R2>.75) but with a flat slope. An expansion of the "autoregulated" range was seen in some patients. The OH_AF group was characterized by a profound fall in BFV in response to a small reduction in BP (mean deltaBP <40 mm Hg; R2>.75). CONCLUSIONS: The most common patterns of cerebral response to OH are autoregulatory failure with a flat flow-pressure relationship or intact autoregulation with an expanded autoregulated range. The least common pattern is autoregulatory failure with a steep flow-pressure relationship. Patients with patterns 1 and 2 have an enhanced capacity to cope with OH, while those with pattern 3 have reduced capacity.

  12. Cerebral blood flow in Alzheimer’s disease

    PubMed Central

    Roher, Alex E; Debbins, Josef P; Malek-Ahmadi, Michael; Chen, Kewei; Pipe, James G; Maze, Sharmeen; Belden, Christine; Maarouf, Chera L; Thiyyagura, Pradeep; Mo, Hua; Hunter, Jesse M; Kokjohn, Tyler A; Walker, Douglas G; Kruchowsky, Jane C; Belohlavek, Marek; Sabbagh, Marwan N; Beach, Thomas G

    2012-01-01

    Background Alzheimer’s disease (AD) dementia is a consequence of heterogeneous and complex interactions of age-related neurodegeneration and vascular-associated pathologies. Evidence has accumulated that there is increased atherosclerosis/arteriosclerosis of the intracranial arteries in AD and that this may be additive or synergistic with respect to the generation of hypoxia/ischemia and cognitive dysfunction. The effectiveness of pharmacologic therapies and lifestyle modification in reducing cardiovascular disease has prompted a reconsideration of the roles that cardiovascular disease and cerebrovascular function play in the pathogenesis of dementia. Methods Using two-dimensional phase-contrast magnetic resonance imaging, we quantified cerebral blood flow within the internal carotid, basilar, and middle cerebral arteries in a group of individuals with mild to moderate AD (n = 8) and compared the results with those from a group of age-matched nondemented control (NDC) subjects (n = 9). Clinical and psychometric testing was performed on all individuals, as well as obtaining their magnetic resonance imaging-based hippocampal volumes. Results Our experiments reveal that total cerebral blood flow was 20% lower in the AD group than in the NDC group, and that these values were directly correlated with pulse pressure and cognitive measures. The AD group had a significantly lower pulse pressure (mean AD 48, mean NDC 71; P = 0.0004). A significant group difference was also observed in their hippocampal volumes. Composite z-scores for clinical, psychometric, hippocampal volume, and hemodynamic data differed between the AD and NDC subjects, with values in the former being significantly lower (t = 12.00, df = 1, P = 0.001) than in the latter. Conclusion These results indicate an association between brain hypoperfusion and the dementia of AD. Cardiovascular disease combined with brain hypoperfusion may participate in the pathogenesis/pathophysiology of neurodegenerative

  13. DETERMINANTS OF RESTING CEREBRAL BLOOD FLOW IN SICKLE CELL DISEASE

    PubMed Central

    Bush, Adam M; Borzage, Matthew T; Choi, Soyoung; Václavů, Lena; Tamrazi, Benita; Nederveen, Aart J; Coates, Thomas D; Wood, John C

    2016-01-01

    Stroke is common in children with sickle cell disease and results from an imbalance in oxygen supply and demand. Cerebral blood flow (CBF) is increased in patients with sickle cell disease to compensate for their anemia, but adequacy of their oxygen delivery has not been systematically demonstrated. This study examined the physiological determinants of CBF in 37 patients with sickle cell disease, 38 ethnicity matched control subjects and 16 patients with anemia of non-sickle origin. Cerebral blood flow was measured using phase contrast MRI of the carotid and vertebral arteries. CBF increased inversely to oxygen content (r2 = 0.69, p < 0.0001). Brain oxygen delivery, the product of CBF and oxygen content, was normal in all groups. Brain composition, specifically the relative amounts of grey and white matter, was the next strongest CBF predictor, presumably by influencing cerebral metabolic rate. Grey matter/white matter ratio and CBF declined monotonically until the age of 25 in all subjects, consistent with known maturational changes in brain composition. Further CBF reductions were observed with age in subjects older than 35 years of age, likely reflecting microvascular aging. On multivariate regression, CBF was independent of disease state, hemoglobin S, hemoglobin F, reticulocyte count and cell free hemoglobin, suggesting that it is regulated similarly in patients and control subjects. In conclusion, sickle cell disease patients had sufficient oxygen delivery at rest, but accomplish this only by marked increases in their resting CBF, potentially limiting their ability to further augment flow in response to stress. PMID:27263497

  14. Neuropsychological disturbances and cerebral blood flow in bipolar disorder.

    PubMed

    Benabarre, Antoni; Vieta, Eduard; Martínez-Arán, Anabel; Garcia-Garcia, Margarida; Martín, Francisco; Lomeña, Francisco; Torrent, Carla; Sánchez-Moreno, José; Colom, Francesc; Reinares, María; Brugue, Esteve; Valdés, Manuel

    2005-04-01

    To determine and correlate alterations in neuropsychological function and cerebral blood flow in bipolar patients. Assessments included the Positive and Negative Symptom Scale, Global Assessment Functioning, Wechsler Adult Intelligence Scale (WAIS), Wisconsin Card Sorting Test (WCST), Stroop test, Trail Making Test (TMT), California Verbal Learning Test (CVLT), Wechsler Memory Scale (WMS) and phonetic verbal fluency/controlled oral word association tests. Single photon emission computed tomography (SPECT) was carried out with the administration of 99mTc-HMPAO. Forty-three outpatients out of 85 fulfilling RDC diagnostic criteria for bipolar disorder and six healthy subjects were included in the study. SPECT and neuropsychological assessments were performed in 30 patients in manic (n = 7), hypomanic (n = 8), depressed (n = 12) or euthymic (n = 3) states. All assessments were carried out before starting treatment. Several corrected correlations between neuropsychological function and cerebral blood flow (CBF) were identified: executive function (WCST) and striatal, frontal, temporal, cerebellum, parietal and cingulate CBF; memory (WMS, WAIS-Digits) and striatal, frontal, temporal and parietal CBF; attentional tasks (Stroop) and striatal, temporo-medial and parietal CBF; verbal learning (CVLT) and frontal, posterior temporal, cingulate and occipital CBF; psychomotor disturbances (TMT) and anterior temporal CBF; poorer intelligence performance scores (WAIS-Vocabulary) and cerebellum and parietal CBF. This study confirms the presence of functional disturbances in fronto-subcortical structures, the cerebellum and limbic system in bipolar patients.

  15. Blood biomarkers in the early stage of cerebral ischemia.

    PubMed

    Maestrini, I; Ducroquet, A; Moulin, S; Leys, D; Cordonnier, C; Bordet, R

    2016-03-01

    In ischemic stroke patients, blood-based biomarkers may be applied for the diagnosis of ischemic origin and subtype, prediction of outcomes and targeted treatment in selected patients. Knowledge of the pathophysiology of cerebral ischemia has led to the evaluation of proteins, neurotransmitters, nucleic acids and lipids as potential biomarkers. The present report focuses on the role of blood-based biomarkers in the early stage of ischemic stroke-within 72h of its onset-as gleaned from studies published in English in such patients. Despite growing interest in their potential role in clinical practice, the application of biomarkers for the management of cerebral ischemia is not currently recommended by guidelines. However, there are some promising clinical biomarkers, as well as the N-methyl-d-aspartate (NMDA) peptide and NMDA-receptor (R) autoantibodies that appear to identify the ischemic nature of stroke, and the glial fibrillary acidic protein (GFAP) that might be able to discriminate between acute ischemic and hemorrhagic strokes. Moreover, genomics and proteomics allow the characterization of differences in gene expression, and protein and metabolite production, in ischemic stroke patients compared with controls and, thus, may help to identify novel markers with sufficient sensitivity and specificity. Additional studies to validate promising biomarkers and to identify novel biomarkers are needed.

  16. Modeling Cerebral Blood Flow Velocity During Orthostatic Stress.

    PubMed

    Mader, Greg; Olufsen, Mette; Mahdi, Adam

    2015-08-01

    Cerebral autoregulation refers to the physiological process that maintains stable cerebral blood flow (CBF) during changes in arterial blood pressure (ABP). In this study, we propose a simple, nonlinear quantitative model with only four parameters that can predict CBF velocity as a function of ABP. The model was motivated by the viscoelastic-like behavior observed in the data collected during postural change from sitting to standing. Qualitative testing of the model involved analysis of dynamic responses to step-changes in pressure both within and outside the autoregulatory range, while quantitative testing was used to show that the model can fit dynamics observed in data measured from a healthy young and a healthy elderly subject. The latter involved analysis of structural and practical identifiability, sensitivity analysis, and parameter estimation. Results showed that the model is able to reproduce observed overshoot and adaptation and predict the different responses in the healthy young and the healthy elderly subject. For the healthy young subject, the overshoot was significantly more pronounced than for the elderly subject, but the recovery time was longer for the young subject. These differences resulted in different parameter values estimated using the two datasets.

  17. Ion channel networks in the control of cerebral blood flow

    PubMed Central

    Longden, Thomas A; Hill-Eubanks, David C

    2015-01-01

    One hundred and twenty five years ago, Roy and Sherrington made the seminal observation that neuronal stimulation evokes an increase in cerebral blood flow.1 Since this discovery, researchers have attempted to uncover how the cells of the neurovascular unit—neurons, astrocytes, vascular smooth muscle cells, vascular endothelial cells and pericytes—coordinate their activity to control this phenomenon. Recent work has revealed that ionic fluxes through a diverse array of ion channel species allow the cells of the neurovascular unit to engage in multicellular signaling processes that dictate local hemodynamics. In this review we center our discussion on two major themes: (1) the roles of ion channels in the dynamic modulation of parenchymal arteriole smooth muscle membrane potential, which is central to the control of arteriolar diameter and therefore must be harnessed to permit changes in downstream cerebral blood flow, and (2) the striking similarities in the ion channel complements employed in astrocytic endfeet and endothelial cells, enabling dual control of smooth muscle from either side of the blood–brain barrier. We conclude with a discussion of the emerging roles of pericyte and capillary endothelial cell ion channels in neurovascular coupling, which will provide fertile ground for future breakthroughs in the field. PMID:26661232

  18. Cerebral small-resistance artery structure and cerebral blood flow in normotensive subjects and hypertensive patients.

    PubMed

    De Ciuceis, Carolina; Cornali, Claudio; Porteri, Enzo; Mardighian, Dikran; Pinardi, Chiara; Fontanella, Marco M; Rodella, Luigi F; Rezzani, Rita; Rizzoni, Damiano; Boari, Gianluca E M; Rosei, Enrico Agabiti; Gasparotti, Roberto

    2014-12-01

    The aim of this study was to prospectively investigate whether the structure of cerebral small-resistance arteries is related to cerebral perfusion parameters as measured with dynamic susceptibility-weighted contrast magnetic resonance imaging (DSC-MRI) in a selected cohort of hypertensive and normotensive patients. Ten hypertensive and 10 normotensive patients were included in the study. All patients underwent neurosurgical intervention for an intracranial tumor and were investigated with DSC-MRI at 1.5 T. Cerebral small-resistance arteries were dissected from a small portion of morphologically normal cerebral tissue and mounted on an isometric myograph for the measurement of the media-to-lumen (M/L) ratio. A quantitative assessment of cerebral blood flow (CBF) and volume (CBV) was performed with a region-of-interest approach. Correlation coefficients were calculated for normally distributed variables. The institutional review board approved the study, and informed consent was obtained from all patients. Compared with normotensive subjects, hypertensive patients had significantly lower regional CBF (mL/100 g/min) in the cortical grey matter (55.63 ± 1.90 vs 58.37 ± 2.19, p < 0.05), basal ganglia (53.34 ± 4.39 vs 58.22. ± 4.33, p < 0.05), thalami (50.65 ± 3.23 vs 57.56 ± 4.45, p < 0.01), subcortical white matter (19.32 ± 2.54 vs 22.24 ± 1.9, p < 0.05), greater M/L ratio (0.099 ± 0.013 vs 0.085 ± 0.012, p < 0.05), and lower microvessel density (1.66 ± 0.67 vs 2.52 ± 1.28, p < 0.05). A statistically significant negative correlation was observed between M/L ratio of cerebral arteries and CBF in the cortical grey matter (r = -0.516, p < 0.05), basal ganglia (r = -0.521, p < 0.05), thalami (r = -0.527 p < 0.05), and subcortical white matter (r = -0.612, p < 0.01). Our results indicate that microvascular structure might play a role in controlling CBF, with possible clinical consequences.

  19. Early post-traumatic cerebral blood flow mapping: correlation with structural damage after focal injury.

    PubMed

    Bullock, R; Sakas, D; Patterson, J; Wyper, D; Hadley, D; Maxwell, W; Teasdale, G M

    1992-01-01

    Focal post traumatic mass lesions such as contusions and intracerebral haematomas are common, and often difficult for neurosurgeons to manage, because little is known of their pathophysiology. We have mapped cerebral blood flow, and studied small vessel ultrastructure at different time points within the first three weeks of head injury, in patients with these lesions. A zone of ischaemic brain is always present around these lesions, and persists for weeks or months. This accords with astrocyte swelling and microvascular compression seen on electron microscopy. Focal zones of hyperaemia were also present in 42% of patients, within the first two weeks of injury, and this appeared only within apparently normal tissue as judged by late MRI or CT.

  20. Correlation between cerebral oxygen metabolism and cerebral blood flow simultaneously measured before and after acetazolamide administration.

    PubMed

    Yamaguchi, H; Yamauchi, H; Hazama, S; Hamamoto, H; Inoue, N

    1999-10-01

    The cerebral circulation and metabolism of ten preoperative cardiac surgery patients were assessed. Alterations in regional cerebral blood flow (rCBF), measured by 123I-N-isopropyl-p-iodo-amphetamine single-photon emission computed tomography, and in cerebral oxygen metabolism, simultaneously detected by near-infrared spectroscopy (NIRS) before and after acetazolamide administration, were investigated. The rCBF (ml/min/100 g) increased significantly from 40.21±7.65 to 56.24±13.69(p<0.001), and a significant increase in oxyhemoglobin (Oxy-Hb) of 13.9% (p=0.0022) and total hemoglobin (Total-Hb) of 5.7% (0.0047) along with a significant decrease in deoxyhemoglobin (Deoxy-Hb) of 8.9% (p=0.0414) were observed concomitantly. Thus, the Oxy-Hb/Total-Hb ratio (%Oxy-Hb) rose significantly from 67.26±9.82% to 72.98±8.09%(p=0.0022). Examination of the relationships between individual parameters showed that the percentage changes in rCBF and Oxy-Hb were significantly correlated (r=0.758,p=0.011). The percentage changes in rCBF and %Oxy-Hb were also correlated significantly (r=0.740,p=0.014). In conclusion, this evidence suggested that NIRS is able to detect relative changes in cerebral hemodynamics and reflect luxury perfusion induced by acetazolamide. © 1999 Society of Photo-Optical Instrumentation Engineers.

  1. Confirmation of CT criteria to distinguish pathophysiologic subtypes of cerebral infarction.

    PubMed

    Dettmers, C; Solymosi, L; Hartmann, A; Buermann, J; Hagendorff, A

    1997-02-01

    To determine whether cerebral infarctions classified as embolic or hemodynamic by their appearance on CT scans reflect distinct pathophysiologic entities. Cerebral infarctions were retrospectively classified into two groups according to their morphologic appearance on CT scans: territorial infarctions and watershed, or terminal supply area, infarctions. Specific CO2 reactivity for both groups of patients was determined with the xenon-133 method and 32 stationary detectors. Twenty-one patients with unilateral, supratentorial, ischemic cerebral infarctions were selected. CT findings were highly suggestive of a territorial infarction in 14 patients (mean age, 56 years) and of a watershed infarction in seven patients (mean age, 52 years). The initial slope index of the territorial and watershed infarction groups during CO2 inhalation was 55.1 +/- 2.4 sec-1 and 52.0 +/- 1.9 sec-1, respectively, in the infarcted hemispheres and 58.3 +/- 2.3 sec-1 and 55.1 +/- 1.5 sec-1, respectively, in the noninfarcted hemispheres. CO2 reactivity of the unaffected detectors was 1.75 +/- 0.3 sec-1 mm Hg-1 and 1.51 +/- 0.2 sec-1 mm Hg-1 for the territorial and watershed infarction groups, respectively. CO2 reactivity of the affected detectors was 1.75 +/- 0.3 sec-1 mm Hg-1 and 1.27 +/- 0.2 sec-1 mm Hg-1 for the two groups, respectively. The CO2 reactivity difference between affected detectors of the hemodynamic group and age-matched healthy control subjects was significant. The difference in CO2 reactivity between the two groups supports the concept that CT criteria can identify two pathophysiologic entities. In addition, we conclude that during the chronic stage, lower CO2 reactivity of the watershed infarction indicates that the global hemodynamic situation in these infarcts is more severely compromised than in territorial infarctions.

  2. Role of Large Arteries in Regulation of Cerebral Blood Flow in Dogs

    PubMed Central

    Heistad, Donald D.; Marcus, Melvin L.; Abboud, Francois M.

    1978-01-01

    Previous studies have demonstrated a significant pressure gradient from carotid artery to pial or middle cerebral arteries. This pressure gradient suggests that large cerebral arteries contribute to cerebral resistance. We have tested the hypothesis that large cerebral arteries contribute to regulation of cerebral blood flow during changes in blood gases and arterial pressure. Microspheres were used to measure brain blood flow in anesthetized dogs. Resistance of large cerebral arteries was estimated by determining the pressure gradient between common carotid and wedged vertebral artery catheters. Systemic hypercapnia and hypoxia dilated large cerebral arteries, and hypocapnia constricted large cerebral arteries. Resistance of large arteries was 0.6±0.1 (mean ± SE) mm Hg per ml/min per 100 g during normocapnia. During hypercapnia and hypoxia, large artery resistance decreased significantly to 0.2 ± 0.03 and 0.3 ± 0.05, respectively. During hypocapnia large artery resistance increased significantly to 1.0 ± 0.1. In other experiments, we found that large cerebral arteries participate in auto-regulatory responses to hemorrhagic hypotension. When arterial pressure was reduced from 110 to 58 mm Hg, autoregulation maintained cerebral blood flow constant, and resistance of large cerebral arteries decreased significantly from 1.0 ± 0.2 to 0.6 ± 0.1 mm Hg per ml/min per 100 g. In absolute terms, we calculated that 20-45% of the change in total cerebral resistance during these interventions was accounted for by changes in large artery resistance. These studies indicate that large cerebral arteries, as well as arterioles, participate actively in regulation of cerebral blood flow during changes in arterial blood gases and during autoregulatory responses to hemorrhagic hypotension. PMID:701475

  3. Cerebral blood flow in patients with congestive heart failure treated with captopril

    SciTech Connect

    Paulson, O.B.; Jarden, J.O.; Godtfredsen, J.; Vorstrup, S.

    1984-05-31

    The effect of captopril on cerebral blood flow was studied in five patients with severe congestive heart failure and in five control subjects. Cerebral blood flow was measured by inhalation of /sup 133/xenon and registration of its uptake and washout from the brain by single photon emission computer tomography. In addition, cerebral (internal jugular) venous oxygen tension was determined in the controls. The measurements were made before and 15, 60, and 180 minutes after a single oral dose of captopril (6.25 mg in patients with congestive heart failure and 25 mg in controls). Despite a marked decrease in blood pressure, cerebral blood flow increased slightly in the patients with severe congestive heart failure. When a correction was applied to take account of a change in arterial carbon dioxide tension, however, cerebral blood flow was unchanged after captopril administration even in patients with the greatest decrease in blood pressure, in whom a decrease in cerebral blood flow might have been expected. In the controls, blood pressure was little affected by captopril, whereas a slight, but not statistically significant, decrease in cerebral blood flow was observed. The cerebral venous oxygen tension decreased concomitantly.

  4. Influence of probe pressure on the diffuse correlation spectroscopy blood flow signal: extra-cerebral contributions

    PubMed Central

    Mesquita, Rickson C.; Schenkel, Steven S.; Minkoff, David L.; Lu, Xiangping; Favilla, Christopher G.; Vora, Patrick M.; Busch, David R.; Chandra, Malavika; Greenberg, Joel H.; Detre, John A.; Yodh, A. G.

    2013-01-01

    A pilot study explores relative contributions of extra-cerebral (scalp/skull) versus brain (cerebral) tissues to the blood flow index determined by diffuse correlation spectroscopy (DCS). Microvascular DCS flow measurements were made on the head during baseline and breath-holding/hyperventilation tasks, both with and without pressure. Baseline (resting) data enabled estimation of extra-cerebral flow signals and their pressure dependencies. A simple two-component model was used to derive baseline and activated cerebral blood flow (CBF) signals, and the DCS flow indices were also cross-correlated with concurrent Transcranial Doppler Ultrasound (TCD) blood velocity measurements. The study suggests new pressure-dependent experimental paradigms for elucidation of blood flow contributions from extra-cerebral and cerebral tissues. PMID:23847725

  5. [Effects of xenon anesthesia on cerebral blood flow in neurosurgical patients without intracranial hypertension].

    PubMed

    Rylova, A V; Beliaev, A Iu; Lubnin, A Iu

    2013-01-01

    Among anesthetic agents used in neurosurgery xenon appears to be the most advantageous. It preserves arterial blood pressure, assures rapid recovery and neuroprotection. But the data is lacking on xenon effect upon cerebral blood flow under anesthetic conditions. We measured flow velocity in middle cerebral artery in neurosurgical patients without intracranial hypertension during closed circuit xenon anesthesia comparing propofol and xenon effect in the same patients. In our study xenon didn't seem to induce clinically relevant changes in cerebral blood flow and preserved cerebral vascular reactivity thus proving its safety in patients without intracranial hypertension.

  6. The cerebral imaging using vessel-around method in the perfusion CT of the human brain

    NASA Astrophysics Data System (ADS)

    Ahn, Choong-Il; Choi, Seung-Wook; Park, Seung-Chul; Shin, Yeong-Gil; Kim, Jae-Hyoung; Chong, Gi-Bong

    2005-04-01

    Perfusion CT has been successfully used as a functional imaging technique for diagnosis of patients with hyperacute stroke. However, the commonly used methods based on curve-fitting are time consuming. Numerous researchers have investigated to what extent Perfusion CT can be used for the quantitative assessment of cerebral ischemia and to rapidly obtain comprehensive information regarding the extent of ischemic damage in acute stroke patients. The aim of this study is to propose an alternative approach to rapidly obtain the brain perfusion mapping and to show the proposed cerebral flow imaging of the vessel and tissue in human brain be reliable and useful. Our main design concern was algorithmic speed, robustness and automation in order to allow its potential use in the emergency situation of acute stroke. To obtain a more effective mapping, we analyzed the signal characteristics of Perfusion CT and defined the vessel-around model which includes the vessel and tissue. We proposed a nonparametric vessel-around approach which automatically discriminates the vessel and tissue around vessel from non-interested brain matter stratifying the level of maximum enhancement of pixel-based TAC. The stratification of pixel-based TAC was executed using the mean and standard deviation of the signal intensity of each pixel and mapped to the cerebral flow imaging. The defined vessel-around model was used to show the cerebral flow imaging and to specify the area of markedly reduced perfusion with loss of function of still viable neurons. Perfusion CT is a fast and practical technique for routine clinical application. It provides substantial and important additional information for the selection of the optimal treatment strategy for patients with hyperacute stroke. The vessel-around approach reduces the computation time significantly when compared with the perfusion imaging using the GVF. The proposed cerebral imaging shows reliable results which are validated by physicians and

  7. Cerebral blood flow in small vessel disease: A systematic review and meta-analysis.

    PubMed

    Shi, Yulu; Thrippleton, Michael J; Makin, Stephen D; Marshall, Ian; Geerlings, Mirjam I; de Craen, Anton Jm; van Buchem, Mark A; Wardlaw, Joanna M

    2016-10-01

    White matter hyperintensities are frequent on neuroimaging of older people and are a key feature of cerebral small vessel disease. They are commonly attributed to chronic hypoperfusion, although whether low cerebral blood flow is cause or effect is unclear. We systematically reviewed studies that assessed cerebral blood flow in small vessel disease patients, performed meta-analysis and sensitivity analysis of potential confounders. Thirty-eight studies (n = 4006) met the inclusion criteria, including four longitudinal and 34 cross-sectional studies. Most cerebral blood flow data were from grey matter. Twenty-four cross-sectional studies (n = 1161) were meta-analysed, showing that cerebral blood flow was lower in subjects with more white matter hyperintensity, globally and in most grey and white matter regions (e.g. mean global cerebral blood flow: standardised mean difference-0.71, 95% CI -1.12, -0.30). These cerebral blood flow differences were attenuated by excluding studies in dementia or that lacked age-matching. Four longitudinal studies (n = 1079) gave differing results, e.g., more baseline white matter hyperintensity predated falling cerebral blood flow (3.9 years, n = 575); cerebral blood flow was low in regions that developed white matter hyperintensity (1.5 years, n = 40). Cerebral blood flow is lower in subjects with more white matter hyperintensity cross-sectionally, but evidence for falling cerebral blood flow predating increasing white matter hyperintensity is conflicting. Future studies should be longitudinal, obtain more white matter data, use better age-correction and stratify by clinical diagnosis.

  8. Cerebral blood flow is an earlier indicator of perfusion abnormalities than cerebral blood volume in Alzheimer's disease.

    PubMed

    Lacalle-Aurioles, María; Mateos-Pérez, José M; Guzmán-De-Villoria, Juan A; Olazarán, Javier; Cruz-Orduña, Isabel; Alemán-Gómez, Yasser; Martino, María-Elena; Desco, Manuel

    2014-04-01

    The purpose of this study was to elucidate whether cerebral blood flow (CBF) can better characterize perfusion abnormalities in predementia stages of Alzheimer's disease (AD) than cerebral blood volume (CBV) and whether cortical atrophy is more associated with decreased CBV or with decreased CBF. We compared measurements of CBV, CBF, and mean cortical thickness obtained from magnetic resonance images in a group of healthy controls, patients with mild cognitive impairment (MCI) who converted to AD after 2 years of clinical follow-up (MCI-c), and patients with mild AD. A significant decrease in perfusion was detected in the parietal lobes of the MCI-c patients with CBF parametric maps but not with CBV maps. In the MCI-c group, a negative correlation between CBF values and cortical thickness in the right parahippocampal gyrus suggests an increase in CBF that depends on cortical atrophy in predementia stages of AD. Our study also suggests that CBF deficits appear before CBV deficits in the progression of AD, as CBV abnormalities were only detected at the AD stage, whereas CBF changes were already detected in the MCI stage. These results confirm the hypothesis that CBF is a more sensitive parameter than CBV for perfusion abnormalities in MCI-c patients.

  9. Cerebral blood flow is an earlier indicator of perfusion abnormalities than cerebral blood volume in Alzheimer's disease

    PubMed Central

    Lacalle-Aurioles, María; Mateos-Pérez, José M; Guzmán-De-Villoria, Juan A; Olazarán, Javier; Cruz-Orduña, Isabel; Alemán-Gómez, Yasser; Martino, María-Elena; Desco, Manuel

    2014-01-01

    The purpose of this study was to elucidate whether cerebral blood flow (CBF) can better characterize perfusion abnormalities in predementia stages of Alzheimer's disease (AD) than cerebral blood volume (CBV) and whether cortical atrophy is more associated with decreased CBV or with decreased CBF. We compared measurements of CBV, CBF, and mean cortical thickness obtained from magnetic resonance images in a group of healthy controls, patients with mild cognitive impairment (MCI) who converted to AD after 2 years of clinical follow-up (MCI-c), and patients with mild AD. A significant decrease in perfusion was detected in the parietal lobes of the MCI-c patients with CBF parametric maps but not with CBV maps. In the MCI-c group, a negative correlation between CBF values and cortical thickness in the right parahippocampal gyrus suggests an increase in CBF that depends on cortical atrophy in predementia stages of AD. Our study also suggests that CBF deficits appear before CBV deficits in the progression of AD, as CBV abnormalities were only detected at the AD stage, whereas CBF changes were already detected in the MCI stage. These results confirm the hypothesis that CBF is a more sensitive parameter than CBV for perfusion abnormalities in MCI-c patients. PMID:24424381

  10. Modelling of impaired cerebral blood flow due to gaseous emboli

    NASA Astrophysics Data System (ADS)

    Hague, J. P.; Banahan, C.; Chung, E. M. L.

    2013-07-01

    Bubbles introduced to the arterial circulation during invasive medical procedures can have devastating consequences for brain function but their effects are currently difficult to quantify. Here we present a Monte Carlo simulation investigating the impact of gas bubbles on cerebral blood flow. For the first time, this model includes realistic adhesion forces, bubble deformation, fluid dynamical considerations, and bubble dissolution. This allows investigation of the effects of buoyancy, solubility, and blood pressure on embolus clearance. Our results illustrate that blockages depend on several factors, including the number and size distribution of incident emboli, dissolution time and blood pressure. We found it essential to model the deformation of bubbles to avoid overestimation of arterial obstruction. Incorporation of buoyancy effects within our model slightly reduced the overall level of obstruction but did not decrease embolus clearance times. We found that higher blood pressures generate lower levels of obstruction and improve embolus clearance. Finally, we demonstrate the effects of gas solubility and discuss potential clinical applications of the model.

  11. Noninvasive Measurement of Cerebral Blood Flow and Blood Oxygenation Using Near-Infrared and Diffuse Correlation Spectroscopies in Critically Brain-Injured Adults

    PubMed Central

    Durduran, Turgut; Frangos, Suzanne; Edlow, Brian L.; Buckley, Erin M.; Moss, Heather E.; Zhou, Chao; Yu, Guoqiang; Choe, Regine; Maloney-Wilensky, Eileen; Wolf, Ronald L.; Grady, M. Sean; Greenberg, Joel H.; Levine, Joshua M.; Yodh, Arjun G.; Detre, John A.; Kofke, W. Andrew

    2009-01-01

    Background This study assesses the utility of a hybrid optical instrument for noninvasive transcranial monitoring in the neurointensive care unit. The instrument is based on diffuse correlation spectroscopy (DCS) for measurement of cerebral blood flow (CBF), and near-infrared spectroscopy (NIRS) for measurement of oxy- and deoxy-hemoglobin concentration. DCS/NIRS measurements of CBF and oxygenation from frontal lobes are compared with concurrent xenon-enhanced computed tomography (XeCT) in patients during induced blood pressure changes and carbon dioxide arterial partial pressure variation. Methods Seven neurocritical care patients were included in the study. Relative CBF measured by DCS (rCBFDCS), and changes in oxy-hemoglobin (ΔHbO2), deoxy-hemoglobin (ΔHb), and total hemoglobin concentration (ΔTHC), measured by NIRS, were continuously monitored throughout XeCT during a baseline scan and a scan after intervention. CBF from XeCT regions-of-interest (ROIs) under the optical probes were used to calculate relative XeCT CBF (rCBFXeCT) and were then compared to rCBFDCS. Spearman’s rank coefficients were employed to test for associations between rCBFDCS and rCBFXeCT, as well as between rCBF from both modalities and NIRS parameters. Results rCBFDCS and rCBFXeCT showed good correlation (rs = 0.73, P = 0.010) across the patient cohort. Moderate correlations between rCBFDCS and ΔHbO2/ΔTHC were also observed. Both NIRS and DCS distinguished the effects of xenon inhalation on CBF, which varied among the patients. Conclusions DCS measurements of CBF and NIRS measurements of tissue blood oxygenation were successfully obtained in neurocritical care patients. The potential for DCS to provide continuous, noninvasive bedside monitoring for the purpose of CBF management and individualized care is demonstrated. PMID:19908166

  12. Effects of forskolin on cerebral blood flow: implications for a role of adenylate cyclase

    SciTech Connect

    Wysham, D.G.; Brotherton, A.F.; Heistad, D.D.

    1986-11-01

    We have studied cerebral vascular effects of forskolin, a drug which stimulates adenylate cyclase and potentiates dilator effects of adenosine in other vascular beds. Our goals were to determine whether forskolin is a cerebral vasodilator and whether it potentiates cerebral vasodilator responses to adenosine. We measured cerebral blood flow with microspheres in anesthetized rabbits. Forskolin (10 micrograms/kg per min) increased blood flow (ml/min per 100 gm) from 39 +/- 5 (mean +/- S.E.) to 56 +/- 9 (p less than 0.05) in cerebrum, and increased flow to myocardium and kidney despite a decrease in mean arterial pressure. Forskolin did not alter cerebral oxygen consumption, which indicates that the increase in cerebral blood flow is a direct vasodilator effect and is not secondary to increased metabolism. We also examined effects of forskolin on the response to infusion of adenosine. Cerebral blood flow was measured during infusion of 1-5 microM/min adenosine into one internal carotid artery, under control conditions and during infusion of forskolin at 3 micrograms/kg per min i.v. Adenosine alone increased ipsilateral cerebral blood flow from 32 +/- 3 to 45 +/- 5 (p less than 0.05). Responses to adenosine were not augmented during infusion of forskolin. We conclude that forskolin is a direct cerebral vasodilator and forskolin does not potentiate cerebral vasodilator responses to adenosine.

  13. Relationship between relative cerebral blood flow, relative cerebral blood volume, and relative cerebral metabolic rate of oxygen in the preterm neonatal brain.

    PubMed

    Nourhashemi, Mina; Kongolo, Guy; Mahmoudzadeh, Mahdi; Goudjil, Sabrina; Wallois, Fabrice

    2017-04-01

    The mechanisms responsible for coupling between relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and relative cerebral metabolic rate of oxygen ([Formula: see text]), an important function of the microcirculation in preterm infants, remain unclear. Identification of a causal relationship between rCBF-rCBV and [Formula: see text] in preterms may, therefore, help to elucidate the principles of cortical hemodynamics during development. We simultaneously recorded rCBF and rCBV and estimated [Formula: see text] by two independent acquisition systems: diffuse correlation spectroscopy and near-infrared spectroscopy, respectively, in 10 preterms aged between 28 and 35 weeks of gestational age. Transfer entropy was calculated in order to determine the directionality between rCBF-rCBV and [Formula: see text]. The surrogate method was applied to determine statistical significance. The results show that rCBV and [Formula: see text] have a predominant driving influence on rCBF at the resting state in the preterm neonatal brain. Statistical analysis robustly detected the correct directionality of rCBV on rCBF and [Formula: see text] on rCBF. This study helps to clarify the early organization of the rCBV-rCBF and [Formula: see text] inter-relationship in the immature cortex.

  14. Risk Assessment of Hemorrhagic Transformation of Acute Middle Cerebral Artery Stroke Using Multimodal CT

    PubMed Central

    Lin, Ke; Zink, Walter E.; Tsiouris, A. John; John, Majnu; Tekchandani, Leena; Sanelli, Pina C.

    2011-01-01

    PURPOSE Multimodal CT with CT angiography (CTA) and CT perfusion (CTP) are increasingly used in stroke triage. Our aim was to identify parameters most predictive of hemorrhagic transformation (HT), especially symptomatic intracerebral hemorrhage (SICH). METHODS This retrospective study included patients evaluated by baseline multimodal CT ≤ 9hours from ictus with acute nonlacunar middle cerebral artery (MCA) territory infarction. Two readers independently evaluated CTP maps for ischemic severity and CTA source images (CTA-SI) for infarct extent (as measured by ASPECTS). Presence of proximal occlusion (ICA or M1) and degree of collateralization (collateral score) were also assessed on CTA. HT was defined as SICH if associated with deterioration ≥ 4-points on NIHSS. Multivariate logistic regression analysis identified independent predictors of SICH. ROC curves selected optimal thresholds. RESULTS Of 84 patients reviewed, HT occurred in 22 (26.2%) and SICH in 8 (9.5%). Univariate predictors for SICH were proximal occlusion (OR = 8.65, P = .049), collateral score (OR = .34, P = .017), ASPECTS (OR = .46, P = .001), and CBV (OR = .001, P = .005). Multivariate analysis revealed ASPECTS as the only independent predictor with optimal threshold ≤ 5 and sensitivity and specificity of 75.0% and 85.5%, respectively. CONCLUSION For acute MCA infarcts ≤ 9 hours, the strongest predictor of SICH on multimodal CT was ASPECTS on CTA-SI. PMID:21143549

  15. Hypoxemia, oxygen content, and the regulation of cerebral blood flow

    PubMed Central

    Bain, Anthony R.; Rieger, Mathew G.; Bailey, Damian M; Ainslie, Philip N.

    2015-01-01

    This review highlights the influence of oxygen (O2) availability on cerebral blood flow (CBF). Evidence for reductions in O2 content (CaO2) rather than arterial O2 tension (PaO2) as the chief regulator of cerebral vasodilation, with deoxyhemoglobin as the primary O2 sensor and upstream response effector, is discussed. We review in vitro and in vivo data to summarize the molecular mechanisms underpinning CBF responses during changes in CaO2. We surmise that 1) during hypoxemic hypoxia in healthy humans (e.g., conditions of acute and chronic exposure to normobaric and hypobaric hypoxia), elevations in CBF compensate for reductions in CaO2 and thus maintain cerebral O2 delivery; 2) evidence from studies implementing iso- and hypervolumic hemodilution, anemia, and polycythemia indicate that CaO2 has an independent influence on CBF; however, the increase in CBF does not fully compensate for the lower CaO2 during hemodilution, and delivery is reduced; and 3) the mechanisms underpinning CBF regulation during changes in O2 content are multifactorial, involving deoxyhemoglobin-mediated release of nitric oxide metabolites and ATP, deoxyhemoglobin nitrite reductase activity, and the downstream interplay of several vasoactive factors including adenosine and epoxyeicosatrienoic acids. The emerging picture supports the role of deoxyhemoglobin (associated with changes in CaO2) as the primary biological regulator of CBF. The mechanisms for vasodilation therefore appear more robust during hypoxemic hypoxia than during changes in CaO2 via hemodilution. Clinical implications (e.g., disorders associated with anemia and polycythemia) and future study directions are considered. PMID:26676248

  16. Predictive modeling and in vivo assessment of cerebral blood flow in the management of complex cerebral aneurysms.

    PubMed

    Walcott, Brian P; Reinshagen, Clemens; Stapleton, Christopher J; Choudhri, Omar; Rayz, Vitaliy; Saloner, David; Lawton, Michael T

    2016-06-01

    Cerebral aneurysms are weakened blood vessel dilatations that can result in spontaneous, devastating hemorrhage events. Aneurysm treatment aims to reduce hemorrhage events, and strategies for complex aneurysms often require surgical bypass or endovascular stenting for blood flow diversion. Interventions that divert blood flow from their normal circulation patterns have the potential to result in unintentional ischemia. Recent developments in computational modeling and in vivo assessment of hemodynamics for cerebral aneurysm treatment have entered into clinical practice. Herein, we review how these techniques are currently utilized to improve risk stratification and treatment planning.

  17. Heterogeneity of muscarinic receptor subtypes in cerebral blood vessels

    SciTech Connect

    Garcia-Villalon, A.L.; Krause, D.N.; Ehlert, F.J.; Duckles, S.P. )

    1991-07-01

    The identity and distribution of muscarinic cholinergic receptor subtypes and associated signal transduction mechanisms was characterized for the cerebral circulation using correlated functional and biochemical investigations. Subtypes were distinguished by the relative affinities of a panel of muscarinic antagonists, pirenzepine, AF-DX 116 (11-2-((2-(diethylaminomethyl)- 1-piperidinyl)acetyl)-5,11-dihydro-6H- pyrido(2,3-b)(1,4)benzodiazepine-6-one), hexahydrosiladifenidol, methoctramine, 4-diphenylacetoxy-N-methylpiperidine methobromide, dicyclomine, para-fluoro-hexahydrosiladifenidol and atropine. Muscarinic receptors characterized by inhibition of (3H)quinuclidinylbenzilate binding in membranes of bovine pial arteries were of the M2 subtype. In contrast pharmacological analysis of (3H)-quinuclidinylbenzilate binding in bovine intracerebral microvessels suggests the presence of an M4 subtype. Receptors mediating endothelium-dependent vasodilation in rabbit pial arteries were of the M3 subtype, whereas muscarinic receptors stimulating endothelium-independent phosphoinositide hydrolysis in bovine pial arteries were of the M1 subtype. These findings suggest that characteristics of muscarinic receptors in cerebral blood vessels vary depending on the type of vessel, cellular location and function mediated.

  18. Cerebral blood flow in sickle cell cerebrovascular disease

    SciTech Connect

    Huttenlocher, P.R.; Moohr, J.W.; Johns, L.; Brown, F.D.

    1984-05-01

    Cerebral blood flow (CBF) has been studied by the xenon-133 (/sup 133/Xe) inhalation method in 16 children with suspected sickle cell cerebrovascular disease. Abnormalities consisting of decreases in total, hemispheral, or regional CBF were found in 17 of 26 studies. Eleven studies performed immediately after stroke, transient ischemic attack, or depression of state of alertness showed abnormalities. In addition to confirming regional cerebrovascular insufficiency in children with stroke due to major cerebral artery occlusion, the method detected diffuse decrease in CBF in children with stupor, coma, and seizures who had normal angiographic findings. In contrast, six of seven studies obtained after exchange transfusion or during maintenance on hypertransfusion therapy showed normal findings. The difference between results in patients with acute neurologic disturbances and those receiving transfusion therapy was statistically significant (P less than .005). The data indicate that the /sup 133/Xe method reliably demonstrates cerebrovascular impairment in sickle cell disease. They also suggest that CBF changes in patients with sickle cell disease can be reversed by exchange transfusion and by hypertransfusion therapy. The /sup 133/Xe CBF method may be useful for following up children with sickle cell disease who are at high risk for recurrent stroke.

  19. Radioactive oxygen-15 in the study of cerebral blood flow, blood volume, and oxygen metabolism

    SciTech Connect

    Ter-Pogossian, M.M.; Herscovitch, P.

    1985-10-01

    The short half-life of /sup 15/O led early observers to believe that it was unsuitable for use as a biological tracer. However, initial studies with this nuclide demonstrated its potential usefulness for in vivo, regional physiologic measurements. Subsequently, techniques were developed to measure cerebral blood flow (CBF), blood volume, and oxygen metabolism using intracarotid injection of /sup 15/O-labeled radiopharmaceuticals and highly collimated scintillation probes to record the time course of radioactivity in the brain. The development of positron emission tomography (PET) made possible the in vivo, noninvasive measurement of the absolute concentration of positron-emitting nuclides. A variety of tracer kinetic models were formulated to obtain physiologic measurements from tomographic images of the distribution of 15O-labeled radiopharmaceuticals in the brain. Regional cerebral oxygen metabolism is measured using scan data obtained following the inhalation of /sup 15/O-labeled oxygen. The tracer kinetic models used to measure rCBV, blood flow, and oxygen metabolism will be described and their relative advantages and limitations discussed. Several examples of the use of /sup 15/O tracer methods will be reviewed to demonstrate their widespread applicability to the study of cerebral physiology and pathophysiology. 110 references.

  20. Association of pulsatile and mean cerebral blood flow velocity with age and neuropsychological performance.

    PubMed

    Pase, Matthew P; Grima, Natalie A; Stough, Con; Scholey, Andrew; Pipingas, Andrew

    2014-05-10

    Low cerebral blood flow velocity is associated with cognitive decline. However, the association between pulsatile brain blood flow velocity and cognition has not been investigated. High pulsatile hemodynamic stress in the brain may impair cognitive function through damage to small cerebral vessels. The current objective was to examine the cross-sectional association of pulsatile and mean cerebral blood flow velocity with age and neuropsychological performance. We also examined whether cerebral blood flow velocity was associated with aortic pulse pressure, a measure of arterial ageing and aortic stiffness. Cerebral blood flow velocity was measured in the middle cerebral artery using Transcranial Doppler Ultrasonography (TDU) while neuropsychological performance was measured using a computerized cognitive test battery. Aortic pulse pressure was non-invasively derived from applanation tonometry of the radial artery. The sample comprised 160 healthy adults aged 50-70 years. Results indicated that increasing age correlated with lower mean (r=-0.23, p<0.01) and higher pulsatile (r=0.27, p<0.01) brain blood flow velocity. In multivariate adjusted models, both peripheral (β=0.28, p<0.05) and aortic (β=0.24, p<0.05) pulse pressure were associated with higher pulsatile flow velocity through the middle cerebral artery. In adjusted models, neither mean nor pulsatile cerebral blood flow velocity was associated with performance on any cognitive task. In conclusion, arterial ageing was associated with increased pulsatile hemodynamic stress in the brain. However, this was not associated with impaired neuropsychological performance.

  1. Ictal regional cerebral blood flow in frontal lobe seizures.

    PubMed

    Duncan, R; Patterson, J; Hadley, D; Roberts, R

    1997-10-01

    99mTC (single photon emission computed tomography) (HMPAO SPECT) was carried out during 16 frontal-lobe seizures in 15 patients. Focal changes in regional cerebral blood flow were seen during all seizures. In 9 of 16 seizures SPECT showed hyperperfusion localized to one frontal lobe. In 1 of 16 seizures ictal hypoperfusion was seen in one frontal lobe. In 2 of 16 seizures there was hyperperfusion in both frontal lobes, and in 4 of 16 seizures hyperperfusion involved the frontal lobe or lobes plus other lobes of the brain. These changes were accompanied by hyperperfusion of subcortical structures in 13 seizures. SPECT thus localized to one frontal lobe in 10 of 16 seizures, and localized to the frontal lobes without lateralizing in two further seizures. No seizure showed a pattern of perfusion similar to that reported in mesial-temporal-lobe seizures. We conclude that ictal SPECT may provide useful localizing information in frontal-lobe seizures.

  2. Cerebral blood flow in normal and abnormal sleep and dreaming

    SciTech Connect

    Meyer, J.S.; Ishikawa, Y.; Hata, T.; Karacan, I.

    1987-07-01

    Measurements of regional or local cerebral blood flow (CBF) by the xenon-133 inhalation method and stable xenon computerized tomography CBF (CTCBF) method were made during relaxed wakefulness and different stages of REM and non-REM sleep in normal age-matched volunteers, narcoleptics, and sleep apneics. In the awake state, CBF values were reduced in both narcoleptics and sleep apneics in the brainstem and cerebellar regions. During sleep onset, whether REM or stage I-II, CBF values were paradoxically increased in narcoleptics but decreased severely in sleep apneics, while in normal volunteers they became diffusely but more moderately decreased. In REM sleep and dreaming CBF values greatly increased, particularly in right temporo-parietal regions in subjects experiencing both visual and auditory dreaming.

  3. Optical coherence Doppler tomography for quantitative cerebral blood flow imaging

    PubMed Central

    You, Jiang; Du, Congwu; Volkow, Nora D.; Pan, Yingtian

    2014-01-01

    Optical coherence Doppler tomography (ODT) is a promising neurotechnique that permits 3D imaging of the cerebral blood flow (CBF) network; however, quantitative CBF velocity (CBFv) imaging remains challenging. Here we present a simple phase summation method to enhance slow capillary flow detection sensitivity without sacrificing dynamic range for fast flow and vessel tracking to improve angle correction for absolute CBFv quantification. Flow phantom validation indicated that the CBFv quantification accuracy increased from 15% to 91% and the coefficient of variation (CV) decreased 9.3-fold; in vivo mouse brain validation showed that CV decreased 4.4-/10.8- fold for venular/arteriolar flows. ODT was able to identify cocaine-elicited microischemia and quantify CBFv disruption in branch vessels and capillaries that otherwise would have not been possible. PMID:25401033

  4. Anterior-Posterior Cerebral Blood Volume Gradient in Human Subiculum

    PubMed Central

    Talati, Pratik; Rane, Swati; Kose, Samet; Gore, John; Heckers, Stephan

    2014-01-01

    The human hippocampal formation is characterized by anterior-posterior gradients of cell density, neurochemistry and hemodynamics. In addition, some functions are associated with specific subfields (subiculum, CA1–4, dentate gyrus) and regions (anterior and posterior). We performed contrast-enhanced, high-resolution T1-weighted 3T steady state (SS) imaging to investigate cerebral blood volume (CBV) gradients of the hippocampal formation. We studied 14 healthy subjects and found significant CBV gradients (anterior > posterior) in the subiculum but not in other hippocampal subfields. Since CBV is a marker of basal metabolism, these results indicate a greater baseline activity in the anterior compared to the posterior subiculum. This gradient might be related to the role of the subiculum as the main outflow station of the hippocampal formation and might have implications for the mechanisms of neuropsychiatric disorders. PMID:24677295

  5. Inherited neurovascular diseases affecting cerebral blood vessels and smooth muscle.

    PubMed

    Sam, Christine; Li, Fei-Feng; Liu, Shu-Lin

    2015-10-01

    Neurovascular diseases are among the leading causes of mortality and permanent disability due to stroke, aneurysm, and other cardiovascular complications. Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and Marfan syndrome are two neurovascular disorders that affect smooth muscle cells through accumulation of granule and osmiophilic materials and defective elastic fiber formations respectively. Moyamoya disease, hereditary hemorrhagic telangiectasia (HHT), microcephalic osteodysplastic primordial dwarfism type II (MOPD II), and Fabry's disease are disorders that affect the endothelium cells of blood vessels through occlusion or abnormal development. While much research has been done on mapping out mutations in these diseases, the exact mechanisms are still largely unknown. This paper briefly introduces the pathogenesis, genetics, clinical symptoms, and current methods of treatment of the diseases in the hope that it can help us better understand the mechanism of these diseases and work on ways to develop better diagnosis and treatment.

  6. Longitudinal cerebral blood flow changes during speech in hereditary ataxia

    PubMed Central

    Sidtis, John J.; Strother, Stephen C.; Groshung, Ansam; Rottenberg, David A.; Gomez, Christopher

    2010-01-01

    The hereditary ataxias constitute a group of degenerative diseases that progress over years or decades. With principal pathology involving the cerebellum, dysarthria is an early feature of many of the ataxias. Positron Emission Tomography was used to study regional cerebral blood flow changes during speech production over a 21 month period in a group of seven right-handed subjects with hereditary ataxia (6 females and 1 male, 3 SCA1 and 4 SCA5, aged 38.3 +/− 18.9 years). The decline in blood flow was greatest in cerebellar regions. In contrast, blood flow actually increased during speech production in the classic speech area (Broca’s area) but not in its right hemisphere homologue at the second evaluation. This increase in cortical flow may have been compensatory for cerebellar degeneration as speech intelligibility did not decline significantly during this period. Compensation was not complete, though, as syllable timing shifted in the direction of equal syllable duration, one of the characteristics of ataxic dysarthria. These results are consistent with previous functional imaging studies of ataxia demonstrating a pattern of brain activity that reflects both loss of function and relative compensation when clinical signs and symptoms are still mild. The combination of disease-relevant tasks, behavioral measurement, and functional imaging may provide insight into the early changes associated with neurodegenerative disease. PMID:20417959

  7. Adaptive sampling of CT data for myocardial blood flow estimation from dose-reduced dynamic CT

    NASA Astrophysics Data System (ADS)

    Modgil, Dimple; Bindschadler, Michael D.; Alessio, Adam M.; La Rivière, Patrick J.

    2015-03-01

    Quantification of myocardial blood flow (MBF) can aid in the diagnosis and treatment of coronary artery disease (CAD). However, there are no widely accepted clinical methods for estimating MBF. Dynamic CT holds the promise of providing a quick and easy method to measure MBF quantitatively, however the need for repeated scans has raised concerns about the potential for high radiation dose. In our previous work, we explored techniques to reduce the patient dose by either uniformly reducing the tube current or by uniformly reducing the number of temporal frames in the dynamic CT sequence. These dose reduction techniques result in very noisy data, which can give rise to large errors in MBF estimation. In this work, we seek to investigate whether nonuniformly varying the tube current or sampling intervals can yield more accurate MBF estimates. Specifically, we try to minimize the dose and obtain the most accurate MBF estimate through addressing the following questions: when in the time attenuation curve (TAC) should the CT data be collected and at what tube current(s). We hypothesize that increasing the sampling rate and/or tube current during the time frames when the myocardial CT number is most sensitive to the flow rate, while reducing them elsewhere, can achieve better estimation accuracy for the same dose. We perform simulations of contrast agent kinetics and CT acquisitions to evaluate the relative MBF estimation performance of several clinically viable adaptive acquisition methods. We found that adaptive temporal and tube current sequences can be performed that impart an effective dose of about 5 mSv and allow for reductions in MBF estimation RMSE on the order of 11% compared to uniform acquisition sequences with comparable or higher radiation doses.

  8. MRI of cerebral blood flow under hyperbaric conditions in rats.

    PubMed

    Cardenas, Damon P; Muir, Eric R; Duong, Timothy Q

    2016-07-01

    Hyperbaric oxygen (HBO) therapy has a number of clinical applications. However, the effects of acute HBO on basal cerebral blood flow (CBF) and neurovascular coupling are not well understood. This study explored the use of arterial spin labeling MRI to evaluate changes in baseline and forepaw stimulus-evoked CBF responses in rats (n = 8) during normobaric air (NB), normobaric oxygen (NBO) (100% O2 ), 3 atm absolute (ATA) hyperbaric air (HB) and 3 ATA HBO conditions. T1 was also measured, and the effects of changes in T1 caused by increasing oxygen on the CBF calculation were investigated. The major findings were as follows: (i) increased inhaled oxygen concentrations led to a reduced respiration rate; (ii) increased dissolved paramagnetic oxygen had significant effects on blood and tissue T1 , which affected the CBF calculation using the arterial spin labeling method; (iii) the differences in blood T1 had a larger effect than the differences in tissue T1 on CBF calculation; (iv) if oxygen-induced changes in blood and tissue T1 were not taken into account, CBF was underestimated by 33% at 3 ATA HBO, 10% at NBO and <5% at HB; (v) with correction, CBF values under HBO, HB and NBO were similar (p > 0.05) and all were higher than CBF under NB by ~40% (p < 0.05), indicating that hypercapnia from the reduced respiration rate masks oxygen-induced vasoconstriction, although blood gas was not measured; and (vi) substantial stimulus-evoked CBF increases were detected under HBO, similar to NB, supporting the notion that activation-induced CBF regulation in the brain does not operate through an oxygen-sensing mechanism. CBF MRI provides valuable insights into the effects of oxygen on basal CBF and neurovascular coupling under hyperbaric conditions. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Cerebral blood flow autoregulation in early experimental S. pneumoniae meningitis.

    PubMed

    Pedersen, Michael; Brandt, Christian T; Knudsen, Gitte M; Ostergaard, Christian; Skinhøj, Peter; Frimodt-Møller, Niels; Møller, Kirsten

    2007-01-01

    We studied cerebral blood flow (CBF) autoregulation and intracranial pressure (ICP) during normo- and hyperventilation in a rat model of Streptococcus pneumoniae meningitis. Meningitis was induced by intracisternal injection of S. pneumoniae. Mean arterial blood pressure (MAP), ICP, cerebral perfusion pressure (CPP, defined as MAP - ICP), and laser-Doppler CBF were measured in anesthetized infected rats (n = 30) and saline-inoculated controls (n = 30). CPP was either incrementally reduced by controlled hemorrhage or increased by intravenous norepinephrine infusion. Twelve hours postinoculation, rats were studied solely during normocapnia, whereas rats studied after 24 h were exposed to either normocapnia or to acute hypocapnia. In infected rats compared with control rats, ICP was unchanged at 12 h but increased at 24 h postinoculation (not significant and P < 0.01, respectively); hypocapnia did not lower ICP compared with normocapnia. Twelve hours postinoculation, CBF autoregulation was lost in all infected rats but preserved in all control rats (P < 0.01). Twenty-four hours after inoculation, 10% of infected rats had preserved CBF autoregulation during normocapnia compared with 80% of control rats (P < 0.01). In contrast, 60% of the infected rats and 100% of the control rats showed an intact CBF autoregulation during hypocapnia (P < 0.05 for the comparison of infected rats at normocapnia vs. hypocapnia). In conclusion, CBF autoregulation is lost both at 12 and at 24 h after intracisternal inoculation of S. pneumoniae in rats. Impairment of CBF autoregulation precedes the increase in ICP, and acute hypocapnia may restore autoregulation without changing the ICP.

  10. Cerebral blood volume in humans by NIRS and PET

    NASA Astrophysics Data System (ADS)

    Pott, Frank; Knudsen, Gitte M.; Rostrup, Egill; Ide, Kojiro; Secher, Niels H.; Paulson, Olaf B.

    1998-01-01

    Near infrared spectroscopy (NIRS) determined changes in the cerebral blood volume (CBV) were compared to those obtained by positron emission tomography (PET) in five healthy volunteers (2 females). Two NIRS optodes were placed on the left forehead and NIRS-CBV was derived from the sum of oxyhemoglobin and deoxyhemoglobin. CBV changes were induced by hyperventilation and inhalation of 6% CO2. After 2 min inhalation of labeled carbon monoxide, data were sampled during 8 min for both PET- and NIRS-CBV as well as for the arterial carbon dioxide tension (PaCO2). The region of interest for PET-CBV was `banana-shaped' with boundaries corresponding to the position of the NIRS optodes on the transmission scan and to a depth of approximately 2 cm. During hyperventilation, PaCO2 decreased from 5.2 (4.6 - 5.8) to 4.6 (4.2 - 4.9) kPa and equally PET-CBV (from 3.9 (2.5 - 5.2) to 3.6 (3.0 - 4.8) ml (DOT) 100 g-1) and NIRS-CBV were reduced (by -0.14 [-0.38 - 0.50] ml (DOT) 100 g-1). During hypercapnia PaCO2 increased to 6.0 (5.9 - 7.0) kPa accompanied by parallel changes in PET- (to 4.5 (3.9 - 4.9) ml (DOT) 100 g-1) and NIRS-CBV (by 0.04 [-0.02 - 0.30] ml (DOT) 100 g-1) and the two variables were correlated (r equals 0.78, p < 0.05). In conclusion, with a moderate change in the arterial carbon dioxide tension, the cerebral blood volumes determined by near infrared spectroscopy and by positron emission tomography change in parallel but the change in NIRS-CBV is small compared to that obtained by PET.

  11. Cerebral blood volume in humans by NIRS and PET

    NASA Astrophysics Data System (ADS)

    Pott, Frank; Knudsen, Gitte M.; Rostrup, Egill; Ide, Kojiro; Secher, Niels H.; Paulson, Olaf B.

    1997-12-01

    Near infrared spectroscopy (NIRS) determined changes in the cerebral blood volume (CBV) were compared to those obtained by positron emission tomography (PET) in five healthy volunteers (2 females). Two NIRS optodes were placed on the left forehead and NIRS-CBV was derived from the sum of oxyhemoglobin and deoxyhemoglobin. CBV changes were induced by hyperventilation and inhalation of 6% CO2. After 2 min inhalation of labeled carbon monoxide, data were sampled during 8 min for both PET- and NIRS-CBV as well as for the arterial carbon dioxide tension (PaCO2). The region of interest for PET-CBV was `banana-shaped' with boundaries corresponding to the position of the NIRS optodes on the transmission scan and to a depth of approximately 2 cm. During hyperventilation, PaCO2 decreased from 5.2 (4.6 - 5.8) to 4.6 (4.2 - 4.9) kPa and equally PET-CBV (from 3.9 (2.5 - 5.2) to 3.6 (3.0 - 4.8) ml (DOT) 100 g-1) and NIRS-CBV were reduced (by -0.14 [-0.38 - 0.50] ml (DOT) 100 g-1). During hypercapnia PaCO2 increased to 6.0 (5.9 - 7.0) kPa accompanied by parallel changes in PET- (to 4.5 (3.9 - 4.9) ml (DOT) 100 g-1) and NIRS-CBV (by 0.04 [-0.02 - 0.30] ml (DOT) 100 g-1) and the two variables were correlated (r equals 0.78, p < 0.05). In conclusion, with a moderate change in the arterial carbon dioxide tension, the cerebral blood volumes determined by near infrared spectroscopy and by positron emission tomography change in parallel but the change in NIRS-CBV is small compared to that obtained by PET.

  12. Scaling of cerebral blood perfusion in primates and marsupials.

    PubMed

    Seymour, Roger S; Angove, Sophie E; Snelling, Edward P; Cassey, Phillip

    2015-08-01

    The evolution of primates involved increasing body size, brain size and presumably cognitive ability. Cognition is related to neural activity, metabolic rate and rate of blood flow to the cerebral cortex. These parameters are difficult to quantify in living animals. This study shows that it is possible to determine the rate of cortical brain perfusion from the size of the internal carotid artery foramina in skulls of certain mammals, including haplorrhine primates and diprotodont marsupials. We quantify combined blood flow rate in both internal carotid arteries as a proxy of brain metabolism in 34 species of haplorrhine primates (0.116-145 kg body mass) and compare it to the same analysis for 19 species of diprotodont marsupials (0.014-46 kg). Brain volume is related to body mass by essentially the same exponent of 0.70 in both groups. Flow rate increases with haplorrhine brain volume to the 0.95 power, which is significantly higher than the exponent (0.75) expected for most organs according to 'Kleiber's Law'. By comparison, the exponent is 0.73 in marsupials. Thus, the brain perfusion rate increases with body size and brain size much faster in primates than in marsupials. The trajectory of cerebral perfusion in primates is set by the phylogenetically older groups (New and Old World monkeys, lesser apes) and the phylogenetically younger groups (great apes, including humans) fall near the line, with the highest perfusion. This may be associated with disproportionate increases in cortical surface area and mental capacity in the highly social, larger primates.

  13. Effect of hematocrit and systolic blood pressure on cerebral blood flow in newborn infants

    SciTech Connect

    Younkin, D.P.; Reivich, M.; Jaggi, J.L.; Obrist, W.D.; Delivoria-Papadopoulos, M.

    1987-06-01

    The effects of hematocrit and systolic blood pressure on cerebral blood flow were measured in 15 stable, low birth weight babies. CBF was measured with a modification of the xenon-133 (/sup 133/Xe) clearance technique, which uses an intravenous bolus of /sup 133/Xe, an external chest detector to estimate arterial /sup 133/Xe concentration, eight external cranial detectors to measure cephalic /sup 133/Xe clearance curves, and a two-compartmental analysis of the cephalic /sup 133/Xe clearance curves to estimate CBF. There was a significant inverse correlation between hematocrit and CBF, presumably due to alterations in arterial oxygen content and blood viscosity. Newborn CBF varied independently of systolic blood pressure between 60 and 84 mm Hg, suggesting an intact cerebrovascular autoregulatory mechanism. These results indicate that at least two of the factors that affect newborn animal CBF are operational in human newborns and may have important clinical implications.

  14. Impacts of small arteriovenous malformations (AVM) on regional cerebral blood flow and glucose metabolism

    SciTech Connect

    Liu, R.S.; Yeh, S.H.; Chu, L.S.

    1994-05-01

    This study assessed the effects of small AVMs (<3 cm) on the regional cerebral blood flow (rCBF) by Tc-99m HMPAO SPECT and on the glucose metabolism (rCGlcM) by [F-18]-FDG PET. Seven AVM patients (pts) were studied. All AVMs were confirmed by cerebral angiography and CT/MR scans. Tc-99m HMPAO SPECT and [F-18]-PDG PET images were interpreted visually to detect the changes of rCBF and rCGlcM. All pts except one brain stem AVM had defects in the regions of nidi on HMPAO and FDG images. FDG PET disclosed low rCGlcM in surrounding areas of AVMs in 6 pts, while HMPAO SPECT detected only 4 cases. One AVM had increased rCBF surrounding the nidus despite of decreased rCGlcM in the same region. Five pts had abnormal rCGlcM over ipsilateral remote cortex but only one had corresponding abnormal rCBF. Contralateral cortical hypofunction was noted in 3 pts by FDG PET but none by HMPAO SPECT. Cross cerebellar diaschisis was found in 2 AVMs by FDG PET and only one by HMPAO SPECT. All regions with abnormal HMPAO uptake did not look as discernibly as seen on the FDG PET scan. CT/MR scans detected the nidi of AVMs of all pts and old hemorrhage in one pt. In conclusion, either HMPAO SPECT or FDG PET is sensitive to detect the functional abnormalities in the region of nidus of small AVM and the surrounding brain tissue. FDG PET is better than HMPAO SPECT to detect functional changes in the remote cortex and diaschisis.

  15. A practical method of serial bedside measurement of cerebral blood flow and metabolism during neurointensive care.

    PubMed Central

    Sharples, P M; Stuart, A G; Aynsley-Green, A; Heaviside, D; Pay, D A; McGann, A; Crawford, P J; Harpin, R; Eyre, J A

    1991-01-01

    Acute encephalopathy is a major cause of death and neurological handicap in children. The principle aims of treatment are to provide adequate cerebral blood flow for the brain's metabolic needs and to prevent intracranial pressure rising above the level at which brain herniation occurs. Rational management requires an understanding of the pathophysiological changes in cerebral blood flow and metabolism which occur. The paucity of data on this subject reflects the perceived difficulty of measuring cerebral blood flow and cerebral metabolism in children. A modification of the Kety Schmidt technique of measuring cerebral blood flow and cerebral metabolism is described. This modification makes it possible to perform serial bedside measurements in children receiving intensive care. This method was used to perform 348 measurements in 58 children. The method was reproducible and no significant complications were encountered. The results indicated that appreciable changes in cerebral blood flow and metabolism could occur in individual patients over time, emphasising the importance of serial measurements. This technique may provide a practical means of monitoring cerebral blood flow and metabolism in very sick children receiving neurointensive care and evaluating the efficacy of treatment. PMID:1755648

  16. Determination of regional cerebral blood flow in patients with cerebral infarction. Use of fluoromethane labeled with fluorine 18 and positron emission tomography

    SciTech Connect

    Celesia, G.G.; Polcyn, R.E.; Holden, J.E.; Nickles, R.J.; Koeppe, R.A.; Gatley, S.J.

    1984-03-01

    Regional cerebral blood flow (rCBF) was determined using the tissue kinetic of fluoromethane labeled with fluorine 18 and positron emission tomography (PET) in 13 normal subjects and 21 patients with cerebrovascular diseases. The mean brain rCBF was 42.9 +/- 4.3 mL/100 g/min during the resting state. The highest rCBF (60 +/- 8 mL/100 g/min) was noted in the mesial occipital region corresponding to cortical area 17. All 17 cases of cerebral ischemic infarcts had depressed rCBF in the hemisphere ipsilateral to the infarct. Every area of decreased density shown in the conventional computed tomograms (CT) was detected on the PET as an area of decreased rCBF (mean rCBF of infarcted area, 14.3 +/- 6 mL/100 g/min). The PET images showed a wider area of depressed rCBF than the region of the anatomic infarct. Five types of remote effects were noted in areas without structural damage: (1) decreased flow in the thalamus and caudate ipsilateral to the infarct; (2) decreased flow in the hemisphere contralateral to the cerebral infarct; (3) decreased flow in the cerebellar hemisphere contralateral to the cerebral infarct; (4) decreased flow in the visual cortex distal to the optic radiation lesion; and (5) decreased flow in the frontal cortex ipsilateral to the infarct. The effects in the contralateral hemisphere and the cerebellum were present only in the acute postictal phase. In four cases of transient ischemic attacks, rCBF was normal. It is concluded that this technique of measuring rCBF is a reliable method of identifying cerebral ischemia and that the determination of the extent of impaired rCBF provides a more accurate assessment of the region of brain dysfunction than CTs.

  17. Interleaving cerebral CT perfusion with neck CT angiography. Part II: clinical implementation and image quality.

    PubMed

    Oei, Marcel T H; Meijer, Frederick J A; van der Woude, Willem-Jan; Smit, Ewoud J; van Ginneken, Bram; Manniesing, Rashindra; Prokop, Mathias

    2017-06-01

    Feasibility evaluation of the One-Step Stroke Protocol, which is an interleaved cerebral computed tomography perfusion (CTP) and neck volumetric computed tomography angiography (vCTA) scanning technique using wide-detector computed tomography, and to assess the image quality of vCTA. Twenty patients with suspicion of acute ischaemic stroke were prospectively scanned and evaluated with a head and neck CTA and with the One-Step Stroke Protocol. Arterial enhancement and contrast-to-noise ratio (CNR) in the carotid arteries was assessed. Three observers scored artefacts and image quality of the cervical arteries. The total z-coverage was evaluated. Mean enhancement in the carotid bifurcation was rated higher in the vCTA (595 ± 164 HU) than CTA (441 ± 117 HU). CNR was rated higher in vCTA. Image quality scores showed no significant difference in the region of the carotid bifurcation between vCTA and CTA. Lower neck image quality scores were slightly lower for vCTA due to artefacts, although not rated as diagnostically relevant. In ten patients, the origin of the left common carotid artery was missed by 1.6 ± 0.8 cm. Mean patient height was 1.8 ± 0.09 m. Carotid bifurcation and origin of vertebral arteries were covered in all patients. The One-Step Stroke Protocol is feasible with good diagnostic image quality of vCTA, although full z-coverage is limited in tall patients. • Interleaving cerebral CTP with neck CTA (One-Step Stroke Protocol) is feasible • Diagnostic quality of One-Step Stroke Protocol neck CTA is similar to conventional CTA • One-Step Stroke Protocol neck CTA suffers from streak artefacts in the lower neck • A limitation of One-Step Stroke Protocol CTA is lack of coverage in tall patients • Precise planning of One-Step Stroke Protocol neck CTA is necessary in tall patients.

  18. A Modeling of Cerebral Blood Flow Changes due to Head Motion for fNIRS

    NASA Astrophysics Data System (ADS)

    Takahashi, Kosuke; Tanaka, Takayuki; Nara, Hiroyuki; Kaneko, Shun'ichi; Inoue, Masao; Shimizu, Shunji; Kojima, Satoru

    2013-04-01

    A method is proposed for measuring brain activity during exercises involving head motion by using functional near-infrared spectroscopy (fNIRS), which investigates cerebral hemodynamics. Obtaining measurements during exercise is difficult because cerebral blood flow changes due to the head motion component (HMC), in addition to neural activity. HMC is an undesirable artifact in the measurement of hemodynamic response caused by neural activity, and as such, it must be estimated and eliminated. In our experiments, cerebral blood flow and head motion were measured during repeated passive forward bending of the subjects. Head motion was measured by 3-D motion capture, and HMC was estimated by deriving a relation between head motion and cerebral blood flow, where the pitch angle was found to be suitable for estimating HMC. In this research, an assumption was made that cerebral blood flow caused by neural activity and that caused by postural change were additive, and thus HMC was eliminated by subtraction.

  19. Surgical treatment of distal anterior cerebral artery aneurysms aided by electromagnetic navigation CT angiography.

    PubMed

    Hermann, Elvis J; Petrakakis, Ioannis; Götz, Friedrich; Lütjens, Götz; Lang, Josef; Nakamura, Makoto; Krauss, Joachim K

    2015-07-01

    The surgical treatment of distal anterior cerebral artery (DACA) aneurysms still presents a challenge for neurosurgeons because of their small size and their location in the depth of the narrow frontal interhemispheric fissure. This study aimed to investigate feasibility, safety, accuracy, and usefulness of electromagnetic (EM) navigation to aid clipping of DACA aneurysms. Eight patients (age between 2 and 68 years, mean age 49.8 years) with a DACA aneurysm underwent EM-guided neuronavigated microsurgery for clipping of the aneurysm. All patients underwent craniocervical 3D-CT angiography preoperatively. After planning the optimal approach and surgical trajectory avoiding opening of the frontal sinus, the head was fixed. Intraoperative screenshots were correlated with the microscopical view of the DACA aneurysms before clipping. EM-guided neuronavigation using CT angiography for DACA aneurysms enabled fast and accurate referencing of the patient and planning of a tailored craniotomy without opening of the frontal sinus. Intraoperative accuracy was highly reliable except in one instance due to dislocation of the dynamic reference frame (DRF). There was a good correlation between the 3D-CT angiography-based navigation data sets and the intraoperative vascular anatomy. In all patients, bridging veins were spared. The aid of EM neuronavigation was considered useful in all instances. EM-guided neuronavigation using CT angiography for surgery of DACA aneurysms is a useful tool optimizing the surgical approach directly to the aneurysm minimizing additional damage to the surrounding tissue during preparation of the aneurysm and the parent vessel.

  20. Dynamic cone beam CT angiography of carotid and cerebral arteries using canine model

    SciTech Connect

    Cai Weixing; Zhao Binghui; Conover, David; Liu Jiangkun; Ning Ruola

    2012-01-15

    Purpose: This research is designed to develop and evaluate a flat-panel detector-based dynamic cone beam CT system for dynamic angiography imaging, which is able to provide both dynamic functional information and dynamic anatomic information from one multirevolution cone beam CT scan. Methods: A dynamic cone beam CT scan acquired projections over four revolutions within a time window of 40 s after contrast agent injection through a femoral vein to cover the entire wash-in and wash-out phases. A dynamic cone beam CT reconstruction algorithm was utilized and a novel recovery method was developed to correct the time-enhancement curve of contrast flow. From the same data set, both projection-based subtraction and reconstruction-based subtraction approaches were utilized and compared to remove the background tissues and visualize the 3D vascular structure to provide the dynamic anatomic information. Results: Through computer simulations, the new recovery algorithm for dynamic time-enhancement curves was optimized and showed excellent accuracy to recover the actual contrast flow. Canine model experiments also indicated that the recovered time-enhancement curves from dynamic cone beam CT imaging agreed well with that of an IV-digital subtraction angiography (DSA) study. The dynamic vascular structures reconstructed using both projection-based subtraction and reconstruction-based subtraction were almost identical as the differences between them were comparable to the background noise level. At the enhancement peak, all the major carotid and cerebral arteries and the Circle of Willis could be clearly observed. Conclusions: The proposed dynamic cone beam CT approach can accurately recover the actual contrast flow, and dynamic anatomic imaging can be obtained with high isotropic 3D resolution. This approach is promising for diagnosis and treatment planning of vascular diseases and strokes.

  1. Observation on the effects of Chinese medicine zhenxuanyin for improving cerebral blood flow in rats with cerebral ischemia.

    PubMed

    Jingyi, W; Yasuhiro, M; Naoya, H; Seok, R C; Yoshiharu, Y; Nagara, T; Fumiko, T; Shigeru, M; Junji, K

    1997-12-01

    Zhenxuanyin [symbol: see text] is composed of pure Chinese medicinal herbs, such as gastrodia tuber, poria cocos, ligusticum wallichii etc. 4-verssel occlusion (4VO) model rats were reperfused after 30 minutes' complete occlusion, and Zhenxuanyin was administered 3 times a day. 24 hours later, 123I-IMP uptake in the brain was evaluated as an index of cerebral blood flow (CBF). The results show that Zhenxuanyin (0.03 g/kg, 0.3 g/kg, 1 g/kg, or 3 g/kg a day) can greatly improve the blood flow in the main cerebral regions, and 0.3 g/kg can increase cerebral blood flow (CBF) to the normal level.

  2. Dragon's blood dropping pills have protective effects on focal cerebral ischemia rats model.

    PubMed

    Xin, Nian; Yang, Fang-Ju; Li, Yan; Li, Yu-Juan; Dai, Rong-Ji; Meng, Wei-Wei; Chen, Yan; Deng, Yu-Lin

    2013-12-15

    Dragon's blood is a bright red resin obtained from Dracaena cochinchinensis (Lour.) S.C.Chen (Yunnan, China). As a traditional Chinese medicinal herb, it has great traditional medicinal value and is used for wound healing and to stop bleeding. Its main biological activity comes from phenolic compounds. In this study, phenolic compounds were made into dropping pills and their protective effects were examined by establishing focal cerebral ischemia rats model used method of Middle Cerebral Artery Occlusion (MCAO), and by investigating indexes of neurological scores, infarct volume, cerebral index, cerebral water content and oxidation stress. Compared to model group, high, middle and low groups of Dragon's blood dropping pills could improve the neurological function significantly (p<0.01) and reduce cerebral infarct volume of focal cerebral ischemia rats remarkably (p<0.05-0.01). Meanwhile, each group could alleviate cerebral water content and cerebral index (p<0.05-0.01) and regulate oxidative stress of focal cerebral ischemia rats obviously (p<0.05-0.01). Activities of middle group corresponded with that treated with positive control drug. The results obtained here showed that Dragon's blood dropping pills had protective effects on focal cerebral ischemia rats.

  3. Application of Blood-Brain Barrier Permeability Imaging in Global Cerebral Edema

    PubMed Central

    Ivanidze, Jana; Kallas, Omar N.; Gupta, Ajay; Weidman, Elizabeth; Baradaran, Hediyeh; Mir, Danial; Giambrone, Ashley; Segal, Alan Z.; Claassen, Jan; Sanelli, Pina C.

    2016-01-01

    Background and Purpose Blood brain barrier permeability (BBBP) is not presently routinely evaluated in the clinical setting. Global cerebral edema (GCE) occurs after SAH and is associated with BBB disruption. Detection of GCE is challenging using current imaging techniques. Our purpose was to apply BBBP imaging in patients with GCE using extended pass CT Perfusion (CTP). Methods SAH patients underwent CTP in the early phase after aneurysmal rupture (days 0-3) and were classified as GCE or non-GCE using established non-contrast CT criteria. CTP were post-processed into BBBP quantitative maps of PS (permeability surface area product), K-trans (volume transfer constant from blood plasma to extravascular extracellular space, EES), Kep (washout rate constant of the contrast agent from EES to intravascular space), VE (EES volume per unit of tissue volume), VP (plasmatic volume per unit of tissue volume) and F (plasma flow) using Olea Sphere software. Mean values were compared using t-tests. Results 22 patients were included in the analysis. Kep (1.32 versus 1.52, p < 0.0001), K-trans (0.15 versus 0.19, p < 0.0001), VP (0.51 versus 0.57, p = 0.0007) and F (1176 versus 1329, p = 0.0001) were decreased in GCE compared to non-GCE while VE (0.81 versus 0.39, p < 0.0001) was increased. Conclusion Extended CTP was utilized to evaluate BBBP in SAH patients with and without GCE. Kep is an important indicator of altered BBBP in patients with decreased blood flow, as Kep is flow-independent. Further study of BBBP is needed to improve diagnosis and monitoring of GCE. PMID:27127002

  4. Regional cerebral blood flow and blood volume in patients with subcortical arteriosclerotic encephalopathy (SAE).

    PubMed

    Gückel, Friedemann J; Brix, Gunnar; Hennerici, Michael; Lucht, Robert; Ueltzhöffer, Christine; Neff, Wolfgang

    2007-10-01

    The aim of the present study was a detailed analysis of the regional cerebral blood flow and blood volume in patients with subcortical arteriosclerotic encephalopathy (SAE) by means of functional magnetic resonance imaging (MRI). A group of 26 patients with SAE and a group of 16 age-matched healthy volunteers were examined. Using a well-established dynamic susceptibility contrast-enhanced MRI method, the regional cerebral blood flow (rCBF) and blood volume (rCBV) were quantified for each subject in 12 different regions in the brain parenchyma. As compared to healthy volunteers, patients with SAE showed significantly reduced rCBF and rCBV values in white matter regions and in the occipital cortex. Regions containing predominantly grey matter show almost normal rCBF and rCBV values. In conclusion, quantitative analysis of rCBF and rCBV values demonstrates clearly that SAE is a disease that is associated with a reduced microcirculation predominantly in white matter.

  5. Cerebral blood flow velocity declines before arterial pressure in patients with orthostatic vasovagal presyncope

    NASA Technical Reports Server (NTRS)

    Dan, Dan; Hoag, Jeffrey B.; Ellenbogen, Kenneth A.; Wood, Mark A.; Eckberg, Dwain L.; Gilligan, David M.

    2002-01-01

    OBJECTIVES: We studied hemodynamic changes leading to orthostatic vasovagal presyncope to determine whether changes of cerebral artery blood flow velocity precede or follow reductions of arterial pressure. BACKGROUND: Some evidence suggests that disordered cerebral autoregulation contributes to the occurrence of orthostatic vasovagal syncope. We studied cerebral hemodynamics with transcranial Doppler recordings, and we closely examined the temporal sequence of changes of cerebral artery blood flow velocity and systemic arterial pressure in 15 patients who did or did not faint during passive 70 degrees head-up tilt. METHODS: We recorded photoplethysmographic arterial pressure, RR intervals (electrocardiogram) and middle cerebral artery blood flow velocities (mean, total, mean/RR interval; Gosling's pulsatility index; and cerebrovascular resistance [mean cerebral velocity/mean arterial pressure, MAP]). RESULTS: Eight men developed presyncope, and six men and one woman did not. Presyncopal patients reported light-headedness, diaphoresis, or a sensation of fatigue 155 s (range: 25 to 414 s) before any cerebral or systemic hemodynamic change. Average cerebral blood flow velocity (CBFV) changes (defined by an iterative linear regression algorithm) began 67 s (range: 9 to 198 s) before reductions of MAP. Cerebral and systemic hemodynamic measurements remained constant in nonsyncopal patients. CONCLUSIONS: Presyncopal symptoms and CBFV changes precede arterial pressure reductions in patients with orthostatic vasovagal syncope. Therefore, changes of cerebrovascular regulation may contribute to the occurrence of vasovagal reactions.

  6. Cerebral blood flow velocity declines before arterial pressure in patients with orthostatic vasovagal presyncope

    NASA Technical Reports Server (NTRS)

    Dan, Dan; Hoag, Jeffrey B.; Ellenbogen, Kenneth A.; Wood, Mark A.; Eckberg, Dwain L.; Gilligan, David M.

    2002-01-01

    OBJECTIVES: We studied hemodynamic changes leading to orthostatic vasovagal presyncope to determine whether changes of cerebral artery blood flow velocity precede or follow reductions of arterial pressure. BACKGROUND: Some evidence suggests that disordered cerebral autoregulation contributes to the occurrence of orthostatic vasovagal syncope. We studied cerebral hemodynamics with transcranial Doppler recordings, and we closely examined the temporal sequence of changes of cerebral artery blood flow velocity and systemic arterial pressure in 15 patients who did or did not faint during passive 70 degrees head-up tilt. METHODS: We recorded photoplethysmographic arterial pressure, RR intervals (electrocardiogram) and middle cerebral artery blood flow velocities (mean, total, mean/RR interval; Gosling's pulsatility index; and cerebrovascular resistance [mean cerebral velocity/mean arterial pressure, MAP]). RESULTS: Eight men developed presyncope, and six men and one woman did not. Presyncopal patients reported light-headedness, diaphoresis, or a sensation of fatigue 155 s (range: 25 to 414 s) before any cerebral or systemic hemodynamic change. Average cerebral blood flow velocity (CBFV) changes (defined by an iterative linear regression algorithm) began 67 s (range: 9 to 198 s) before reductions of MAP. Cerebral and systemic hemodynamic measurements remained constant in nonsyncopal patients. CONCLUSIONS: Presyncopal symptoms and CBFV changes precede arterial pressure reductions in patients with orthostatic vasovagal syncope. Therefore, changes of cerebrovascular regulation may contribute to the occurrence of vasovagal reactions.

  7. Cognitive tasks during walking affect cerebral blood flow signal features in middle cerebral arteries and their correlation to gait characteristics.

    PubMed

    Gatouillat, Arthur; Bleton, Héloïse; VanSwearingen, Jessie; Perera, Subashan; Thompson, Scott; Smith, Traci; Sejdić, Ervin

    2015-09-26

    Gait is a complex process involving both cognitive and sensory ability and is strongly impacted by the environment. In this paper, we propose to study of the impact of a cognitive task during gait on the cerebral blood flow velocity, the blood flow signal features and the correlation of gait and blood flow features through a dual task methodology. Both cerebral blood flow velocity and gait characteristics of eleven participants with no history of brain or gait conditions were recorded using transcranial Doppler on mid-cerebral artery while on a treadmill. The cognitive task was induced by a backward counting starting from 10,000 with decrement of 7. Central blood flow velocity raw and envelope features were extracted in both time, frequency and time-scale domain; information-theoretic metrics were also extracted and statistical significances were inspected. A similar feature extraction was performed on the stride interval signal. Statistical differences between the cognitive and baseline trials, between the left and right mid-cerebral arteries signals and the impact of the antropometric variables where studied using linear mixed models. No statistical differences were found between the left and right mid-cerebral arteries flows or the baseline and cognitive state gait features, while statistical differences for specific features were measured between cognitive and baseline states. These statistical differences found between the baseline and cognitive states show that cognitive process has an impact on the cerebral activity during walking. The state was found to have an impact on the correlation between the gait and blood flow features.

  8. Cerebral blood flow effects of acute intravenous heroin administration.

    PubMed

    Kosel, Markus; Noss, Roger S; Hämmig, Robert; Wielepp, Peter; Bundeli, Petra; Heidbreder, Rebeca; Kinser, Jane A; Brenneisen, Rudolf; Fisch, Hans-Ulrich; Kayser, Sarah; Schlaepfer, Thomas E

    2008-04-01

    We examined acute effects of intravenous diacetylmorphine (heroin) administration - which induces a characteristic biphasic response: A short rush-sensation associated with intense pleasurable feelings followed by a subjectively different period of euphoria on cerebral blood flow. This was assessed in nine male heroin dependent patients participating in a heroin maintenance program in a setting resembling everyday pattern of heroin abuse. 99mTc-HMPAO was administered 45 s (rush) and 15 min (euphoria) after administration of i.v. heroin and 45 s after administration of saline (placebo). Plasma concentration of diacetylmorphine and its metabolites were measured with high-pressure liquid chromatography (HPLC). Compared to the euphoria condition, rush was associated with blood flow increase in the left posterior cerebellar lobe, left anterior cingulate gyrus and right precuneus. Our results are in line with recent reports indicating that the cerebellum is an important component in functional brain systems subserving sensory and motor integration, learning, modulation of affect, motivation and social behaviour, which all play important roles in reinforcing properties of opioids.

  9. Cerebral Blood Volume MRI with Intravascular Superparamagentic Iron Oxide Nanoparticles

    PubMed Central

    Kim, Seong-Gi; Harel, Noam; Jin, Tao; Kim, Tae; Lee, Phil; Zhao, Fuqiang

    2013-01-01

    Cerebral blood volume (CBV) is a crucial physiological indicator of tissue viability and vascular reactivity. Thus, non-invasive CBV mapping has been of great interest. For this, ultrasmall superparamagnetic iron oxide nanoparticles (USPIO) including monocrystalline iron oxide nanoparticles (MION) can be used as long half-life, intravascular susceptibility agents of CBV MRI measurements. Also, CBV-weighted fMRI with USPIO provides enhanced sensitivity, reduced large vessel contribution, and improved spatial specificity compared to conventional blood oxygenation-level dependent (BOLD) fMRI, and measures a single physiological parameter that is easily interpretable. We review physiochemical and magnetic properties as well as pharmacokinetics of USPIO in brief. We then extensively discuss quantifications of baseline CBV, vessel size index, and functional CBV change. We also provide reviews of dose-dependent sensitivity, vascular filter function, specificity, characteristics, and impulse response function of CBV fMRI. Examples of CBV fMRI specificity at the laminar and columnar resolution are provided. Finally, we briefly review application of CBV measurements to functional and pharmacological studies in animals. Overall, the use of USPIO can determine baseline CBV and its changes induced by functional activity and pharmacological interventions. PMID:23208650

  10. ECMO Maintains Cerebral Blood Flow During Endotoxic Shock in Piglets

    PubMed Central

    Batts, Sherreen G.; Uyehara-Lock, Jane H.; Murata, Lee-Ann; Uyehara, Catherine F. T.

    2016-01-01

    Cerebrovascular injury while on extracorporeal membrane oxygenation (ECMO) may be caused by excessive brain perfusion during hypoxemic reperfusion. Previous studies have postulated that the most vulnerable period of time for cerebrovascular injury is during the transfer period to ECMO. Therefore, our objective was to compare brain perfusion and hemodynamics in a piglet endotoxic shock ECMO model. The effect of ECMO flow on microcirculation of different brain regions was compared between 10 control pigs and six pigs (7–10 kg) administered IV endotoxin to achieve a drop in mean arterial blood pressure (MAP) of at least 30%. Cardiac output (CO), brain oxygen utilization, and microcirculatory blood flow (BF) were compared at baseline and 2 hours after ECMO stabilization. Matching ECMO delivery with baseline CO in control animals increased perfusion (p < 0.05) in all areas of the brain. In contrast, with endotoxin, ECMO returned perfusion closer to baseline levels in all regions of the brain and maintained brain tissue oxygen consumption. Both control and endotoxic pigs showed no evidence of acute neuronal necrosis in histologic cerebral cortical sections examined after 2 hours of ECMO. Results show that during endotoxic shock, transition to ECMO can maintain brain BF equally to all brain regions without causing overperfusion, and does not appear to cause brain tissue histopathologic changes (hemorrhage or necrosis) during the acute stabilization period after ECMO induction. PMID:27442858

  11. The effect of magnesium sulfate on large cerebral artery blood flow in preeclampsia.

    PubMed

    Hatab, Mustapha R; Zeeman, Gerda G; Twickler, Diane M

    2005-03-01

    To determine the effect of a 6 gram intravenous bolus of magnesium sulfate on maternal cerebral blood flow in women with preeclampsia. Velocity-encoded phase-contrast magnetic resonance imaging studies were performed on twelve preeclamptic women prior to and immediately after infusion of a 6 gram magnesium sulfate loading dose. Cerebral blood flow was determined at the bilateral proximal middle and posterior cerebral arteries. Study participants returned 6 weeks postpartum for a non-pregnant measurement of cerebral blood flow. The Wilcoxon paired-sample test was used with statistical significance defined as p<0.05. There was no significant difference in cerebral vessel diameter nor blood flow for any of the examined arteries between the pre- and post magnesium sulfate therapy states. The absence of a significant difference in cerebral blood flow of the middle and posterior cerebral arteries before and after infusion of a 6 gram loading dose of magnesium sulfate in women with preeclampsia could suggest the absence of vasoconstriction of the large cerebral arteries in preeclampsia and question the role of magnesium sulfate as a vasodilator of these arteries.

  12. Robust low-dose dynamic cerebral perfusion CT image restoration via coupled dictionary learning scheme.

    PubMed

    Tian, Xiumei; Zeng, Dong; Zhang, Shanli; Huang, Jing; Zhang, Hua; He, Ji; Lu, Lijun; Xi, Weiwen; Ma, Jianhua; Bian, Zhaoying

    2016-11-22

    Dynamic cerebral perfusion x-ray computed tomography (PCT) imaging has been advocated to quantitatively and qualitatively assess hemodynamic parameters in the diagnosis of acute stroke or chronic cerebrovascular diseases. However, the associated radiation dose is a significant concern to patients due to its dynamic scan protocol. To address this issue, in this paper we propose an image restoration method by utilizing coupled dictionary learning (CDL) scheme to yield clinically acceptable PCT images with low-dose data acquisition. Specifically, in the present CDL scheme, the 2D background information from the average of the baseline time frames of low-dose unenhanced CT images and the 3D enhancement information from normal-dose sequential cerebral PCT images are exploited to train the dictionary atoms respectively. After getting the two trained dictionaries, we couple them to represent the desired PCT images as spatio-temporal prior in objective function construction. Finally, the low-dose dynamic cerebral PCT images are restored by using a general DL image processing. To get a robust solution, the objective function is solved by using a modified dictionary learning based image restoration algorithm. The experimental results on clinical data show that the present method can yield more accurate kinetic enhanced details and diagnostic hemodynamic parameter maps than the state-of-the-art methods.

  13. Anxiety and cerebral blood flow during behavioral challenge. Dissociation of central from peripheral and subjective measures

    SciTech Connect

    Zohar, J.; Insel, T.R.; Berman, K.F.; Foa, E.B.; Hill, J.L.; Weinberger, D.R.

    1989-06-01

    To investigate the relationship between anxiety and regional cerebral blood flow, we administered behavioral challenges to 10 patients with obsessive-compulsive disorder while measuring regional cerebral blood flow with the xenon 133 inhalation technique. Each patient was studied under three conditions: relaxation, imaginal flooding, and in vivo (actual) exposure to the phobic stimulus. Subjective anxiety, obsessive-compulsive ratings, and autonomic measures (heart rate, blood pressure) increased significantly, but respiratory rate and PCO/sub 2/ did not change across the three conditions. Regional cerebral blood flow increased slightly (in the temporal region) during imaginal flooding, but decreased markedly in several cortical regions during in vivo exposure, when anxiety was highest by subjective and peripheral autonomic measures. These results demonstrate that intense anxiety can be associated with decreased rather than increased cortical perfusion and that ostensibly related states of anxiety (eg, anticipatory and obsessional anxiety) may be associated with opposite effects on regional cerebral blood flow.

  14. Laser speckle contrast imaging of cerebral blood flow of newborn mice at optical clearing

    NASA Astrophysics Data System (ADS)

    Timoshina, Polina A.; Zinchenko, Ekaterina M.; Tuchina, Daria K.; Sagatova, Madina M.; Semyachkina-Glushkovskaya, Oxana V.; Tuchin, Valery V.

    2017-03-01

    In this work, we consider the use of optical clearing agents to improve imaging quality of the cerebral blood flow of newborn mice. Aqueous 60%-glycerol solution, aqueous 70%-OmnipaqueTM(300) solution and OmnipaqueTM (300) solution in water/DMSO(25%/5%) were selected as the optical clearing agents. Laser speckle contrast imaging (LSCI) was used for imaging of cerebral blood flow in newborn mice brain during topical optical clearing of tissuesin the area of the fontanelle. These results demonstrate the effectiveness of glycerol and Omnipaque solutions as optical clearing agents for investigation of cerebral blood flow in newborn mice without scalp removing and skull thinning.

  15. Hemodynamic study of internal carotid artery stenosis and occlusion: value of combined isotopic measurements of regional cerebral blood flow and blood volume

    SciTech Connect

    Derlon, J.M.; Bouvard, G.; Lechevalier, B.; Dupuy, B.; Maiza, D.; Hubert, P.; Courtheoux, P.; Peres, J.C.; Houtteville, J.P.

    1986-05-01

    The assessment of the intracranial hemodynamic consequences of obstructive lesions of the carotid artery by measuring resting rCBF is inadequate because cerebral blood flow may remain constant in spite of significant drops in the intraluminal pressure due to autoregulation. Moreover, flow may be permanently decreased following cerebral infarction, even if the arterial anatomical conditions have resumed their normal state because of the decreased metabolic demand of an infarcted area. Measurement of the regional cerebral blood volume (rCBV) helps with the hemodynamic assessment of these conditions, since there is a linear and inverse relationship between intraarterial pressure and intracranial blood volume. In 24 patients exhibiting various carotid and ischemic brain lesions we studied both rCBF and rCBV. The latter is a comparative measure between hemispheres obtained by single photon emission tomography after autotransfusion of 99mTechnetium labeled erythrocytes. There was no correlation between rCBF and clinical status, CT scan or arterial lesions. There was no correlation between rCBV and clinical status or CT scan. There was, however, an interesting correlation between rCBV and the severity of the arterial lesion. The rCBV was symmetrical in all patients with normal or moderately stenotic carotid arteries before and after operation. In some patients with severe unilateral stenosis or occlusion, there was a significant relative increase of rCBV in the hemisphere downstream from the lesion, which disappeared after surgery (endarterectomy or extra-intracranial bypass). In some patients with severe and bilateral carotid lesions, we noted an asymmetry in rCBV that disappeared after a unilateral operation. Other patients with similar lesions develop asymmetry only after an operation that resulted in a relative increase in rCBV in the hemisphere supplied by the non-operated artery.

  16. Adrenergic and prostanoid mechanisms in control of cerebral blood flow in hypotensive newborn pigs

    SciTech Connect

    Armstead, W.M.; Leffler, C.W.; Busija, D.W.; Beasley, D.G.; Mirro, R. )

    1988-04-01

    The interaction between adrenergic and prostanoid mechanisms in the control of cerebral hemodynamics in the conscious, hypotensive newborn pig was investigated. Pretreatment with the selective {alpha}{sub 1}- and {alpha}{sub 2}-adrenoceptor antagonists prazosin and yohimbine, respectively, had no effect on cerebral blood flow, calculated cerebral vascular resistance, or cerebral metabolic rate either before or after hemmorrhagic hypotension. Indomethacin treatment (5 mg/kg ia) of piglets following hemorrhage caused a significant decrease in blood flow to all brain regions within 20 min. This decrease in cerebral blood flow resulted from increased cerebral vascular resistances of 54 and 177%, 20 and 40 min after treatment, respectively. Cerebral oxygen consumption was reduced from 2.42 {+-} 0.28 to 1.45 {+-} 0.28 ml{center dot}100 g{sup {minus}1} and to 1.0 {+-} 0.28 ml{center dot}100 g{sup {minus}1}{center dot}min{sup {minus}1} 20 and 40 min after indomethacin, respectively, in hemorrhaged piglets. Decreases in cerebral blood flow and metabolic rate and increases in vascular resistance on treatment with indomethacin were the same as in animals pretreated with vehicle, prazosin, or yohimbine. These data are consistent with the hypothesis that the prostanoid system contributes to the maintenance of cerebral blood flow and cerebral metabolic rate during hypotension in the newborn, as reported previously. These data do not implicate removal of sympathetic modulation by prostanoids as a mechanism for indomethacin-induced cerebral vasoconstriction in hypotensive newborn piglets.

  17. Cerebral blood flow during HUTT in young patients with orthostatic intolerance.

    PubMed

    Lankford, Jeremy; Numan, Mohammed; Hashmi, S Shahrukh; Gourishankar, Anand; Butler, Ian J

    2015-10-01

    To investigate patterns of change in cerebral perfusion during head-up tilt testing (HUTT) in children and young adults with autonomic dysfunction. We utilized near-infrared spectroscopy (NIRS) to estimate bilateral cerebral perfusion patterns during HUTT in 71 adolescents and young adults with a diagnosis of autonomic dysfunction. In addition, we used transthoracic impedance to measure cardiac stroke volume and thus infer autonomic tone, heart rate, and blood pressure during the test. Cerebral blood-flow wave-patterns were then visually analyzed and associated with clinical symptoms and measures of cardiovascular and autonomic function. Visual analysis of contour changes in head NIRS values during phases of HUTT revealed variable patterns of cerebral blood flow, some specifically associated with severe symptomatology (i.e., syncope). We also observed an inequality in blood flow of the cerebral hemispheres in many patients. Finally, we observed changes in cardiac stroke volume during HUTT, as previously reported, that related to changes in head NIRS. These results confirm a decrease in cerebral blood flow during HUTT as assessed by head NIRS in patients with autonomic dysfunction. Specifically, we have profiled the cerebral blood flow contours throughout the phases of HUTT, which add insight into the clinical spectrum of the disorder and may correlate with clinical severity.

  18. Prediction of clinical outcome with baseline and 24-hour perfusion CT in acute middle cerebral artery territory ischemic stroke treated with intravenous recanalization therapy.

    PubMed

    Lee, Ji-Yong; Kim, Seo Hyun; Lee, Myeong Sub; Park, Sang Hyun; Lee, Sung Soo

    2008-05-01

    We sought to determine whether Alberta Stroke Program Early CT Scores (ASPECTS) derived from baseline noncontrast CT (NCCT) and perfusion CT (CTP) imaging maps can predict clinical outcome after recanalization therapy in acute ischemic stroke of the middle cerebral artery (MCA) territory and whether changes in the ASPECTS from baseline to 24 h after recanalization therapy can help predict clinical outcome. We retrospectively studied consecutive patients with acute ischemic stroke of the MCA territory treated with intravenous tissue plasminogen activator (t-PA) or abciximab within 6 h of symptom onset. We performed NCCT and CTP before and 24 h after intravenous t-PA or abciximab treatment and determined the ASPECTS and the changes in the ASPECTS from baseline to 24 h. A favorable outcome was defined as a modified Rankin scale score of 0 or 1 at 3 months. During the 18-month study period 44 patients were studied. In multivariate logistic regression analysis, the cerebral blood volume (CBV) ASPECTS (OR 1.80, 95% CI 1.10 to 2.93) at baseline and the increase in cerebral blood flow (CBF) ASPECTS (OR 1.68, 95% CI 1.13 to 2.50) from baseline to 24 h were associated with a favorable outcome. The cutoff values for a favorable outcome using receiver operating characteristic curves were 8 and 1, respectively. When the CBV ASPECTS at baseline was 8 or more, its positive predictive value was only 58.1%. When the CBV ASPECTS at baseline was 8 or more and the increase in CBF ASPECTS from baseline to 24 h was 1 or more, the positive predictive value was 100% and the negative predictive value was 74.2%. The CBV ASPECTS derived from baseline CTP maps was found to be predictive of a favorable outcome, but its positive predictive value was suboptimal. The change in the CBF ASPECTS from baseline to 24 h after treatment was helpful in predicting outcome.

  19. The probability of middle cerebral artery MRA flow signal abnormality with quantified CT ischaemic change: targets for future therapeutic studies.

    PubMed

    Barber, P A; Demchuk, A M; Hill, M D; Pexman, J H Warwick; Hudon, M E; Frayne, R; Buchan, A M

    2004-10-01

    In this study we define the probability of vascular abnormality in the middle cerebral artery (MCA) territory according to the extent of ischaemic change seen using computed tomography (CT). We assessed the sensitivity and specificity of the hyperdense middle cerebral artery (HMCA) and the "dot" sign using magnetic resonance angiography (MRA). Patients presenting with ischaemic stroke had a CT scan (<6 h) prior to MRI (<7 h). A quantitative CT scoring system (ASPECTS) was applied to CT and diffusion weighted images (DWI) at baseline and follow up (24 h) by five independent observers. The presence of HMCA and the MCA "dot" sign was also evaluated. An expert reader assessed the 3D time of flight (TOF) MRA in the anterior circulation for areas of decreased vascular signal in the MCA territory, with an absent signal taken to represent severely reduced or absent flow. A total of 100 consecutive patients had baseline CT and MR scans. The median NIHSS was 9. The median CT ASPECTS was 8 and equalled the median DWI ASPECTS. There were a total of 10 HMCA and 19 MCA "dot" signs, with four patients having both HMCA and "dot" signs. A total of 47 MRA flow signal abnormalities were observed in the anterior circulation. In the absence of accessible neurovascular imaging, the extent of CT ischaemia (ASPECTS) is a strong predictor of vascular occlusion. The CT hyperdense artery signs have a high positive predictive value but low negative predictive value.

  20. [The comparison of volume of ischemia zone in CT examination with neurological and functional status of patients after cerebral ischemia].

    PubMed

    Bartynowska, Karolina

    2013-01-01

    The aim of this work was to establish the correlation between volume of ischemic zone in CT examination and neurological and functional (Barthel index) disorders after cerebral ischemia. The retrospective study was performed. The 30 patients (the median age was 73 years; 14 woman and 16 man) were examined. The medial cerebral artery stroke was recognised in CT. CT examinations without contrast media injection, neurological and functional (Barthel index) diagnostic tests were performed directly and 18 months after ischemia. The evolution of ischemic zone in CT and neurological and functional disorders were estimated. The correlation between volume of ischemic zone in CT, neurological parameters and Barthel index results was examined. The statistical correlation between ischemic zone volumetry and physiological reactions was ascertained. In acute phase the greater volume of ischemic zone responds to neurological dysfunctions. The same tendency, without statistical significance, was observed between volume of ischemic zone and Barthel index result (inversely proportional). 18 months after cerebral stroke the statistical correlation was significant only for comparison of volume of the ischemic zone and Barthel index result. The greater volume of ischemic zone responded to lower Barthel index. Ischemic stroke volumetry in CT examination can facilitate neurological (physiological reactions disorders) and functional (Barthel index) status assessment.

  1. Role of hypotension in decreasing cerebral blood flow in porcine endotoxemia

    SciTech Connect

    Miller, C.F.; Breslow, M.J.; Shapiro, R.M.; Traystman, R.J. )

    1987-10-01

    The role of reduced arterial blood pressure (MAP) in decreasing cerebral blood flow (CBF) during endotoxemia was studied in pentobarbital-anesthetized pigs. Microspheres were used to measure regional CBF changes during MAP manipulations in animals with and without endotoxin. Endotoxin decreased MAP to 50 mmHg and decreased blood flow to the cortex and cerebellum without affecting cerebral cortical oxygen consumption (CMRo{sub 2}). Elevating MAP from 50 to 70 mmHg during endotoxemia with norepinephrine did not change cortical blood flow or CMRo{sub 2} but increased cerebellar blood flow. Brain stem blood flow was not affected by endotoxin or norepinephrine. When MAP was decreased to 50 mmHg by hemorrhage without endotoxin, no change in blood flow to cortex, cerebellum, or brain stem was observed from base-line levels. These results suggest that decreased MAP below a lower limit for cerebral autoregulation does not account for the decreased CBF observed after endotoxin.

  2. Regional cerebral blood flow study with 123I-IMP in patients with degenerative dementia

    SciTech Connect

    Ohnishi, T.; Hoshi, H.; Nagamachi, S.; Jinnouchi, S.; Futami, S.; Watanabe, K.; Mitsuyama, Y. )

    1991-05-01

    Regional cerebral blood flow was evaluated by single-photon emission CT (SPECT) with 123I-N-isopropyl-p-iodoamphetamine (123I-IMP) in 11 patients with dementia of the Alzheimer type, three patients with progressive dementia and motor neuron disease, and eight healthy control subjects. Regional blood flow measurements in the bilateral frontal, parietal association, and temporal cortices were lower in the Alzheimer dementia patients than in controls. Flow deficits in the parietal association cortex were demonstrated in all patients with Alzheimer-type dementia; these deficits were correlated with the severity of disease. Lateral hemispheric asymmetry was seen in nine of 11 patients with Alzheimer-type dementia. In all three patients with progressive dementia and motor neuron disease, flow deficits were demonstrated in the bilateral frontal and temporal cortices, but no flow deficits were seen in the parietal association cortex. Brain SPECT with 123I-IMP may be useful in the differential diagnosis and evaluation of the severity of degenerative dementia.

  3. CT perfusion for detection of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.

    PubMed

    Mir, D I A; Gupta, A; Dunning, A; Puchi, L; Robinson, C L; Epstein, H-A B; Sanelli, P C

    2014-05-01

    Delayed cerebral ischemia is a significant cause of morbidity and mortality after aneurysmal SAH, leading to poor outcomes. The purpose of this study was to evaluate the usefulness of CTP in determining delayed cerebral ischemia in patients with aneurysmal SAH. We conducted a systematic review evaluating studies that assessed CTP in patients with aneurysmal SAH for determining delayed cerebral ischemia. Studies using any of the following definitions of delayed cerebral ischemia were included in the systematic review: 1) new onset of clinical deterioration, 2) cerebral infarction identified on follow-up CT or MR imaging, and 3) functional disability. A random-effects meta-analysis was performed assessing the strength of association between a positive CTP result and delayed cerebral ischemia. The systematic review identified 218 studies that met our screening criteria, of which 6 cohort studies met the inclusion criteria. These studies encompassed a total of 345 patients, with 155 (45%) of 345 patients classified as having delayed cerebral ischemia and 190 (55%) of 345 patients as not having delayed cerebral ischemia. Admission disease severity was comparable across all groups. Four cohort studies reported CTP test characteristics amenable to the meta-analysis. The weighted averages and ranges of the pooled sensitivity and specificity of CTP in the determination of delayed cerebral ischemia were 0.84 (0.7-0.95) and 0.77 (0.66-0.82), respectively. The pooled odds ratio of 23.14 (95% CI, 5.87-91.19) indicates that patients with aneurysmal SAH with positive CTP test results were approximately 23 times more likely to experience delayed cerebral ischemia compared with patients with negative CTP test results. Perfusion deficits on CTP are a significant finding in determining delayed cerebral ischemia in aneurysmal SAH. This may be helpful in identifying patients with delayed cerebral ischemia before development of infarction and neurologic deficits. © 2014 by American

  4. Unveiling astrocytic control of cerebral blood flow with optogenetics.

    PubMed

    Masamoto, Kazuto; Unekawa, Miyuki; Watanabe, Tatsushi; Toriumi, Haruki; Takuwa, Hiroyuki; Kawaguchi, Hiroshi; Kanno, Iwao; Matsui, Ko; Tanaka, Kenji F; Tomita, Yutaka; Suzuki, Norihiro

    2015-06-16

    Cortical neural activities lead to changes in the cerebral blood flow (CBF), which involves astrocytic control of cerebrovascular tone. However, the manner in which astrocytic activity specifically leads to vasodilation or vasoconstriction is difficult to determine. Here, cortical astrocytes genetically expressing a light-sensitive cation channel, channelrhodopsin-2 (ChR2), were transcranially activated with a blue laser while the spatiotemporal changes in CBF were noninvasively monitored with laser speckle flowgraphy in the anesthetised mouse cortex. A brief photostimulation induced a fast transient increase in CBF. The average response onset time was 0.7 ± 0.7 sec at the activation foci, and this CBF increase spread widely from the irradiation spot with an apparent propagation speed of 0.8-1.1 mm/sec. The broad increase in the CBF could be due to a propagation of diffusible vasoactive signals derived from the stimulated astrocytes. Pharmacological manipulation showed that topical administration of a K(+) channel inhibitor (BaCl2; 0.1-0.5 mM) significantly reduced the photostimulation-induced CBF responses, which indicates that the ChR2-evoked astrocytic activity involves K(+) signalling to the vascular smooth muscle cells. These findings demonstrate a unique model for exploring the role of the astrocytes in gliovascular coupling using non-invasive, time-controlled, cell-type specific perturbations.

  5. Regional cerebral blood flow in normal pressure hydrocephalus.

    PubMed Central

    Graff-Radford, N R; Rezai, K; Godersky, J C; Eslinger, P; Damasio, H; Kirchner, P T

    1987-01-01

    Regional cerebral blood flow (rcbf) was studied preoperatively and at 2 and 6 months postoperatively in 22 normal pressure hydrocephalus patients using xenon-133 inhalation and single photon emission computed tomography. Sixteen of the 22 patients improved (improved group) and six did not (unimproved group). The following comparisons were made: (1) preoperative rcbf in the improved group, to 14 normal elderly volunteers and to that in 59 SDAT (senile dementia of the Alzheimer type) patients; (2) preoperative rcbf in the improved and unimproved groups to determine if rcbf could predict surgical outcome; (3) pre- to postoperative rcbf in the improved group to see if increased cbf accounted for clinical improvement. The findings were: (1) preoperative rcbf in the improved group was lower than that in normal controls but was the same as that in SDAT; however, the ratios of rcbf values in anterior and posterior brain regions were significantly different between improved group and SDAT (p = 0.02); (2) an anterior/posterior ratio of 1.05 correctly classified surgical outcome in 19/22 patients; five of six in the unimproved group were above this cut off while 14/16 in the improved group were below; (3) in the improved group rcbf increased at 2 but not at 6 months after surgery without a corresponding reduction of clinical signs, supporting the notion that increase in cbf probably does not account for clinical improvement in normal pressure hydrocephalus. Images PMID:3501800

  6. Functional laser speckle imaging of cerebral blood flow under hypothermia

    NASA Astrophysics Data System (ADS)

    Li, Minheng; Miao, Peng; Zhu, Yisheng; Tong, Shanbao

    2011-08-01

    Hypothermia can unintentionally occur in daily life, e.g., in cardiovascular surgery or applied as therapeutics in the neurosciences critical care unit. So far, the temperature-induced spatiotemporal responses of the neural function have not been fully understood. In this study, we investigated the functional change in cerebral blood flow (CBF), accompanied with neuronal activation, by laser speckle imaging (LSI) during hypothermia. Laser speckle images from Sprague-Dawley rats (n = 8, male) were acquired under normothermia (37°C) and moderate hypothermia (32°C). For each animal, 10 trials of electrical hindpaw stimulation were delivered under both temperatures. Using registered laser speckle contrast analysis and temporal clustering analysis (TCA), we found a delayed response peak and a prolonged response window under hypothermia. Hypothermia also decreased the activation area and the amplitude of the peak CBF. The combination of LSI and TCA is a high-resolution functional imaging method to investigate the spatiotemporal neurovascular coupling in both normal and pathological brain functions.

  7. Increased hippocampal CA1 cerebral blood volume in schizophrenia

    PubMed Central

    Talati, Pratik; Rane, Swati; Kose, Samet; Blackford, Jennifer Urbano; Gore, John; Donahue, Manus J.; Heckers, Stephan

    2014-01-01

    Hippocampal hyperactivity has been proposed as a biomarker in schizophrenia. However, there is a debate whether the CA1 or the CA2/3 subfield is selectively affected. We studied 15 schizophrenia patients and 15 matched healthy control subjects with 3T steady state, gadolinium-enhanced, absolute cerebral blood volume (CBV) maps, perpendicular to the long axis of the hippocampus. The subfields of the hippocampal formation (subiculum, CA1, CA2/3, and hilus/dentate gyrus) were manually segmented to establish CBV values. Comparing anterior CA1 and CA2/3 CBV between patients and controls revealed a significant subfield-by-diagnosis interaction. This interaction was due to the combined effect of a trend of increased CA1 CBV (p = .06) and non-significantly decreased CA2/3 CBV (p = 0.14) in patients relative to healthy controls. These results support the emerging hypothesis of increased hippocampal activity as a biomarker of schizophrenia and highlight the importance of subfield-level investigations. PMID:25161901

  8. Unveiling astrocytic control of cerebral blood flow with optogenetics

    PubMed Central

    Masamoto, Kazuto; Unekawa, Miyuki; Watanabe, Tatsushi; Toriumi, Haruki; Takuwa, Hiroyuki; Kawaguchi, Hiroshi; Kanno, Iwao; Matsui, Ko; Tanaka, Kenji F.; Tomita, Yutaka; Suzuki, Norihiro

    2015-01-01

    Cortical neural activities lead to changes in the cerebral blood flow (CBF), which involves astrocytic control of cerebrovascular tone. However, the manner in which astrocytic activity specifically leads to vasodilation or vasoconstriction is difficult to determine. Here, cortical astrocytes genetically expressing a light-sensitive cation channel, channelrhodopsin-2 (ChR2), were transcranially activated with a blue laser while the spatiotemporal changes in CBF were noninvasively monitored with laser speckle flowgraphy in the anesthetised mouse cortex. A brief photostimulation induced a fast transient increase in CBF. The average response onset time was 0.7 ± 0.7 sec at the activation foci, and this CBF increase spread widely from the irradiation spot with an apparent propagation speed of 0.8–1.1 mm/sec. The broad increase in the CBF could be due to a propagation of diffusible vasoactive signals derived from the stimulated astrocytes. Pharmacological manipulation showed that topical administration of a K+ channel inhibitor (BaCl2; 0.1–0.5 mM) significantly reduced the photostimulation-induced CBF responses, which indicates that the ChR2-evoked astrocytic activity involves K+ signalling to the vascular smooth muscle cells. These findings demonstrate a unique model for exploring the role of the astrocytes in gliovascular coupling using non-invasive, time-controlled, cell-type specific perturbations. PMID:26076820

  9. Middle cerebral artery thrombosis: acute blood-brain barrier consequences

    SciTech Connect

    Dietrich, W.D.; Prado, R.; Watson, B.D.; Nakayama, H.

    1988-07-01

    The effect of middle cerebral artery (MCA) thrombosis on the integrity of the blood-brain barrier (BBB) was studied in rats using horseradish peroxidase (HRP). Endothelial injury with subsequent platelet thrombosis was produced by means of a rose bengal-sensitized photochemical reaction, facilitated by irradiating the right proximal MCA segment with the focused beam of an argon laser. At 15 minutes following thrombosis formation, diffuse leakage of HRP was observed bilaterally within cortical and subcortical brain areas. Peroxidase extravasation was most dense within the territory of the occluded artery including neocortical areas and dorso-lateral striatum. Contralaterally, a similar distribution was observed but with less intense HRP leakage. Ultrastructural studies demonstrated an increase in permeability to HRP within arterioles, venules and capillaries. At these sites, the vascular endothelium contained HRP-filled pinocytotic vesicles and tubular profiles. Although less intense, bilateral HRP leakage was also observed following MCA stenosis or femoral artery occlusion. Endothelial-platelet interactions at the site of vascular injury may be responsible for releasing substances or neurohumoral factors which contribute to the acute opening of the BBB.

  10. Raised intracranial pressure and cerebral blood flow. 5. Effects of episodic intracranial pressure waves in primates.

    PubMed Central

    Johnston, I H; Rowan, J O; Park, D M; Rennie, M J

    1975-01-01

    The effects of episodic waves of intracranial pressure on cerebral blood flow were studied in primates. Six pressure waves each of 20 minutes' duration and ranging from 50 to 100 mmHg in magnitude were induced in baboons, at intervals of 30 minutes, in an attempt to simulate clinical plateau waves. With pressure waves up to 75 mmHg, cerebral blood flow remained at control levels despite falling cerebral perfusion pressures. Between the initial pressure waves a marked hyperaemia developed, with cerebral blood flow increasing by as much as 100%, and this appeared to be a means whereby adequate flow was maintained during pressure waves. Later pressure waves, up to 100 mmHg, eventually reduced blood flow below control levels, although moderately high flows were maintained during periods of very low perfusion pressure. Brain metabolism was affected by eht episodic pressure waves, although no consistent change was seen. Images PMID:812960

  11. Effect of age on cerebral blood flow during hypothermic cardiopulmonary bypass

    SciTech Connect

    Brusino, F.G.; Reves, J.G.; Smith, L.R.; Prough, D.S.; Stump, D.A.; McIntyre, R.W.

    1989-04-01

    Cerebral blood flow was measured in 20 patients by xenon 133 clearance methodology during nonpulsatile hypothermic cardiopulmonary bypass to determine the effect of age on regional cerebral blood flow during these conditions. Measurements of cerebral blood flow at varying perfusion pressures were made in patients arbitrarily divided into two age groups at nearly identical nasopharyngeal temperature, hematocrit value, and carbon dioxide tension and with equal cardiopulmonary bypass flows of 1.6 L/min/m2. The range of mean arterial pressure was 30 to 110 mm Hg for group I (less than or equal to 50 years of age) and 20 to 90 mm Hg for group II (greater than or equal to 65 years of age). There was no significant difference (p = 0.32) between the mean arterial pressure in group I (54 +/- 28 mm Hg) and that in group II (43 +/- 21 mm Hg). The range of cerebral blood flow was 14.8 to 29.2 ml/100 gm/min for group I and 13.8 to 37.5 ml/100 gm/min for group II. There was no significant difference (p = 0.37) between the mean cerebral blood flow in group I (21.5 +/- 4.6 ml/100 gm/min) and group II (24.3 +/- 8.1 ml/100 gm/min). There was a poor correlation between mean arterial pressure and cerebral blood flow in both groups: group I, r = 0.16 (p = 0.67); group II, r = 0.5 (p = 0.12). In 12 patients, a second cerebral blood flow measurements was taken to determine the effect of mean arterial pressure on cerebral blood flow in the individual patient. Changes in mean arterial pressure did not correlate with changes in cerebral blood flow (p less than 0.90). We conclude that age does not alter cerebral blood flow and that cerebral blood flow autoregulation is preserved in elderly patients during nonpulsatile hypothermic cardiopulmonary bypass.

  12. Cerebral blood flow during delirium tremens and related clinical states studied with xenon-133 inhalation tomography

    SciTech Connect

    Hemmingsen, R.; Vorstrup, S.; Clemmesen, L.; Holm, S.; Tfelt-Hansen, P.; Sorensen, A.S.; Hansen, C.; Sommer, W.; Bolwig, T.G.

    1988-11-01

    The regional cerebral blood flow of 12 patients with severe alcohol withdrawal reactions (delirium tremens or impending delirium tremens) was measured during the acute state before treatment and after recovery. Greater cerebral blood flow was significantly correlated with visual hallucinations and agitation during the acute withdrawal reaction. The results suggest that delirium tremens and related clinical states represent a type of acute brain syndrome mainly characterized by CNS hyperexcitability.

  13. Longitudinal cerebral blood flow and amyloid deposition: an emerging pattern?

    PubMed Central

    Sojkova, Jitka; Beason-Held, Lori; Zhou, Yun; An, Yang; Kraut, Michael A; Ye, Weigo; Ferrucci, Luigi; Mathis, Chester A; Klunk, William E; Wong, Dean F; Resnick, Susan M

    2008-01-01

    Although cerebral amyloid deposition may precede cognitive impairment by decades, the relationship between amyloid deposition and longitudinal change in neuronal function has not been studied. The aim of this paper is to determine whether nondemented individuals with high and low amyloid burden show different patterns of longitudinal regional cerebral blood flow (rCBF) changes in the years preceding measurement of amyloid deposition. Methods Twenty-eight nondemented participants (mean (SD) age at [11C] PIB 82.5(4.8) yrs; 6 mildly impaired) from the Baltimore Longitudinal Study of Aging underwent yearly resting-state [15O]H2O PET scans for up to 8 years. [11C]PIB images of amyloid deposition were acquired on average 10.8(0.8) years after the first CBF scan. [11C]PIB distribution volume ratios (DVR) of regions of interest were estimated by fitting a reference tissue model to the measured time activity curves. Based on mean cortical DVR, participants were divided into high and low [11C]PIB retention groups. Differences in longitudinal rCBF changes between high and low [11C]PIB groups were investigated by voxel-based analysis. Results Longitudinal rCBF changes differed significantly between high (n=10) and low (n=18) [11C]PIB groups (p<=0.001). Greater longitudinal decreases in rCBF in the high [11C]PIB group were seen in right anterior/mid cingulate, right supramarginal gyrus, left thalamus and midbrain bilaterally relative to the low group. Greater increases in rCBF over time in the high [11C]PIB group were found in left medial and inferior frontal gyri, right precuneus, left inferior parietal lobule, and the left postcentral gyrus. Conclusion In this group of nondemented older adults, those with high [11C]PIB show greater longitudinal declines in rCBF in certain areas, representing regions with greater decrements in neuronal function. Greater longitudinal increases in rCBF are also observed in those with higher amyloid load and may represent an attempt to preserve

  14. Brain barrier properties and cerebral blood flow in neonatal mice exposed to cerebral hypoxia-ischemia

    PubMed Central

    Ek, C Joakim; D'Angelo, Barbara; Baburamani, Ana A; Lehner, Christine; Leverin, Anna-Lena; Smith, Peter LP; Nilsson, Holger; Svedin, Pernilla; Hagberg, Henrik; Mallard, Carina

    2015-01-01

    Insults to the developing brain often result in irreparable damage resulting in long-term deficits in motor and cognitive functions. The only treatment today for hypoxic-ischemic encephalopathy (HIE) in newborns is hypothermia, which has limited clinical benefit. We have studied changes to the blood–brain barriers (BBB) as well as regional cerebral blood flow (rCBF) in a neonatal model of HIE to further understand the underlying pathologic mechanisms. Nine-day old mice pups, brain roughly equivalent to the near-term human fetus, were subjected to hypoxia-ischemia. Hypoxia-ischemia increased BBB permeability to small and large molecules within hours after the insult, which normalized in the following days. The opening of the BBB was associated with changes to BBB protein expression whereas gene transcript levels were increased showing direct molecular damage to the BBB but also suggesting compensatory mechanisms. Brain pathology was closely related to reductions in rCBF during the hypoxia as well as the areas with compromised BBB showing that these are intimately linked. The transient opening of the BBB after the insult is likely to contribute to the pathology but at the same time provides an opportunity for therapeutics to better reach the infarcted areas in the brain. PMID:25627141

  15. Mechanisms of recovery from aphasia: evidence from serial xenon 133 cerebral blood flow studies

    SciTech Connect

    Knopman, D.S.; Rubens, A.B.; Selnes, O.A.; Klassen, A.C.; Meyer, M.W.

    1984-06-01

    In 21 patients who suffered aphasia resulting from left hemisphere ischemic infarction, the xenon 133 inhalation cerebral blood flow technique was used to measure cerebral blood flow within 3 months and 5 to 12 months after stroke. In addition to baseline measurements, cerebral blood flow measurements were also carried out while the patients were performing purposeful listening. In patients with incomplete recovery of comprehension and left posterior temporal-inferior parietal lesions, greater cerebral blood flow occurred with listening in the right inferior frontal region in the late studies than in the early studies. In patients with nearly complete recovery of comprehension and without left posterior temporal-inferior parietal lesions, early listening studies showed diffuse right hemisphere increases in cerebral blood flow. Later listening studies in this latter patient group showed greater cerebral blood flow in the left posterior temporal-inferior parietal region. The study provides evidence for participation of the right hemisphere in language comprehension in recovering aphasics, and for later return of function in left hemisphere regions that may have been functionally impaired early during recovery.

  16. Intra-vascular blood velocity and volumetric flow rate calculated from dynamic 4D CT angiography using a time of flight technique.

    PubMed

    Barfett, Joseph John; Velauthapillai, Nivethan; Fierstra, Jorn; Crawley, Adrian; Coolens, Catherine; Crean, Andrew; Jaskolka, Jeff; Dufort, Paul; Krings, Timo; Mikulis, David

    2014-10-01

    We examine a time of flight (TOF) approach for the analysis of contrast enhanced 4D volumetric CT angiography scans to derive and display blood velocity in arteries. Software was written to divide blood vessels into a series of cross sections and to track contrast bolus TOF along the central vessel axis, which was defined by a user, from 4D CT source data. Time density curves at each vessel cross section were fit with quadratic, Gaussian, and gamma variate functions to determine bolus time to peak (TTP). A straight line was used to plot TTP versus vessel path length for all three functions and the slope used to calculate intraluminal velocity. Software was validated in a simulated square channel and non-pulsatile flow phantom prior to the calculation of blood velocity in the major cerebral arteries of 8 normal patients. The TOF algorithm correctly calculates intra-luminal fluid velocity in eight flow conditions of the CT flow phantom where quadratic functions were used. Across all conditions, in phantoms and in vivo, the success of calculations depended strongly on having a sufficiently long path length to make measurements and avoiding venous contamination. Total blood flow into the brain was approximately 17 % of a normal 5 L cardiac output. The technique was explored in vivo in a patient with subclavian steal syndrome, in the pulmonary arteries and in the iliac artery from clinical 4D CT source data. Intravascular blood velocity and flow may be calculated from 4D CT angiography using a TOF approach.

  17. Measuring Cerebral Blood Flow in Moyamoya Angiopathy by Quantitative Magnetic Resonance Angiography Noninvasive Optimal Vessel Analysis.

    PubMed

    Khan, Nadia; Lober, Robert M; Ostergren, Lauren; Petralia, Jacob; Bell-Stephens, Teresa; Navarro, Ramon; Feroze, Abdullah; Steinberg, Gary K

    2017-02-14

    Moyamoya disease causes progressive occlusion of the supraclinoidal internal carotid artery, and middle, anterior, and less frequently the posterior cerebral arteries, carrying the risk of stroke. Blood flow is often partially reconstituted by compensatory moyamoya collaterals and sometimes the posterior circulation. Cerebral revascularization can further augment blood flow. These changes to blood flow within the cerebral vessels, however, are not well characterized. To evaluate blood flow changes resulting from the disease process and revascularization surgery using quantitative magnetic resonance angiography with noninvasive optimal vessel analysis (NOVA). We retrospectively analyzed 190 preoperative and postoperative imaging scans in 66 moyamoya patients after revascularization surgery. Images were analyzed for blood flow using NOVA and compared with preoperative angiographic staging and postoperative blood flow. Blood flow rates within superficial temporal artery grafts were compared based on angiographic evidence of patency. Diseased vessels had lower blood flow, correlating with angiographic staging. Flow in posterior cererbal and basilar arteries increased with disease severity, particularly when both the anterior and middle cerebral arteries were occluded. Basilar artery flow and ipsilateral internal carotid artery flow decreased after surgery. Flow rates were different between angiographically robust and poor direct bypass grafts, as well as between robust and patent grafts. Preoperative changes in cerebral vessel flow as measured by NOVA correlated with angiographic disease progression. NOVA demonstrated that preoperative augmentation of the posterior circulation decreased after surgery. This report is the first to quantify the shift in collateral supply from the posterior circulation to the bypass graft.

  18. Cerebral energy metabolism, glucose transport and blood flow: changes with maturation and adaptation to hypoglycaemia.

    PubMed

    Nehlig, A

    1997-02-01

    Brain maturation is characterized by a peak of cerebral energy metabolism and blood flow occurring between 3 and 8 years of age in humans and around 14-17 days of postnatal life in rats. This high activity coincides with the period of active brain growth. The human brain is dependent on glucose alone during that period, whereas rat brain uses both glucose and ketone bodies to cover its energetic and biosynthetic needs. The maturation of the density of glucose transporter sites-GLUT1 located at the blood-brain barrier and GLUT3 at the neuronal membrane-parallels the development of cerebral glucose utilization. During moderate acute hypoglycaemia, there are no changes in cerebral functional activity; cerebral glucose utilization decreases and blood flow increases only when hypoglycaemia is severe (lower than 2 mumol/ml). During chronic hypoglycaemia, the brain adapts to the low circulating levels of glucose: the number of glucose transporter sites is increased, and cerebral glucose utilization and function are maintained at normal levels while cerebral blood flow is more moderately increased than during acute hypoglycaemia. Neuronal damage consecutive to severe and prolonged hypoglycaemia occurs mainly in the cerebral cortex, hippocampus and caudate-putamen as a result of active release of excitatory amino acids.

  19. Regional cerebral blood flow estimates in newborn lamb using amplitude-mode color Doppler ultrasound.

    PubMed

    Taylor, G A

    1996-01-01

    To establish the feasibility of determining changes in regional cerebral blood flow using amplitude-mode color Doppler ultrasound in the newborn lamb. Regional cerebral blood flow was modified by intrastriatal injection of N -methyl-D-aspartic acid (NMDA) in two newborn lambs and compared with that in a control animal receiving only intrastriatal saline. Serial color Doppler ultrasound energy images were obtained in coronal projection at the level of the foramen of Monro, before and at 20, 40, and 60 min after NMDA or saline injection using a 7.0-MHz linear transducer. Real-time images were obtained and transferred onto a computer workstation. Regions of interest were drawn over each striatum and cerebral hemisphere and were analyzed for mean pixel intensity (MPI) at each interval. Paired regional cerebral blood flow (r-CBF) determinations (radiolabeled microsphere technique) were also obtained in every animal. MPI and r-CBF for each anatomic region were compared using linear regression. Mean color pixel intensities increased significantly in the ipsilateral basal ganglia and cerebral hemisphere (p < 0.0001) in both animals injected with NMDA, but not in the animal injected with normal saline (p < 0.63). A strong and significant linear correlation was found between MPI and r-CBF for striatum (r = 0.89, p < 0.0001) and cerebral hemisphere (r = 0.85, p < 0.0001). Amplitude-mode color Doppler ultrasound shows potential for technically simple determination of serial changes in regional cerebral blood flow in infants.

  20. Cerebral blood flow changes during sodium-lactate-induced panic attacks

    SciTech Connect

    Stewart, R.S.; Devous, M.D. Sr.; Rush, A.J.; Lane, L.; Bonte, F.J.

    1988-04-01

    Dynamic single-photon emission computed axial tomography (CAT) with inhaled xenon-133 was used to measure regional cerebral blood flow in 10 drug-free patients with DSM-III-diagnosed panic disorder and in five normal control subjects. All subjects underwent regional cerebral blood flow studies while at rest or during normal saline infusion and during sodium lactate infusion. Six of the 10 patients and none of the control subjects experienced lactate-induced panic attacks. Lactate infusion markedly raised hemispheric blood flow levels in both control subjects and patients who did not panic. Patients who did panic experienced either a minimal increase or a decrease in hemispheric blood flow.

  1. Acupuncture regulates the glucose metabolism in cerebral functional regions in chronic stage ischemic stroke patients---a PET-CT cerebral functional imaging study

    PubMed Central

    2012-01-01

    Background Acupuncture has been applied to aid in the recovery of post-stroke patients, but its mechanism is unclear. This study aims to analyze the relationship between acupuncture and glucose metabolism in cerebral functional regions in post-stroke patients using 18 FDG PET-CT techniques. Forty-three ischemic stroke patients were randomly divided into 5 groups: the Waiguan (TE5) needling group, the TE5 sham needling group, the sham point needling group, the sham point sham needling group and the non-needling group. Cerebral functional images of all patients were then acquired using PET-CT scans and processed by SPM2 software. Results Compared with the non-needling group, sham needling at TE5 and needling/sham needling at the sham point did not activate cerebral areas. However, needling at TE5 resulted in the activation of Brodmann Area (BA) 30. Needling/sham needling at TE5 and needling at the sham point did not deactivate any cerebral areas, whereas sham needling at the sham point led to deactivation in BA6. Compared with sham needling at TE5, needling at TE5 activated BA13, 19 and 47 and did not deactivate any areas. Compared with needling at the sham point, needling at TE5 had no associated activation but a deactivating effect on BA9. Conclusion Needling at TE5 had a regulating effect on cerebral functional areas shown by PET-CT, and this may relate to its impact on the recovery of post-stroke patients. PMID:22738270

  2. HIV and chronic methamphetamine dependence affect cerebral blood flow.

    PubMed

    Ances, Beau M; Vaida, Florin; Cherner, Mariana; Yeh, Melinda J; Liang, Christine L; Gardner, Carly; Grant, Igor; Ellis, Ronald J; Buxton, Richard B

    2011-09-01

    Human immunodeficiency virus (HIV) and methamphetamine (METH) dependence are independently associated with neuronal dysfunction. The coupling between cerebral blood flow (CBF) and neuronal activity is the basis of many task-based functional neuroimaging techniques. We examined the interaction between HIV infection and a previous history of METH dependence on CBF within the lenticular nuclei (LN). Twenty-four HIV-/METH-, eight HIV-/METH+, 24 HIV+/METH-, and 15 HIV+/METH+ participants performed a finger tapping paradigm. A multiple regression analysis of covariance assessed associations and two-way interactions between CBF and HIV serostatus and/or previous history of METH dependence. HIV+ individuals had a trend towards a lower baseline CBF (-10%, p = 0.07) and greater CBF changes for the functional task (+32%, p = 0.01) than HIV- subjects. Individuals with a previous history of METH dependence had a lower baseline CBF (-16%, p = 0.007) and greater CBF changes for a functional task (+33%, p = 0.02). However, no interaction existed between HIV serostatus and previous history of METH dependence for either baseline CBF (p = 0.53) or CBF changes for a functional task (p = 0.10). In addition, CBF and volume in the LN were not correlated. A possible additive relationship could exist between HIV infection and a history of METH dependence on CBF with a previous history of METH dependence having a larger contribution. Abnormalities in CBF could serve as a surrogate measure for assessing the chronic effects of HIV and previous METH dependence on brain function.

  3. Effects of cannabidiol (CBD) on regional cerebral blood flow.

    PubMed

    Crippa, José Alexandre de Souza; Zuardi, Antonio Waldo; Garrido, Griselda E J; Wichert-Ana, Lauro; Guarnieri, Ricardo; Ferrari, Lucas; Azevedo-Marques, Paulo M; Hallak, Jaime Eduardo Cecílio; McGuire, Philip K; Filho Busatto, Geraldo

    2004-02-01

    Animal and human studies have suggested that cannabidiol (CBD) may possess anxiolytic properties, but how these effects are mediated centrally is unknown. The aim of the present study was to investigate this using functional neuroimaging. Regional cerebral blood flow (rCBF) was measured at rest using (99m)Tc-ECD SPECT in 10 healthy male volunteers, randomly divided into two groups of five subjects. Each subject was studied on two occasions, 1 week apart. In the first session, subjects were given an oral dose of CBD (400 mg) or placebo, in a double-blind procedure. SPECT images were acquired 90 min after drug ingestion. The Visual Analogue Mood Scale was applied to assess subjective states. In the second session, the same procedure was performed using the drug that had not been administered in the previous session. Within-subject between-condition rCBF comparisons were performed using statistical parametric mapping (SPM). CBD significantly decreased subjective anxiety and increased mental sedation, while placebo did not induce significant changes. Assessment of brain regions where anxiolytic effects of CBD were predicted a priori revealed two voxel clusters of significantly decreased ECD uptake in the CBD relative to the placebo condition (p<0.001, uncorrected for multiple comparisons). These included a medial temporal cluster encompassing the left amygdala-hippocampal complex, extending into the hypothalamus, and a second cluster in the left posterior cingulate gyrus. There was also a cluster of greater activity with CBD than placebo in the left parahippocampal gyrus (p<0.001). These results suggest that CBD has anxiolytic properties, and that these effects are mediated by an action on limbic and paralimbic brain areas.

  4. Cerebral blood oxygenation changes induced by visual stimulation in humans

    NASA Astrophysics Data System (ADS)

    Wenzel, Rudiger; Obrig, Hellmuth; Ruben, Jan; Villringer, Kersten; Thiel, Andreas; Bernarding, Johannes; Dirnagl, Ulrich; Villringer, Arno

    1996-10-01

    We examined local changes of cerebral oxygenation in response to visual stimuli by means of near infrared spectroscopy. A sharply outlined colored moving stimulus which is expected to evoke a broad activation of the striate and prestriate cortex was presented to sixteen healthy subjects. Six of these subjects were also exposed to a colored stationary and a gray stationary stimulus. In two subjects the colored moving stimulus was tested against the colored stationary with an optode position presumably over area V5/MT. As a control condition, subjects performed a simple finger opposition task. Since the calcarine fissure varies greatly with respect to bony landmarks, optodes were positioned individually according to 3D reconstructed magnetic resonance imaging (MRI). Concentration changes in oxyhemoglobin (oxy-Hb) and deoxyhemoglobin (deoxy-Hb) were continuously monitored with a temporal resolution of 1 s, using an NIRO 500. In response to the visual stimulus, the grand average across all sixteen subjects resulted in a significant increase in oxy-Hb of 0.33 +/- 0.09 arbitrary units mirrored by a significant decrease in deoxy-Hb of -0.18 +/- 0.02 arbitrary units, while the motor control condition elicited no significant changes in any parameters. When the near infrared spectroscopy probes were positioned over area V5/MT, the drop of deoxy-Hb associated with the moving stimulus was significantly more pronounced than with the stationary stimulus in both subjects examined. No significant differences between the visual stimuli were observed at the optode position close to the calcarine fissure. The oxygenation changes observed in this study are consistent with the pattern we have reported for motor activation. They are in line with physiological considerations and functional MRI studies relying on blood oxygenation level-dependent contrast.

  5. Relationship between blood pressure and cerebral blood flow during supine cycling: influence of aging

    PubMed Central

    Hoffman, Keegan; Tzeng, Yu-Chieh; Hansen, Alex; Ainslie, Philip N.

    2015-01-01

    The cerebral pressure-flow relationship can be quantified as a high-pass filter, where slow oscillations are buffered (<0.20 Hz) and faster oscillations are passed through relatively unimpeded. During moderate intensity exercise, previous studies have reported paradoxical transfer function analysis (TFA) findings (altered phase or intact gain). This study aimed to determine whether these previous findings accurately represent this relationship. Both younger (20–30 yr; n = 10) and older (62–72 yr; n = 9) adults were examined. To enhance the signal-to-noise ratio, large oscillations in blood pressure (via oscillatory lower body negative pressure; OLBNP) were induced during steady-state moderate intensity supine exercise (∼45–50% of heart rate reserve). Beat-to-beat blood pressure, cerebral blood velocity, and end-tidal Pco2 were monitored. Very low frequency (0.02–0.07 Hz) and low frequency (0.07–0.20 Hz) range spontaneous data were quantified. Driven OLBNP point estimates were sampled at 0.05 and 0.10 Hz. The OLBNP maneuvers augmented coherence to >0.97 at 0.05 Hz and >0.98 at 0.10 Hz in both age groups. The OLBNP protocol conclusively revealed the cerebrovascular system functions as a high-pass filter during exercise throughout aging. It was also discovered that the older adults had elevations (+71%) in normalized gain (+0.46 ± 0.36%/%: 0.05 Hz) and reductions (−34%) in phase (−0.24 ± 0.22 radian: 0.10 Hz). There were also age-related phase differences between resting and exercise conditions. It is speculated that these age-related changes in the TFA metrics are mediated by alterations in vasoactive factors, sympathetic tone, or the mechanical buffering of the compliance vessels. PMID:26586907

  6. Bacopa monnieri increases cerebral blood flow in rat independent of blood pressure.

    PubMed

    Kamkaew, Natakorn; Norman Scholfield, C; Ingkaninan, Kornkanok; Taepavarapruk, Niwat; Chootip, Krongkarn

    2013-01-01

    Bacopa monnieri (L.) Wettst. (Brahmi in India and Thailand) is an ayurvedic dementia treatment, but its effect on cerebral blood flow (CBF) is still unknown. We sought to test its chronic and acute effects on CBF compared with Ginkgo biloba and donepezil. CBF was measured by laser Doppler from rat cerebral cortex after 8 weeks of daily oral dosing of these drugs. Systolic blood pressure was also measured using the tail cuff method or via arterial cannulation. In rats treated with B. monnieri (40 mg/kg), CBF was 25% increased [2927 ± 123 perfusion units, (PU)] compared with shams (2337 ± 217 PU, p < 0.05, nine rats). G. biloba (60 mg/kg) also increased CBF (by 29% to 3019 ± 208 PU, p < 0.05, nine rats). No clear effect was obtained with donepezil (1 mg/kg). Chronic administration of the preparations had no effect on blood pressure. In contrast, intravenous acute infusion of these herbals (20-60 mg/kg) had marked dose-dependent hypotensive actions (diastolic ~31 mmHg lower with 40 mg/kg of either extract), which correspondingly reduced CBF by ~15%. Likewise, CBF fell slightly with acute intravenous sodium nitroprusside and rose with noradrenaline. Donepezil (1 mg/kg) was slightly hypotensive without affecting CBF. Increased CBF with B. monnieri may account for its reported procognitive effect, and its further exploration as an alternative nootropic drug is worthwhile.

  7. Relationship between blood pressure and cerebral blood flow during supine cycling: influence of aging.

    PubMed

    Smirl, Jonathan D; Hoffman, Keegan; Tzeng, Yu-Chieh; Hansen, Alex; Ainslie, Philip N

    2016-03-01

    The cerebral pressure-flow relationship can be quantified as a high-pass filter, where slow oscillations are buffered (<0.20 Hz) and faster oscillations are passed through relatively unimpeded. During moderate intensity exercise, previous studies have reported paradoxical transfer function analysis (TFA) findings (altered phase or intact gain). This study aimed to determine whether these previous findings accurately represent this relationship. Both younger (20-30 yr; n = 10) and older (62-72 yr; n = 9) adults were examined. To enhance the signal-to-noise ratio, large oscillations in blood pressure (via oscillatory lower body negative pressure; OLBNP) were induced during steady-state moderate intensity supine exercise (∼45-50% of heart rate reserve). Beat-to-beat blood pressure, cerebral blood velocity, and end-tidal Pco2 were monitored. Very low frequency (0.02-0.07 Hz) and low frequency (0.07-0.20 Hz) range spontaneous data were quantified. Driven OLBNP point estimates were sampled at 0.05 and 0.10 Hz. The OLBNP maneuvers augmented coherence to >0.97 at 0.05 Hz and >0.98 at 0.10 Hz in both age groups. The OLBNP protocol conclusively revealed the cerebrovascular system functions as a high-pass filter during exercise throughout aging. It was also discovered that the older adults had elevations (+71%) in normalized gain (+0.46 ± 0.36%/%: 0.05 Hz) and reductions (-34%) in phase (-0.24 ± 0.22 radian: 0.10 Hz). There were also age-related phase differences between resting and exercise conditions. It is speculated that these age-related changes in the TFA metrics are mediated by alterations in vasoactive factors, sympathetic tone, or the mechanical buffering of the compliance vessels. Copyright © 2016 the American Physiological Society.

  8. Cerebral blood flow and oxygen metabolism during mild hypothermia in patients with subarachnoid haemorrhage.

    PubMed

    Kawamura, S; Suzuki, A; Hadeishi, H; Yasui, N; Hatazawa, J

    2000-01-01

    Cerebral blood flow and O2 metabolism during hypothermia (33-34 degrees C) was evaluated in 5 patients with aneurysmal subarachnoid haemorrhage by positron emission tomography (PET). Their preoperative clinical condition was WFNS scale IV or V. The patients received surface cooling postoperatively, and were maintained in a hypothermic state during transfer for radiological examination. Positron emission tomography revealed a decrease in cerebral blood flow and O2 metabolic rate. Cerebral blood flow was 34.8+/-15.1 ml/100 ml/min and the O2 metabolic rate was 1.85+/-0.61 ml/100 ml/min in areas of the middle cerebral artery ipsilateral to the ruptured aneurysms, whereas these values were 30.8+/-7.1 and 2.21+/-0.45 ml/100 ml/min, respectively, on the contralateral side. This represents a decrease of 37+/-27% compared to normal cerebral blood flow and 52+/-16% compared to normal O2 metabolic rate (p < 0.02) in the ipsilateral areas, and decreases of 44+/-13% and 43+/-12%, respectively, on the contralateral side. The present results reflected the luxury perfusion state in almost all cases and provide the first PET evidence of decreased cerebral blood flow and metabolic rate of O2 during hypothermia in humans.

  9. Novel optoacoustic system for noninvasive continuous monitoring of cerebral venous blood oxygenation

    NASA Astrophysics Data System (ADS)

    Petrov, Yuriy; Petrov, Irene Y.; Prough, Donald S.; Esenaliev, Rinat O.

    2012-02-01

    Traumatic brain injury (TBI) and spinal cord injury are a major cause of death for individuals under 50 years of age. In the USA alone, 150,000 patients per year suffer moderate or severe TBI. Moreover, TBI is a major cause of combatrelated death. Monitoring of cerebral venous blood oxygenation is critically important for management of TBI patients because cerebral venous blood oxygenation below 50% results in death or severe neurologic complications. At present, there is no technique for noninvasive, accurate monitoring of this clinically important variable. We proposed to use optoacoustic technique for noninvasive monitoring of cerebral venous blood oxygenation by probing cerebral veins such as the superior sagittal sinus (SSS) and validated it in animal studies. In this work, we developed a novel, medical grade optoacoustic system for continuous, real-time cerebral venous blood oxygenation monitoring and tested it in human subjects at normal conditions and during hyperventilation to simulate changes that may occur in patients with TBI. We designed and built a highly-sensitive optoacoustic probe for SSS signal detection. Continuous measurements were performed in the near infrared spectral range and the SSS oxygenation absolute values were automatically calculated in real time using a special algorithm developed by our group. Continuous measurements performed at normal conditions and during hyperventilation demonstrated that hyperventilation resulted in approximately 12% decrease of cerebral venous blood oxygenation.

  10. The contribution of arterial blood gases in cerebral blood flow regulation and fuel utilization in man at high altitude

    PubMed Central

    Willie, Christopher K; MacLeod, David B; Smith, Kurt J; Lewis, Nia C; Foster, Glen E; Ikeda, Keita; Hoiland, Ryan L; Ainslie, Philip N

    2015-01-01

    The effects of partial acclimatization to high altitude (HA; 5,050 m) on cerebral metabolism and cerebrovascular function have not been characterized. We hypothesized (1) increased cerebrovascular reactivity (CVR) at HA; and (2) that CO2 would affect cerebral metabolism more than hypoxia. PaO2 and PaCO2 were manipulated at sea level (SL) to simulate HA exposure, and at HA, SL blood gases were simulated; CVR was assessed at both altitudes. Arterial–jugular venous differences were measured to calculate cerebral metabolic rates and cerebral blood flow (CBF). We observed that (1) partial acclimatization yields a steeper CO2-H+ relation in both arterial and jugular venous blood; yet (2) CVR did not change, despite (3) mean arterial pressure (MAP)-CO2 reactivity being doubled at HA, thus indicating effective cerebral autoregulation. (4) At SL hypoxia increased CBF, and restoration of oxygen at HA reduced CBF, but neither had any effect on cerebral metabolism. Acclimatization resets the cerebrovasculature to chronic hypocapnia. PMID:25690474

  11. Spiral CT angiography in diagnosis of cerebral aneurysms of cases with acute subarachnoid hemorrhage.

    PubMed

    Uysal, Ender; Yanbuloğlu, Bariş; Ertürk, Mehmet; Kilinç, Bekir M; Başak, Muzaffer

    2005-06-01

    To investigate the diagnostic accuracy of spiral CT angiography (CTA) in detection of cerebral aneurysms in cases with acute subarachnoid hemorrhage (SAH). Spiral CT angiography and DSA examinations were performed in 32 cases due to non-traumatic SAH. CTA data were obtained by maximum intensity projection (MIP) method. CTA and DSA findings were evaluated and compared in terms of existence of aneurysm, size and location. In 32 patients, DSA detected 34 aneurysms with diameters ranging from 3 to 13 mm while four cases were free of aneurysms. With CTA, an aneurysm at anterior communicating artery location could not be demonstrated. In all other cases CTA correlated well with DSA in detecting the site, size and orientation of the aneurysms. It was found that CTA sensitivity was 97% and specificity was 100% in diagnosis of intracranial aneurysms. Spiral CTA is a highly accurate, cheap and non-invasive imaging method in diagnosis of intracranial aneurysms in cases with SAH and can be used as a safe alternative method to DSA when emergency surgery is needed.

  12. An intelligent support system for automatic detection of cerebral vascular accidents from brain CT images.

    PubMed

    Hajimani, Elmira; Ruano, M G; Ruano, A E

    2017-07-01

    This paper presents a Radial Basis Functions Neural Network (RBFNN) based detection system, for automatic identification of Cerebral Vascular Accidents (CVA) through analysis of Computed Tomographic (CT) images. For the design of a neural network classifier, a Multi Objective Genetic Algorithm (MOGA) framework is used to determine the architecture of the classifier, its corresponding parameters and input features by maximizing the classification precision, while ensuring generalization. This approach considers a large number of input features, comprising first and second order pixel intensity statistics, as well as symmetry/asymmetry information with respect to the ideal mid-sagittal line. Values of specificity of 98% and sensitivity of 98% were obtained, at pixel level, by an ensemble of non-dominated models generated by MOGA, in a set of 150 CT slices (1,867,602pixels), marked by a NeuroRadiologist. This approach also compares favorably at a lesion level with three other published solutions, in terms of specificity (86% compared with 84%), degree of coincidence of marked lesions (89% compared with 77%) and classification accuracy rate (96% compared with 88%). Copyright © 2017. Published by Elsevier B.V.

  13. Induction and Micro-CT Imaging of Cerebral Cavernous Malformations in Mouse Model.

    PubMed

    Choi, Jaesung P; Yang, Xi; Foley, Matthew; Wang, Xian; Zheng, Xiangjian

    2017-09-04

    Mutations in the CCM1 (aka KRIT1), CCM2, or CCM3 (aka PDCD10) gene cause cerebral cavernous malformation (CCM) in humans. Mouse models of CCM disease have been established by tamoxifen induced deletion of Ccm genes in postnatal animals. These mouse models provide invaluable tools to investigate molecular mechanism and therapeutic approaches for CCM disease. An accurate and quantitative method to assess lesion burden and progression is essential to harness the full value of these animal models. Here, we demonstrate the induction of CCM disease in a mouse model and the use of the contrast enhanced X-ray micro computed tomography (micro-CT) method to measure CCM lesion burden in mouse brains. At postnatal day 1 (P1), we used 4-hydroxytamoxifen (4HT) to activate Cre recombinase activity from the Cdh5-CreErt2 transgene to cleave the floxed allele of Ccm2. CCM lesions in mouse brains were analyzed at P8. For micro-CT, iodine based Lugol's solution was used to enhance contrast in brain tissue. We have optimized the scan parameters and utilized a voxel dimension of 9.5 µm, which lead to a minimum feature size of approximately 25 µm. This resolution is sufficient to measure CCM lesion volume and number globally and accurately, and provide high-quality 3-D mapping of CCM lesions in mouse brains. This method enhances the value of the established mouse models to study the molecular basis and potential therapies for CCM and other cerebrovascular diseases.

  14. Global oxygen extraction fraction by blood sampling to anticipate cerebral hyperperfusion phenomenon after carotid artery stenting.

    PubMed

    Iwata, Tomonori; Mori, Takahisa; Miyazaki, Yuichi; Tanno, Yuhei; Kasakura, Shigen; Aoyagi, Yoshinori

    2014-11-01

    Cerebral hyperperfusion syndrome sometimes occurs after carotid revascularization in patients with severe hemodynamic failure. To prevent cerebral hyperperfusion syndrome, cerebral hyperperfusion phenomenon (CHP) must be detected early. Single-photon emission computed tomography (SPECT) is useful for detecting CHP, but it is impractical on a daily basis. A tool with high availability to find CHP is desired. To investigate whether global oxygen extraction fraction (OEF) by a blood sampling method is useful for indicating CHP after carotid artery stenting (CAS). When patients underwent elective CAS from September 2010 to August 2012, we performed blood sampling for OEF calculation and SPECT before and immediately after elective CAS. Data were collected prospectively. OEF was calculated from the cerebral arteriovenous oxygen difference. Cerebral blood flow was measured in the affected middle cerebral artery (MCA) territory and in the ipsilateral cerebellum by SPECT. The ratio of MCA to cerebellar activity was defined as cerebral blood flow in the affected MCA territory divided by cerebral blood flow in the ipsilateral cerebellar hemisphere. Probable CHP was defined as ≥10% increase in the ratio of MCA to cerebellar activity after CAS. The relationship between peri-CAS OEF and probable CHP was evaluated. Of the 96 patients enrolled, 92 patients were analyzed. Probable CHP occurred in 17 patients. Post-CAS OEF was related to probable CHP (P < .01), but pre-CAS OEF was not. The receiver-operating characteristic curve showed that the cutoff value was 45% for probable CHP (P < .001). An increase in blood sampling OEF immediately after CAS was related to probable CHP; then the oxygen demand should be reduced.

  15. Cerebral blood flow thresholds predicting new hypoattenuation areas due to macrovascular ischemia during the acute phase of severe and complicated aneurysmal subarachnoid hemorrhage. A preliminary study.

    PubMed

    Chieregato, A; Tanfani, A; Noto, A; Fronza, S; Cocciolo, F; Fainardi, E

    2008-01-01

    Focal ischemia may affect patients with aneurysmal subarachnoid hemorrhage (SAH), and the potential evolution of cerebral infarction may greatly influence the patients' outcome. The aim of the study was to assess the values of regional cortical cerebral blood flow (rCBF) thresholds predictive for ischemia during the acute phase of SAH. In 34 patients affected by poor grade or complicated SAH, 52 pairs of Xenon-CT (Xe-CT) studies of regional CBF were analyzed, in which the follow-up Xe-CT study was obtained no later than 72 hours after the baseline study. Corresponding cortical ROIs were placed in the perimeter of the cortex on both the Xe-CT studies. A blinded, experienced neuroradiologist classified for each ROI, the development of a new hypoattenuation at the unenhanced CT images included in the follow-up Xe-CT, while another independent investigator collected rCBF levels of the ROI in the baseline Xe-CT study. New hypoattenuation developed in 3.94% of the ROIs in the paired follow-up Xe-CT studies, and these evolving ROIs were associated with a lower rCBF in baseline Xe-CT. However, the positive predictive value of rCBF levels for the development of new hypoattenuation was only moderately predictive (28.3%) for very low physiological values (5 ml/100gr/min). The results suggest that there is no absolute rCBF threshold ofischemia in severe and complicated SAH patients and that the rCBF values are only moderately predictive at levels lower than previously described.

  16. Healthy term and moderately preterm infants have similar cerebral oxygen saturation and cerebral blood flow volumes during early post-natal transition.

    PubMed

    Demel, A; Feilke, K; Schöning, M; Wolf, M; Poets, C F; Franz, A R

    2015-08-01

    This pilot study evaluated changes in regional cerebral oxygen saturation and cerebral blood flow volume during the transitional period in healthy term and moderately preterm infants. The cohort comprised 16 preterm infants and seven full-term infants with mean gestational ages of 34 and 39 weeks, respectively. Longitudinal measurements were conducted during the first three days after birth. Regional cerebral oxygen saturation was determined bilaterally by frequency domain near-infrared spectroscopy. Flow volumes were determined in internal carotid and vertebral arteries by multiplying the time-averaged velocity by the cross-sectional area: cerebral blood flow volume was calculated as the sum of flow volumes and adjusted for brain weight. Brain weight-adjusted cerebral blood flow volumes and regional cerebral oxygen saturation were similar in preterm and term infants. Regional cerebral oxygen saturation did not correlate with brain weight-adjusted cerebral blood flow volume. Right and left brain weight-adjusted internal carotid flow volumes did not correlate with right and left regional cerebral oxygen saturation. Our findings suggest that during the first three days after birth there was adequate cardiorespiratory adaptation, cerebral perfusion and adequate compensation through the arterial circle of Willis in both healthy term and moderately preterm infants. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  17. Abdominopelvic hemorrhage: correlation of CT positivity with the subsequent decision to perform blood transfusion.

    PubMed

    Chong, Suzanne T; Ellis, James H; Cohan, Richard H; Knoepp, Ursula S; Langley, Travis J; Lau, Darryl; Khalatbari, Shokoufeh

    2015-10-01

    The purpose of this study is to determine the role of computed tomography (CT) on the decision to administer blood transfusions in patients with abdominopelvic hemorrhage (trauma, surgery, invasive procedure, and spontaneous) and to determine the clinical parameters most likely to influence the decision to administer blood transfusions in patients with spontaneous abdominopelvic hemorrhage. In this IRB approved and HIPPA compliant study, retrospective analysis was performed on 298 patients undergoing abdominal and pelvic CT for suspected abdominopelvic hemorrhage and the CT reports and electronic medical records were reviewed. Odds ratios and 95% CI were calculated to compare the odds of abdominopelvic hemorrhage and transfusion for categorical and continuous predictors. The presence of abdominopelvic hemorrhage by CT was significantly associated with blood transfusions for trauma patients (p-value <0.0001) only. 106 patients with suspected spontaneous abdominopelvic hemorrhage had the lowest CT positivity rate (n = 23, 21.7%) but the highest blood transfusion rate (n = 62, 58.5%) compared to the patients with abdominopelvic hemorrhage from known preceding causes. In patients with spontaneous abdominopelvic hemorrhage, low hemoglobin and hematocrit levels immediately prior to obtaining the CT study were more predictive for receiving a blood transfusion (p-value <0.0001) than the presence of hemorrhage by CT. CT positivity is strongly correlated with the decision to administer blood transfusions for patients with abdominopelvic hemorrhage from trauma, indicating that CT studies play a significant role in determining the clinical management of trauma patients. For patients with spontaneous abdominopelvic hemorrhage, the decision to transfuse depends not on the CT study but on the patient's hemoglobin and hematocrit levels. CT studies should therefore not be performed for the sole purpose of determining the need for blood transfusion in patients with spontaneous

  18. Disodium Cromoglycate, A Mast-Cell Stabilizer, Alters Postradiation Regional Cerebral Blood Flow in Primates

    DTIC Science & Technology

    1986-01-01

    Systemic blood pressures were determined si- multaneously. The data indicated that DSCG was successful in diminishing postra- diation decrease in cerebral...blood flow, Irradiated animals pretreated with DSCG , showed only a 10% decrease in hypothalamic blood flow 60 min postradiation, while untreated...irradiated animals showed’ a 57% decrease. The cortical blood flow of DSCG treated, irradiated animal ’Iweda triphasic response, with a decrease of 38

  19. Cerebral Blood Flow and Metabolism in the Wernicke-Korsakoff Syndrome*

    PubMed Central

    Shimojyo, Sadatomo; Scheinberg, Peritz; Reinmuth, Oscar

    1967-01-01

    Cerebral blood flow and metabolism were measured by the iodoantipyrine-4-131I method in nine patients and by the nitrous oxide method in three patients with the Wernicke-Korsakoff syndrome. Cerebral blood flow and cerebral oxygen and glucose consumption were strikingly reduced from the normal, whereas cerebral vascular resistance was increased. Total cerebral metabolism and blood flow may be greatly reduced even though the cerebral metabolic defect is confined to circumscribed anatomical areas. Profound reduction in brain metabolism is not necessarily reflected in alterations of consciousness or awareness as has been previously suggested, or in electroencephalographic abnormalities. This appears to provide cogent support for the neurophysiological principle that disturbance of consciousness is a function of the location of the lesion, not the over-all degree of metabolic defect. The absence of improvement of cerebral metabolic functions in two patients who were restudied after an additional 2 to 3 weeks of treatment confirms the clinical impression of incomplete recovery in many such patients. PMID:6025486

  20. Spontaneous obliteration of MRI-silent cerebral angiomatosis revealed by CT angiography in a patient with Sturge-Weber syndrome.

    PubMed

    Aguglia, Umberto; Latella, Maria Adele; Cafarelli, Franco; Le Piane, Emilio; Gangemi, Antonio; Labate, Angelo; Gambardella, Antonio; Quattrone, Aldo

    2008-01-15

    Type I Sturge-Weber syndrome (SWS) is a neurocutaneous syndrome characterized by facial port wine stain and ipsilateral leptomeningeal angiomatosis. It is commonly complicated by glaucoma and neurological disturbances including seizures, hemiparesis, transient stroke-like deficits, and behavioral problems. Gadolinium-enhanced MRI is the study of choice for demonstrating the leptomeningeal angiomatosis, and is particularly useful for making the diagnosis. Cerebral hematoma and spontaneous obliteration of cerebral angiomatosis have never been reported in SWS. We describe a patient with type I SWS in which a hemorrhage in the left temporal lobe was caused by an underlying angiomatosis. No arteriovenous malformations were detected by brain CT or gadolinium-enhanced MRI, whereas a small angiomatous nidus draining into an ectasic venous collector near the hematoma was disclosed by brain CT angiography. Carotid angiography, performed 3 years after the hemorrhage, demonstrated the spontaneous obliteration of the angioma. This description expands the phenotypic spectrum of type I SWS in which the occurrence of cerebral hemorrhage and MRI-silent cerebral angiomatosis should be included, and emphasizes the need of performing a brain CT angiography in SWS patients whose routine neuroimaging studies fail to detect potentially harmful vessel malformation.

  1. Traumatic Brain Injury by a Closed Head Injury Device Induces Cerebral Blood Flow Changes and Microhemorrhages

    PubMed Central

    Kallakuri, Srinivasu; Bandaru, Sharath; Zakaria, Nisrine; Shen, Yimin; Kou, Zhifeng; Zhang, Liying; Haacke, Ewart Mark; Cavanaugh, John M

    2015-01-01

    Objectives: Traumatic brain injury is a poly-pathology characterized by changes in the cerebral blood flow, inflammation, diffuse axonal, cellular, and vascular injuries. However, studies related to understanding the temporal changes in the cerebral blood flow following traumatic brain injury extending to sub-acute periods are limited. In addition, knowledge related to microhemorrhages, such as their detection, localization, and temporal progression, is important in the evaluation of traumatic brain injury. Materials and Methods: Cerebral blood flow changes and microhemorrhages in male Sprague Dawley rats at 4 h, 24 h, 3 days, and 7 days were assessed following a closed head injury induced by the Marmarou impact acceleration device (2 m height, 450 g brass weight). Cerebral blood flow was measured by arterial spin labeling. Microhemorrhages were assessed by susceptibility-weighted imaging and Prussian blue histology. Results: Traumatic brain injury rats showed reduced regional and global cerebral blood flow at 4 h and 7 days post-injury. Injured rats showed hemorrhagic lesions in the cortex, corpus callosum, hippocampus, and brainstem in susceptibility-weighted imaging. Injured rats also showed Prussian blue reaction products in both the white and gray matter regions up to 7 days after the injury. These lesions were observed in various areas of the cortex, corpus callosum, hippocampus, thalamus, and midbrain. Conclusions: These results suggest that changes in cerebral blood flow and hemorrhagic lesions can persist for sub-acute periods after the initial traumatic insult in an animal model. In addition, microhemorrhages otherwise not seen by susceptibility-weighted imaging are present in diverse regions of the brain. The combination of altered cerebral blood flow and microhemorrhages can potentially be a source of secondary injury changes following traumatic brain injury and may need to be taken into consideration in the long-term care of these cases. PMID:26605126

  2. Cerebral Oxygenation and Pain of Heel Blood Sampling Using Manual and Automatic Lancets in Premature Infants.

    PubMed

    Hwang, Mi-Jung; Seol, Geun Hee

    2015-01-01

    Heel blood sampling is a common but painful procedure for neonates. Automatic lancets have been shown to be more effective, with reduced pain and tissue damage, than manual lancets, but the effects of lancet type on cortical activation have not yet been compared. The study aimed to compare the effects of manual and automatic lancets on cerebral oxygenation and pain of heel blood sampling in 24 premature infants with respiratory distress syndrome. Effectiveness was measured by assessing numbers of pricks and squeezes and duration of heel blood sampling. Pain responses were measured using the premature infant pain profile score, heart rate, and oxygen saturation (SpO2). Regional cerebral oxygen saturation (rScO2) was measured using near-infrared spectroscopy, and cerebral fractional tissue oxygen extraction was calculated from SpO2 and rScO. Measures of effectiveness were significantly better with automatic than with manual lancing, including fewer heel punctures (P = .009) and squeezes (P < .001) and shorter duration of heel blood sampling (P = .002). rScO2 was significantly higher (P = .013) and cerebral fractional tissue oxygen extraction after puncture significantly lower (P = .040) with automatic lancing. Premature infant pain profile scores during (P = .004) and after (P = .048) puncture were significantly lower in the automatic than in the manual lancet group. Automatic lancets for heel blood sampling in neonates with respiratory distress syndrome significantly reduced pain and enhanced cerebral oxygenation, suggesting that heel blood should be sampled routinely using an automatic lancet.

  3. Emesis, radiation exposure, and local cerebral blood flow in the ferret

    SciTech Connect

    Tuor, U.I.; Kondysar, M.H.; Harding, R.K.

    1988-06-01

    We examined the sensitivity of the ferret to emetic stimuli and the effect of radiation exposure near the time of emesis on local cerebral blood flow. Ferrets vomited following the administration of either apomorphine (approx 45% of the ferrets tested) or peptide YY (approx 36% of those tested). Exposure to radiation was a very potent emetic stimulus, but vomiting could be prevented by restraint of the hindquarters of the ferret. Local cerebral blood flow was measured using a quantitative autoradiographic technique and with the exception of several regions in the telencephalon and cerebellum, local cerebral blood flow in the ferret was similar to that in the rat. In animals with whole-body exposure to moderate levels of radiation (4 Gy of /sup 137/Cs), mean arterial blood pressure was similar to that in the control group. However, 15-25 min following irradiation there was a general reduction of local cerebral blood flow ranging from 7 to 33% of that in control animals. These cerebral blood flow changes likely correspond to a reduced activation of the central nervous system.

  4. [Cerebral blood flow and oxygen extraction in lacunar hemiplegia. Semi-quantitative study using oxygen 15 and emission tomography].

    PubMed

    Rougemont, D; Baron, J C; Lebrun-Grandie, P; Bousser, M G; Cabanis, E; Laplane, D

    1983-01-01

    The oxygen 15 non invasive continuous inhalation technique coupled with positron emission tomography (P.E.T.) allows the local study of cerebral blood flow and oxygen metabolism. Recent P.E.T. studies have demonstrated the frequent occurrence of widespread metabolic depression remote from the site of middle cerebral artery territory infarct per se, especially over the cortical mantle and thalamus ipsilaterally, and over the cerebellar hemisphere contralaterally. These phenomena have been taken as indicative of transneural depression (i.e. diaschisis). We thought it interesting to study the possible occurrence of such abnormalities in patients with lacunar syndromes. We have applied the (15)0 technique to six patients (2 with pure motor hemiplegia, 4 with ataxic hemiparesis) for whom no large causal ischemic lesion could be demonstrated on CT scans; in only one patient was a lacunar lesion, presumably responsible for the clinical deficit demonstrated. Compared to a set of 19 patients without brain disease, the semi-quantitative results (analyzed in terms of asymmetry indices between homologous brain regions) in our patients did not disclose any pathophysiologically significant abnormality. More specifically, no evidence of physiological dysfunction similar to that reported in internal carotid artery territory infarcts, was detected over the cerebral or cerebellar cortices. These findings are commented upon in view of the presumably small size and the uncertain topography of the causal lesion.

  5. Cerebral oxygenation in the beach chair position for shoulder surgery in regional anesthesia: impact on cerebral blood flow and neurobehavioral outcome.

    PubMed

    Aguirre, José A; Märzendorfer, Olivia; Brada, Muriel; Saporito, Andrea; Borgeat, Alain; Bühler, Philipp

    2016-12-01

    Beach chair position is considered a potential risk factor for central neurological events particularly if combined with low blood pressure. The aim of this study was to assess the impact of regional anesthesia on cerebral blood flow and neurobehavioral outcome. This is a prospective, assessor-blinded observational study evaluating patients in the beach chair position undergoing shoulder surgery under regional anesthesia. University hospital operating room. Forty patients with American Society of Anesthesiologists classes I-II physical status scheduled for elective shoulder surgery. Cerebral saturation and blood flow of the middle cerebral artery were measured prior to anesthesia and continued after beach chair positioning until discharge to the postanesthesia care unit. The anesthesiologist was blinded for these values. Controlled hypotension with systolic blood pressure≤100mm Hg was maintained during surgery. Neurobehavioral tests and values of regional cerebral saturation, bispectral index, the mean maximal blood flow of the middle cerebral artery, and invasive blood pressure were measured prior to regional anesthesia, and measurements were repeated after placement of the patient on the beach chair position and every 20 minutes thereafter until discharge to postanesthesia care unit. The neurobehavioral tests were repeated the day after surgery. The incidence of cerebral desaturation events was 5%. All patients had a significant blood pressure drop 5 minutes after beach chair positioning, measured at the heart as well as the acoustic meatus levels, when compared with baseline values (P<.05). There was no decrease in either the regional cerebral saturation (P=.136) or the maximal blood flow of the middle cerebral artery (P=.212) at the same time points. Some neurocognitive tests showed an impairment 24 hours after surgery (P<.001 for 2 of 3 tests). Beach chair position in patients undergoing regional anesthesia for shoulder surgery had no major impact on

  6. Prolonged Cerebral Circulation Time Is the Best Parameter for Predicting Vasospasm during Initial CT Perfusion in Subarachnoid Hemorrhagic Patients

    PubMed Central

    Lin, Chun Fu; Hsu, Sanford P. C.; Lin, Chung Jung; Guo, Wan Yuo; Liao, Chih Hsiang; Chu, Wei Fa; Hung, Sheng Che; Shih, Yang Shin; Lin, Yen Tzu

    2016-01-01

    Purpose We sought to imitate angiographic cerebral circulation time (CCT) and create a similar index from baseline CT perfusion (CTP) to better predict vasospasm in patients with subarachnoid hemorrhage (SAH). Methods Forty-one SAH patients with available DSA and CTP were retrospectively included. The vasospasm group was comprised of patients with deterioration in conscious functioning and newly developed luminal narrowing; remaining cases were classified as the control group. The angiography CCT (XA-CCT) was defined as the difference in TTP (time to peak) between the selected arterial ROIs and the superior sagittal sinus (SSS). Four arterial ROIs were selected to generate four corresponding XA-CCTs: the right and left anterior cerebral arteries (XA-CCTRA2 and XA-CCTLA2) and right- and left-middle cerebral arteries (XA-CCTRM2 and XA-CCTLM2). The CCTs from CTP (CT-CCT) were defined as the differences in TTP from the corresponding arterial ROIs and the SSS. Correlations of the different CCTs were calculated and diagnostic accuracy in predicting vasospasm was evaluated. Results Intra-class correlations ranged from 0.96 to 0.98. The correlations of XA-CCTRA2, XA-CCTRM2, XA-CCTLA2, and XA-CCTLM2 with the corresponding CT-CCTs were 0.64, 0.65, 0.53, and 0.68, respectively. All CCTs were significantly prolonged in the vasospasm group (5.8–6.4 s) except for XA-CCTLA2. CT-CCTA2 of 5.62 was the optimal cut-off value for detecting vasospasm with a sensitivity of 84.2% and specificity 82.4% Conclusion CT-CCTs can be used to interpret cerebral flow without deconvolution algorithms, and outperform both MTT and TTP in predicting vasospasm risk. This finding may help facilitate management of patients with SAH. PMID:26986626

  7. Partial pharmacologic blockade shows sympathetic connection between blood pressure and cerebral blood flow velocity fluctuations.

    PubMed

    Hilz, Max J; Wang, Ruihao; Marthol, Harald; Liu, Mao; Tillmann, Alexandra; Riss, Stephan; Hauck, Paulina; Hösl, Katharina M; Wasmeier, Gerald; Stemper, Brigitte; Köhrmann, Martin

    2016-06-15

    Cerebral autoregulation (CA) dampens transfer of blood pressure (BP)-fluctuations onto cerebral blood flow velocity (CBFV). Thus, CBFV-oscillations precede BP-oscillations. The phase angle (PA) between sympathetically mediated low-frequency (LF: 0.03-0.15Hz) BP- and CBFV-oscillations is a measure of CA quality. To evaluate whether PA depends on sympathetic modulation, we assessed PA-changes upon sympathetic stimulation with and without pharmacologic sympathetic blockade. In 10 healthy, young men, we monitored mean BP and CBFV before and during 120-second cold pressor stimulation (CPS) of one foot (0°C ice-water). We calculated mean values, standard deviations and sympathetic LF-powers of all signals, and PAs between LF-BP- and LF-CBFV-oscillations. We repeated measurements after ingestion of the adrenoceptor-blocker carvedilol (25mg). We compared parameters before and during CPS, without and after carvedilol (analysis of variance, post-hoc t-tests, significance: p<0.05). Without carvedilol, CPS increased BP, CBFV, BP-LF- and CBFV-LF-powers, and shortened PA. Carvedilol decreased resting BP, CBFV, BP-LF- and CBFV-LF-powers, while PAs remained unchanged. During CPS, BPs, CBFVs, BP-LF- and CBFV-LF-powers were lower, while PAs were longer with than without carvedilol. With carvedilol, CPS no longer shortened resting PA. Sympathetic activation shortens PA. Partial adrenoceptor blockade abolishes this PA-shortening. Thus, PA-measurements provide a subtle marker of sympathetic influences on CA and might refine CA evaluation. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Cerebral blood flow velocity response to induced and spontaneous sudden changes in arterial blood pressure.

    PubMed

    Panerai, R B; Dawson, S L; Eames, P J; Potter, J F

    2001-05-01

    The influence of different types of maneuvers that can induce sudden changes of arterial blood pressure (ABP) on the cerebral blood flow velocity (CBFV) response was studied in 56 normal subjects (mean age 62 yr, range 23-80). ABP was recorded in the finger with a Finapres device, and bilateral recordings of CBFV were performed with Doppler ultrasound of the middle cerebral arteries. Recordings were performed at rest (baseline) and during the thigh cuff test, lower body negative pressure, cold pressor test, hand grip, and Valsalva maneuver. From baseline recordings, positive and negative spontaneous transients were also selected. Stability of PCO2 was monitored with transcutaneous measurements. Dynamic autoregulatory index (ARI), impulse, and step responses were obtained for 1-min segments of data for the eight conditions by fitting a mathematical model to the ABP-CBFV baseline and transient data (Aaslid's model) and by the Wiener-Laguerre moving-average method. Impulse responses were similar for the right- and left-side recordings, and their temporal pattern was not influenced by type of maneuver. Step responses showed a sudden rise at time 0 and then started to fall back to their original level, indicating an active autoregulation. ARI was also independent of the type of maneuver, giving an overall mean of 4.7 +/- 2.9 (n = 602 recordings). Amplitudes of the impulse and step responses, however, were significantly influenced by type of maneuver and were highly correlated with the resistance-area product before the sudden change in ABP (r = -0.93, P < 0.0004). These results suggest that amplitude of the CBFV step response is sensitive to the point of operation of the instantaneous ABP-CBFV relationship, which can be shifted by different maneuvers. Various degrees of sympathetic nervous system activation resulting from different ABP-stimulating maneuvers were not reflected by CBFV dynamic autoregulatory responses within the physiological range of ABP.

  9. Increased cerebral blood flow during hypercapnia is not affected by lesion of the nucleus locus ceruleus

    SciTech Connect

    Harik, S.I.; Prado, R.; Busto, R.; Ginsberg, M.D.

    1986-11-01

    To test the hypothesis that the putative noradrenergic innervation of intraparenchymal cerebral blood vessels from the nucleus locus ceruleus mediates the vasodilatory response to hypercapnia, regional cerebral blood flow was measured by iodo-(/sup 14/C)antipyrine autoradiography in awake and restrained rats with unilateral 6-hydroxydopamine lesion of the nucleus locus ceruleus and in unlesioned control rats. Hypercapnia, induced by the inhalation of 5% or 8% CO/sub 2/ in air for 8 minutes caused a 2 to 5-fold increase in regional cerebral blood flow. However, despite a marked reduction of about 90% in cortical norepinephrine levels ipsilateral to the lesion, blood flow to the frontal and parietal cortex, hippocampus, striatum and cerebellum increased to the same extent in ipsilateral and contralateral regions. Thus, lesion of the locus ceruleus and the resultant depletion of endogenous cortical and hippocampal norepinephrine, does not influence the cerebrovascular response to hypercapnia.

  10. Blood pressure reduction does not reduce perihematoma oxygenation: a CT perfusion study.

    PubMed

    Kate, Mahesh P; Hansen, Mikkel B; Mouridsen, Kim; Østergaard, Leif; Choi, Victor; Gould, Bronwen E; McCourt, Rebecca; Hill, Michael D; Demchuk, Andrew M; Coutts, Shelagh B; Dowlatshahi, Dariush; Emery, Derek J; Buck, Brian H; Butcher, Kenneth S

    2014-01-01

    Blood pressure (BP) reduction after intracerebral hemorrhage (ICH) is controversial, because of concerns that this may cause critical reductions in perihematoma perfusion and thereby precipitate tissue damage. We tested the hypothesis that BP reduction reduces perihematoma tissue oxygenation.Acute ICH patients were randomized to a systolic BP target of <150 or <180 mm Hg. Patients underwent CT perfusion (CTP) imaging 2 hours after randomization. Maps of cerebral blood flow (CBF), maximum oxygen extraction fraction (OEF(max)), and the resulting maximum cerebral metabolic rate of oxygen (CMRO2(max)) permitted by local hemodynamics, were calculated from raw CTP data.Sixty-five patients (median (interquartile range) age 70 (20)) were imaged at a median (interquartile range) time from onset to CTP of 9.8 (13.6) hours. Mean OEF(max) was elevated in the perihematoma region (0.44±0.12) relative to contralateral tissue (0.36±0.11; P<0.001). Perihematoma CMRO2(max) (3.40±1.67 mL/100 g per minute) was slightly lower relative to contralateral tissue (3.63±1.66 mL/100 g per minute; P=0.025). Despite a significant difference in systolic BP between the aggressive (140.5±18.7 mm Hg) and conservative (163.0±10.6 mm Hg; P<0.001) treatment groups, perihematoma CBF was unaffected (37.2±11.9 versus 35.8±9.6 mL/100 g per minute; P=0.307). Similarly, aggressive BP treatment did not affect perihematoma OEF(max) (0.43±0.12 versus 0.45±0.11; P=0.232) or CMRO2(max) (3.16±1.66 versus 3.68±1.85 mL/100 g per minute; P=0.857). Blood pressure reduction does not affect perihematoma oxygen delivery. These data support the safety of early aggressive BP treatment in ICH.

  11. Cerebral Blood Flow, Heart Rate, and Blood Pressure Patterns during the Tilt Test in Common Orthostatic Syndromes.

    PubMed

    Novak, Peter

    2016-01-01

    Objective. The head-up tilt test is widely used for evaluation of orthostatic intolerance. Although orthostatic symptoms usually reflect cerebral hypoperfusion, the cerebral blood flow velocity (CBFv) profile in orthostatic syndromes is not well described. This study evaluated CBFv and cardiovascular patterns associated with the tilt test in common orthostatic syndromes. Methods. This retrospective study analyzed the tilt test of patients with history of orthostatic intolerance. The following signals were recorded: ECG, blood pressure, CBFv using transcranial Doppler, respiratory signals, and end tidal CO2. Results. Data from 744 patients were analyzed. Characteristic pattern associated with a particular orthostatic syndrome can be grouped into abnormalities predominantly affecting blood pressure (orthostatic hypotension, orthostatic hypertension syndrome, vasomotor oscillations, and neurally mediated syncope-cardioinhibitory, vasodepressor, and mixed), cerebral blood flow (orthostatic hypoperfusion syndrome, primary cerebral autoregulatory failure), and heart rate (tachycardia syndromes: postural tachycardia syndrome, paroxysmal sinus tachycardia, and inappropriate sinus tachycardia). Psychogenic pseudosyncope is associated with stable CBFv. Conclusions. The tilt test is useful add-on in diagnosis of several orthostatic syndromes. However diagnostic criteria for several syndromes had to be modified to allow unambiguous pattern classification. CBFv monitoring in addition to blood pressure and heart rate may increase diagnostic yield of the tilt test.

  12. Cerebral Blood Flow, Heart Rate, and Blood Pressure Patterns during the Tilt Test in Common Orthostatic Syndromes

    PubMed Central

    2016-01-01

    Objective. The head-up tilt test is widely used for evaluation of orthostatic intolerance. Although orthostatic symptoms usually reflect cerebral hypoperfusion, the cerebral blood flow velocity (CBFv) profile in orthostatic syndromes is not well described. This study evaluated CBFv and cardiovascular patterns associated with the tilt test in common orthostatic syndromes. Methods. This retrospective study analyzed the tilt test of patients with history of orthostatic intolerance. The following signals were recorded: ECG, blood pressure, CBFv using transcranial Doppler, respiratory signals, and end tidal CO2. Results. Data from 744 patients were analyzed. Characteristic pattern associated with a particular orthostatic syndrome can be grouped into abnormalities predominantly affecting blood pressure (orthostatic hypotension, orthostatic hypertension syndrome, vasomotor oscillations, and neurally mediated syncope—cardioinhibitory, vasodepressor, and mixed), cerebral blood flow (orthostatic hypoperfusion syndrome, primary cerebral autoregulatory failure), and heart rate (tachycardia syndromes: postural tachycardia syndrome, paroxysmal sinus tachycardia, and inappropriate sinus tachycardia). Psychogenic pseudosyncope is associated with stable CBFv. Conclusions. The tilt test is useful add-on in diagnosis of several orthostatic syndromes. However diagnostic criteria for several syndromes had to be modified to allow unambiguous pattern classification. CBFv monitoring in addition to blood pressure and heart rate may increase diagnostic yield of the tilt test. PMID:27525257

  13. Pulsed arterial spin labeling effectively and dynamically observes changes in cerebral blood flow after mild traumatic brain injury.

    PubMed

    Peng, Shu-Ping; Li, Yi-Ning; Liu, Jun; Wang, Zhi-Yuan; Zhang, Zi-Shu; Zhou, Shun-Ke; Tao, Fang-Xu; Zhang, Zhi-Xue

    2016-02-01

    Cerebral blood flow is strongly associated with brain function, and is the main symptom and diagnostic basis for a variety of encephalopathies. However, changes in cerebral blood flow after mild traumatic brain injury remain poorly understood. This study sought to observe changes in cerebral blood flow in different regions after mild traumatic brain injury using pulsed arterial spin labeling. Our results demonstrate maximal cerebral blood flow in gray matter and minimal in the white matter of patients with mild traumatic brain injury. At the acute and subacute stages, cerebral blood flow was reduced in the occipital lobe, parietal lobe, central region, subcutaneous region, and frontal lobe. Cerebral blood flow was restored at the chronic stage. At the acute, subacute, and chronic stages, changes in cerebral blood flow were not apparent in the insula. Cerebral blood flow in the temporal lobe and limbic lobe diminished at the acute and subacute stages, but was restored at the chronic stage. These findings suggest that pulsed arterial spin labeling can precisely measure cerebral blood flow in various brain regions, and may play a reference role in evaluating a patient's condition and judging prognosis after traumatic brain injury.

  14. Cigarette smoking impairs nitric oxide-mediated cerebral blood flow increase: Implications for Alzheimer's disease.

    PubMed

    Toda, Noboru; Okamura, Tomio

    2016-08-01

    Cerebral blood flow is mainly regulated by nitrergic (parasympathetic, postganglionic) nerves and nitric oxide (NO) liberated from endothelial cells in response to shear stress and stretch of vasculature, whereas sympathetic vasoconstrictor control is quite weak. On the other hand, peripheral vascular resistance and blood flow are mainly controlled by adrenergic vasoconstrictor nerves; endothelium-derived NO and nitrergic nerves play some roles as vasodilator factors. Cigarette smoking impairs NO synthesis in cerebral vascular endothelial cells and nitrergic nerves leading to interference with cerebral blood flow and glucose metabolism in the brain. Smoking-induced cerebral hypoperfusion is induced by impairment of synthesis and actions of NO via endothelial nitric oxide synthase (eNOS)/neuronal NOS (nNOS) inhibition and by increased production of oxygen radicals, resulting in decreased actions of NO on vascular smooth muscle. Nicotine acutely and chronically impairs the action of endothelial NO and also inhibits nitrergic nerve function in chronic use. Impaired cerebral blood supply promotes the synthesis of amyloid β that accelerates blood flow decrease. This vicious cycle is thought to be one of the important factors involving in Alzheimer's disease (AD). Quitting smoking is undoubtedly one of the important ways to prevent and delay the genesis or slow the progress of impaired cognitive function and AD. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  15. Problems in cerebral blood flow calculation using xenon-133 in patients with pulmonary diseases

    SciTech Connect

    Hansen, M.; Jakobsen, M.; Enevoldsen, E.; Egede, F. )

    1990-05-01

    We used the end-tidal concentration of xenon-133 (air curve) to estimate the profile of its arterial concentration in calculating cerebral blood flow. We examined the effects of pulmonary disease and artificial ventilation on the air curve and the calculated cerebral blood flow. We studied the relation between arterial and end-tidal xenon activities in 19 subjects, of whom 15 had pulmonary dysfunction. The t 1/2 of the declining phases of the arterial and air curves were used to express their shapes. The mean +/- SD reference t 1/2 from 15 normal volunteers was 26.8 +/- 8.4 seconds. The mean +/- SD t 1/2 s of the air and arterial curves from the 15 patients with pulmonary dysfunction were 10.4 +/- 2.9 and 33.8 +/- 10.9 seconds. The degree of pulmonary dysfunction (expressed as the pulmonary shunt percentage) correlated with distortion of the air curve. Substituting the arterial for the air curve, mean calculated cerebral blood flow (as the initial slope index) increased from 40 to 61 for the 12 patients with chronic obstructive pulmonary disease. The degree of underestimation of cerebral blood flow using the air curve correlated with the pulmonary shunt percentage. Our work confirms the problems of estimating cerebral blood flow in subjects with pulmonary dysfunction.

  16. Laser speckle contrast imaging to measure changes in cerebral blood flow.

    PubMed

    Winship, Ian R

    2014-01-01

    Laser speckle contrast imaging (LSCI) is a powerful tool capable of acquiring detailed maps of blood flow in arteries and veins on the cortical surface. Based on the blurring of laser speckle patterns by the motion of blood cells, LSCI can be combined with a variety of optical imaging preparations to acquire high-spatiotemporal resolution images of blood flow, and track changes in blood flow over time, using relatively simple instrumentation. Here, we describe methods for LSCI of cerebral blood flow via a thin skull imaging preparation in mice or rats. This preparation allows precise semiquantitative mapping of changes in blood flow over time using straightforward surgical protocols and equipment.

  17. Longitudinal quantitation of middle cerebral artery blood flow in normal human fetuses.

    PubMed

    Veille, J C; Hanson, R; Tatum, K

    1993-12-01

    We attempted to quantify noninvasively blood flow of the middle cerebral artery in human fetuses during five distinct periods. Twenty normal fetuses had color pulsed Doppler ultrasonography of the middle cerebral artery. A total of 68 studies were successfully done and are reported. The Doppler sample was placed as parallel to the direction of the vessel flow as possible. All waveforms were recorded on a strip chart at a preset speed of 100 mm/sec. Six Doppler waveforms were digitized for the time velocity integral (area under the curve is equal to time velocity integral) and averaged. Middle cerebral blood flow was obtained by multiplying the time velocity integral of the Doppler curve by the cross-sectional area of the vessel. The combined cardiac output was obtained by adding the right and left ventricular outputs, which were obtained by multiplying the time velocity integrals by the area of the corresponding annuli. Analysis of variance for repeated measurements was used to determine significance. The diameter of the middle cerebral artery, the time velocity integral, and the peak flow velocity of the Doppler waveform increased significantly with advancing gestational age. Blood flow to the middle cerebral artery ranged from 23 ml/min at 19 weeks to 133 ml/min at term. Resistivity index values were not correlated with advancing gestational age. The percent of the cardiac output to one of the two middle cerebral arteries remained constant throughout gestation with a range between 3% and 7%. (1) Time velocity integral, peak flow velocity, diameter, and blood flow of the middle cerebral artery increased significantly with gestational age; (2) the percent of the total cardiac output to the middle cerebral artery does not significantly change with gestational age.

  18. The Hemodynamic Effects of Blood Flow-Arterial Wall Interaction on Cerebral Aneurysms

    NASA Astrophysics Data System (ADS)

    Oshima, Marie

    2005-11-01

    Mechanical stresses such as wall shear induced by blood flow play an important role on cardiovascular diseases and cerebral disorders like arterioscleroses and cerebral aneurysm. In order to obtain a better understanding of mechanism of formation, growth, and rupture of cerebral aneurysm, this paper focuses on investigation of cerebral hemodynamics and its effects on aneurismal wall. The paper mainly consists of three parts. Since it is important to obtain the detailed information on the hemodynamic properties in the cerebral circulatory system, the first part discusses a large-scale hemodynamic simulation of the Cerebral Arterial Circle of Willis. The second part presents the simulation and in-vitro experiment of cerebral aneurysm with the consideration of blood flow-arterial wall interaction. Both simulations in the first and the second parts are conducted in a patient specific manner using medical images and also include modeling of boundary conditions to emulate realistic hemodynamic conditions. The present mathematical model, however, includes only macroscopic mechanical functions. Therefore, in the third part, the paper touches upon on future prospects in modeling of microscopic functions such as the effects of endothelial cells and multi physics functions such as physiological effects.

  19. Cerebral blood velocity and other cardiovascular responses to 2 days of head-down tilt

    NASA Technical Reports Server (NTRS)

    Frey, Mary A. B.; Mader, Thomas H.; Bagian, James P.; Charles, John B.; Meehan, Richard T.

    1993-01-01

    Spaceflight induces a cephalad redistribution of fluid volume and blood flow within the human body, and space motion sickness, which is a problem during the first few days of space flight, could be related to these changes in fluid status and in blood flow of the cerebrum and vestibular system. To evaluate possible changes in cerebral blood flow during simulated weightlessness, we measured blood velocity in the middle cerebral artery (MCA) along with retinal vascular diameters, intraocular pressure, impedance cardiography, and sphygmomanometry on nine men (26.2 +/- 6.6 yr) morning and evening for 2 days during continuous 10 deg head-down tilt (HDT). When subjects went from seated to head-down bed rest, their heart rate and retinal diameters decreased, and intraocular pressures increased. After 48 h of HDT, blood flow velocity in the MCA was decreased and thoracic impedance was increased, indicating less fluid in the thorax. Percent changes in blood flow velocities in the MCA after 48 h of HDT were inversely correlated with percent changes in retinal vascular diameters. Blood flow velocities in the MCA were inversely correlated (intersubject) with arterial pressures and retinal vascular diameters. Heart rate, stroke volume, cardiac output, systolic arterial pressure, and at times pulse pressure and blood flow velocities in the MCA were greater in the evening. Total peripheral resistance was higher in the morning. Although cerebral blood velocity is reduced after subjects are head down for 2 days, the inverse relationship with retinal vessel diameters, which have control analogous to that of cerebral vessels, indicates cerebral blood flow is not reduced.

  20. Cerebral blood velocity and other cardiovascular responses to 2 days of head-down tilt

    NASA Technical Reports Server (NTRS)

    Frey, Mary A. B.; Mader, Thomas H.; Bagian, James P.; Charles, John B.; Meehan, Richard T.

    1993-01-01

    Spaceflight induces a cephalad redistribution of fluid volume and blood flow within the human body, and space motion sickness, which is a problem during the first few days of space flight, could be related to these changes in fluid status and in blood flow of the cerebrum and vestibular system. To evaluate possible changes in cerebral blood flow during simulated weightlessness, we measured blood velocity in the middle cerebral artery (MCA) along with retinal vascular diameters, intraocular pressure, impedance cardiography, and sphygmomanometry on nine men (26.2 +/- 6.6 yr) morning and evening for 2 days during continuous 10 deg head-down tilt (HDT). When subjects went from seated to head-down bed rest, their heart rate and retinal diameters decreased, and intraocular pressures increased. After 48 h of HDT, blood flow velocity in the MCA was decreased and thoracic impedance was increased, indicating less fluid in the thorax. Percent changes in blood flow velocities in the MCA after 48 h of HDT were inversely correlated with percent changes in retinal vascular diameters. Blood flow velocities in the MCA were inversely correlated (intersubject) with arterial pressures and retinal vascular diameters. Heart rate, stroke volume, cardiac output, systolic arterial pressure, and at times pulse pressure and blood flow velocities in the MCA were greater in the evening. Total peripheral resistance was higher in the morning. Although cerebral blood velocity is reduced after subjects are head down for 2 days, the inverse relationship with retinal vessel diameters, which have control analogous to that of cerebral vessels, indicates cerebral blood flow is not reduced.

  1. Regional brain blood flow and cerebral hemispheric oxygen consumption during acute hypoxaemia in the llama fetus

    PubMed Central

    Llanos, Aníbal J; Riquelme, Raquel A; Sanhueza, Emilia M; Herrera, Emilio; Cabello, Gertrudis; Giussani, Dino A; Parer, Julian T

    2002-01-01

    Unlike fetal animals of lowland species, the llama fetus does not increase its cerebral blood flow during an episode of acute hypoxaemia. This study tested the hypothesis that the fetal llama brain maintains cerebral hemispheric O2 consumption by increasing cerebral O2 extraction rather than decreasing cerebral oxygen utilisation during acute hypoxaemia. Six llama fetuses were surgically instrumented under general anaesthesia at 217 days of gestation (term ca 350 days) with vascular and amniotic catheters in order to carry out cardiorespiratory studies. Following a control period of 1 h, the llama fetuses underwent 3 × 20 min episodes of progressive hypoxaemia, induced by maternal inhalational hypoxia. During basal conditions and during each of the 20 min of hypoxaemia, fetal cerebral blood flow was measured with radioactive microspheres, cerebral oxygen extraction was calculated, and fetal cerebral hemispheric O2 consumption was determined by the modified Fick principle. During hypoxaemia, fetal arterial O2 tension and fetal pH decreased progressively from 24 ± 1 to 20 ± 1 Torr and from 7.36 ± 0.01 to 7.33 ± 0.01, respectively, during the first 20 min episode, to 16 ± 1 Torr and 7.25 ± 0.05 during the second 20 min episode and to 14 ± 1 Torr and 7.21 ± 0.04 during the final 20 min episode. Fetal arterial partial pressure of CO2 (Pa,CO2, 42 ± 2 Torr) remained unaltered from baseline throughout the experiment. Fetal cerebral hemispheric blood flow and cerebral hemispheric oxygen extraction were unaltered from baseline during progressive hypoxaemia. In contrast, a progressive fall in fetal cerebral hemispheric oxygen consumption occurred during the hypoxaemic challenge. In conclusion, these data do not support the hypothesis that the fetal llama brain maintains cerebral hemispheric O2 consumption by increasing cerebral hemispheric O2 extraction. Rather, the data show that in the llama fetus, a reduction in cerebral hemispheric metabolism occurs during acute

  2. Cerebral blood flow in experimental ischemia assessed by sup 19 F magnetic resonance spectroscopy in cats

    SciTech Connect

    Brunetti, A.; Nagashima, G.; Bizzi, A.; DesPres, D.J. )

    1990-10-01

    We evaluated a 19F magnetic resonance spectroscopic technique that detects Freon-23 washout as a means of measuring cerebral blood flow in halothane-anesthetized adult cats during and after transient cerebral ischemia produced by vascular occlusion. The experiments were performed to test the ability of this recently developed method to detect postischemic flow deficits. Results were consistent with postischemic hypoperfusion. The method also proved valuable for measuring small residual flow during vascular occlusion. Our experiments indicate that this method provides simple, rapid, and repeatable flow measurements that can augment magnetic resonance examinations of cerebral metabolic parameters in the study of ischemia.

  3. Dual role of cerebral blood flow in regional brain temperature control in the healthy newborn infant.

    PubMed

    Iwata, Sachiko; Tachtsidis, Ilias; Takashima, Sachio; Matsuishi, Toyojiro; Robertson, Nicola J; Iwata, Osuke

    2014-10-01

    Small shifts in brain temperature after hypoxia-ischaemia affect cell viability. The main determinants of brain temperature are cerebral metabolism, which contributes to local heat production, and brain perfusion, which removes heat. However, few studies have addressed the effect of cerebral metabolism and perfusion on regional brain temperature in human neonates because of the lack of non-invasive cot-side monitors. This study aimed (i) to determine non-invasive monitoring tools of cerebral metabolism and perfusion by combining near-infrared spectroscopy and echocardiography, and (ii) to investigate the dependence of brain temperature on cerebral metabolism and perfusion in unsedated newborn infants. Thirty-two healthy newborn infants were recruited. They were studied with cerebral near-infrared spectroscopy, echocardiography, and a zero-heat flux tissue thermometer. A surrogate of cerebral blood flow (CBF) was measured using superior vena cava flow adjusted for cerebral volume (rSVC flow). The tissue oxygenation index, fractional oxygen extraction (FOE), and the cerebral metabolic rate of oxygen relative to rSVC flow (CMRO₂ index) were also estimated. A greater rSVC flow was positively associated with higher brain temperatures, particularly for superficial structures. The CMRO₂ index and rSVC flow were positively coupled. However, brain temperature was independent of FOE and the CMRO₂ index. A cooler ambient temperature was associated with a greater temperature gradient between the scalp surface and the body core. Cerebral oxygen metabolism and perfusion were monitored in newborn infants without using tracers. In these healthy newborn infants, cerebral perfusion and ambient temperature were significant independent variables of brain temperature. CBF has primarily been associated with heat removal from the brain. However, our results suggest that CBF is likely to deliver heat specifically to the superficial brain. Further studies are required to assess the

  4. Relationship of 133Xe cerebral blood flow to middle cerebral arterial flow velocity in men at rest

    NASA Technical Reports Server (NTRS)

    Clark, J. M.; Skolnick, B. E.; Gelfand, R.; Farber, R. E.; Stierheim, M.; Stevens, W. C.; Beck, G. Jr; Lambertsen, C. J.

    1996-01-01

    Cerebral blood flow (CBF) was measured by 133Xe clearance simultaneously with the velocity of blood flow through the left middle cerebral artery (MCA) over a wide range of arterial PCO2 in eight normal men. Average arterial PCO2, which was varied by giving 4% and 6% CO2 in O2 and by controlled hyperventilation on O2, ranged from 25.3 to 49.9 mm Hg. Corresponding average values of global CBF15 were 27.2 and 65.0 ml 100 g min-1, respectively, whereas MCA blood-flow velocity ranged from 42.8 to 94.2 cm/s. The relationship of CBF to MCA blood-flow velocity over the imposed range of arterial PCO2 was described analytically by a parabola with the equation: CBF = 22.8 - 0.17 x velocity + 0.006 x velocity2 The observed data indicate that MCA blood-flow velocity is a useful index of CBF response to change in arterial PCO2 during O2 breathing at rest. With respect to baseline values measured while breathing 100% O2 spontaneously, percent changes in velocity were significantly smaller than corresponding percent changes in CBF at increased levels of arterial PCO2 and larger than CBF changes at the lower arterial PCO2. These observed relative changes are consistent with MCA vasodilation at the site of measurement during exposure to progressive hypercapnia and also during extreme hyperventilation hypocapnia.

  5. Relationship of 133Xe cerebral blood flow to middle cerebral arterial flow velocity in men at rest

    NASA Technical Reports Server (NTRS)

    Clark, J. M.; Skolnick, B. E.; Gelfand, R.; Farber, R. E.; Stierheim, M.; Stevens, W. C.; Beck, G. Jr; Lambertsen, C. J.

    1996-01-01

    Cerebral blood flow (CBF) was measured by 133Xe clearance simultaneously with the velocity of blood flow through the left middle cerebral artery (MCA) over a wide range of arterial PCO2 in eight normal men. Average arterial PCO2, which was varied by giving 4% and 6% CO2 in O2 and by controlled hyperventilation on O2, ranged from 25.3 to 49.9 mm Hg. Corresponding average values of global CBF15 were 27.2 and 65.0 ml 100 g min-1, respectively, whereas MCA blood-flow velocity ranged from 42.8 to 94.2 cm/s. The relationship of CBF to MCA blood-flow velocity over the imposed range of arterial PCO2 was described analytically by a parabola with the equation: CBF = 22.8 - 0.17 x velocity + 0.006 x velocity2 The observed data indicate that MCA blood-flow velocity is a useful index of CBF response to change in arterial PCO2 during O2 breathing at rest. With respect to baseline values measured while breathing 100% O2 spontaneously, percent changes in velocity were significantly smaller than corresponding percent changes in CBF at increased levels of arterial PCO2 and larger than CBF changes at the lower arterial PCO2. These observed relative changes are consistent with MCA vasodilation at the site of measurement during exposure to progressive hypercapnia and also during extreme hyperventilation hypocapnia.

  6. Antegrade selective cerebral perfusion combined with deep hypothermic circulatory arrest on cerebral circulation: comparison between pulsatile and nonpulsatile blood flows.

    PubMed

    Soeda, Masao

    2007-04-01

    In aortic arch surgeries, antegrade selective cerebral perfusion (SCP) combined with deep hypothermic circulatory arrest (DHCA) has been recently widely used in institutions as one of the most reliable methods for cerebral protection. However, some studies reported a 3.7-9.3% incidence of postoperative cerebral complications. To perform antegrade SCP more safely, we sought to examine the impact of pulsatile flow perfusion during DHCA on cerebral tissue metabolism, focusing on physiological effects of pulsatile flow perfusion. Sixteen pigs were divided into 2 groups. In each group, antegrade SCP combined with DHCA was conducted. During circulatory arrest, for SCP, a pulsatile flow (group P) and a nonpulsatile flow (group N) were used. We compared results between group P and group N. Jugular venous oxygen saturation (SjO(2)) and cerebral tissue oxygen partial pressure (PtO(2)) were measured at baseline, and continuously throughout the extracorporeal circulation. Hematocrit (Ht), and concentrations of S-100 protein and CK-BB in blood and the cerebrospinal fluid (CSF) were measured at baseline (before the beginning of extracorporeal circulation), following SCP, and after rewarming. Following rewarming, each brain under perfused fixation was removed, and histopathological examinations were conducted using Kluver-Barrera and Tunnel staining methods, electron micrograph. SjO(2) was found to be within normal ranges until after SCP, but decreased with rewarming in both groups. In Group N, changes in SjO(2) were significant, with a decrease to < or =50%. In Group N, concentrations of S-100 protein and CK-BB in CSF after SCP and after rewarming were significantly higher than those in Group P. The time needed for rewarming to 36 degrees C in Group P was shorter than that in Group N. Our results suggest that the pulsatile flow circulation method shows cerebral protection effects with increasing blood flow in small cerebral tissues. In addition, it is effective for improving the

  7. Imaging cerebral blood flow through the intact rat skull with temporal laser speckle imaging.

    PubMed

    Li, Pengcheng; Ni, Songlin; Zhang, Li; Zeng, Shaoqun; Luo, Qingming

    2006-06-15

    We discovered that laser speckle temporal contrast analysis (LSTCA) is able to access the two-dimensional (2D) cerebral blood flow velocity and vessel structure through the intact rat skull. It is demonstrated that LSTCA can significantly suppress the influence of the laser speckle from the stationary structure, such as the skull, and thus reveal the blood flow and morphology of blood vessels through the laser speckle images recorded from the intact rat skull.

  8. Imaging cerebral blood flow through the intact rat skull with temporal laser speckle imaging

    NASA Astrophysics Data System (ADS)

    Li, Pengcheng; Ni, Songlin; Zhang, Li; Zeng, Shaoqun; Luo, Qingming

    2006-06-01

    We discovered that laser speckle temporal contrast analysis (LSTCA) is able to access the two-dimensional (2D) cerebral blood flow velocity and vessel structure through the intact rat skull. It is demonstrated that LSTCA can significantly suppress the influence of the laser speckle from the stationary structure, such as the skull, and thus reveal the blood flow and morphology of blood vessels through the laser speckle images recorded from the intact rat skull.

  9. Intraoperative blood pressure and cerebral perfusion: strategies to clarify hemodynamic goals.

    PubMed

    Williams, Monica; Lee, Jennifer K

    2014-07-01

    Blood pressure can vary considerably during anesthesia. If blood pressure falls outside the limits of cerebrovascular autoregulation, children can become at risk of cerebral ischemic or hyperemic injury. However, the blood pressure limits of autoregulation are unclear in infants and children, and these limits can shift after brain injury. This article will review autoregulation, considerations for the hemodynamic management of children with brain injuries, and research on autoregulation monitoring techniques.

  10. Changes in cerebral blood flow and recovery from acute stroke

    SciTech Connect

    Burke, A.M.; Younkin, D.; Gordon, J.; Goldberg, H.; Graham, T.; Kushner, M.; Obrist, W.; Jaggi, J.; Rosen, M.; Reivich, M.

    1986-03-01

    We prospectively studied 14 patients with acute cerebral infarctions using serial /sup 133/Xenon inhalation cerebral determination (/sup 133/Xe-rCBF), scored neurological examinations, and neuropsychological testing. All patients underwent the same battery of tests at 3 days, 1 week, 2 weeks, and 4 weeks after cerebral infarction to determine the prognostic value of early rCBF studies and the chronological relationship of changes in rCBF to clinical status. Baseline rCBF within 3 days of symptoms of acute stroke did not correlate with clinical neurological outcome (r = -0.17, p less than 0.30; r = -0.18, p less than 0.28, for the two indices of rCBF used). Among the 11 patients demonstrating neurological recovery, 7 improved at 1 week, significantly before increases in rCBF (p less than 0.05). We conclude that early baseline rCBF does not predict clinical outcome in patients with acute cerebral infarctions and that return of neurological function precedes rather than follows increases in rCBF.

  11. Cerebral blood flow and oxygenation in infants after birth asphyxia. Clinically useful information?

    PubMed

    Greisen, Gorm

    2014-10-01

    The term 'luxury perfusion' was coined nearly 50 years ago after observation of bright-red blood in the cerebral veins of adults with various brain pathologies. The bright-red blood represents decreased oxygen extraction and hence the perfusion is 'luxurious' compared to oxygen needs. Gradual loss of cellular energy charge during the hours following severe birth asphyxia was observed twenty years later by sequential cranial magnetic resonance spectroscopy. This led to the concept of delayed energy failure that is linked to mitochondrial dysfunction and apoptotic cell death. Abnormally increased perfusion and lack of normal cerebral blood flow regulation are also typically present, but whether the perfusion abnormalities at this secondary stage are detrimental, beneficial, or a mere epiphenomenon remains elusive. In contrast, incomplete reoxygenation of the brain during and following resuscitation is likely to compromise outcome. The clinical value of cerebral oximetry in this context can only be examined in a randomised clinical trial.

  12. Regional cerebral blood flow utilizing the gamma camera and xenon inhalation: reproducibility and clinical applications

    SciTech Connect

    Fox, R.A.; Knuckey, N.W.; Fleay, R.F.; Stokes, B.A.; Van der Schaaf, A.; Surveyor, I.

    1985-11-01

    A modified collimator and standard gamma camera have been used to measure regional cerebral blood flow following inhalation of radioactive xenon. The collimator and a simplified analysis technique enables excellent statistical accuracy to be achieved with acceptable precision in the measurement of grey matter blood flow. The validity of the analysis was supported by computer modelling and patient measurements. Sixty-one patients with subarachnoid hemorrhage, cerebrovascular disease or dementia were retested to determine the reproducibility of our method. The measured coefficient of variation was 6.5%. Of forty-six patients who had a proven subarachnoid hemorrhage, 15 subsequently developed cerebral ischaemia. These showed a CBF of 42 +/- 6 ml X minute-1 X 100 g brain-1 compared with 49 +/- 11 ml X minute-1 X 100 g brain-1 for the remainder. There is evidence that decreasing blood flow and low initial flow correlate with the subsequent onset of cerebral ischemia.

  13. PET evaluation of cerebral blood flow reactivity in symptomatic and asymptomatic carotid artery stenosis

    SciTech Connect

    Dey, H.M.; Brass, L.; Rich, D.

    1994-05-01

    The purpose of this study was to use acetazolamide (AZ) enhanced O-15 water PET to evaluate cerebral perfusion reserve in symptomatic and asymptomatic carotid artery stenosis. We hypothesized that impaired vasoreactivity would be associated with symptomatic disease and a higher likelihood of future ischemic events. Twenty-two patients with significant (>75%) carotid artery occlusion underwent cerebral blood flow imaging at baseline and following AZ infusion. Paired O-15 data sets were coregistered and globally normalized. Regions of interest were drawn on baseline blood flow images and superimposed upon (AZ - baseline) difference images to derive a % change in regional blood flow after AZ administration. The results showed a significant difference in cerebral perfusion reserve between symptomatic (n=19) and asymptomatic (n=3) carotid artery disease.

  14. Blood flow increase by cervical spinal cord stimulation in middle cerebral and common carotid arteries.

    PubMed

    Robaina, Francisco; Clavo, Bernardino; Catalá, Luis; Caramés, Miguel Á; Morera, Jesús

    2004-01-01

    The effect of spinal cord stimulation (SCS) on cerebral blood flow (CBF) has, in the past, been evaluated by semiquantitative techniques, but has not been used to treat CBF diseases. The aim of this study was to assess the effect of cervical SCS on regional blood flow by both semiquantitative and quantitative methods. Thirty-five patients with cervical SCS-implanted devices were enrolled. The following parameters were measured before and after cervical SCS: systolic and diastolic velocity (cm/s) in the middle cerebral artery (MCA) by transcranial Doppler (TCD) and volume blood flow quantification (ml/min) in the common carotid artery (CCA) by color Doppler. During cervical SCS there was a significant and bilateral increase in systolic (21%) and diastolic (26%) velocity in the MCA and in CCA blood flow (50%). We conclude that cervical SCS increases blood flow in the middle cerebral artery and common carotid artery. The consistent increase supports the potential usefulness of cervical SCS as an adjuvant treatment for cerebral blood flow diseases.

  15. Effect of increases in cardiac contractility on cerebral blood flow in humans.

    PubMed

    Ogoh, Shigehiko; Moralez, Gilbert; Washio, Takuro; Sarma, Satyam; Hieda, Michinari; Romero, Steven A; Cramer, Matthew N; Shibasaki, Manabu; Crandall, Craig G

    2017-09-15

    The effect of acute increases in cardiac contractility on cerebral blood flow (CBF) remains unknown. We hypothesized that the external carotid artery (ECA) downstream vasculature modifies the direct influence of acute increases in heart rate and cardiac function on CBF regulation. Twelve healthy subjects received two infusions of dobutamine (first a low dose; 5 μg/kg/min and then a high dose; 15 μg/kg/min) for 12 min each. Cardiac output, blood flow through the internal carotid artery (ICA) and ECA and echocardiographic measurements were performed during dobutamine infusions. Despite increases in cardiac contractility, cardiac output and arterial pressure with dobutamine, ICA blood flow and conductance slightly decreased from resting baseline during both low and high dose infusions. In contrast, ECA blood flow and conductance increased appreciably during both low and high dose infusions. Greater ECA vascular conductance and corresponding increases in blood flow may protect over-perfusion of intracranial cerebral arteries during enhanced cardiac contractility and associated increases in cardiac output and perfusion pressure. Importantly, these findings suggest that the acute increase of blood perfusion due to dobutamine administration does not cause cerebral over-perfusion or an associated risk of cerebral vascular damage. Copyright © 2017, American Journal of Physiology-Heart and Circulatory Physiology.

  16. Ten-minute umbilical cord occlusion markedly reduces cerebral blood flow and heat production in fetal sheep.

    PubMed

    Lotgering, Fred K; Bishai, John M; Struijk, Piet C; Blood, Arlin B; Hunter, Christian J; Power, Gordon G; Longo, Lawrence D

    2003-07-01

    The study was undertaken to determine to what extent a 10-minute total umbilical cord occlusion affects autoregulation of cerebral blood flow and cerebral heat production in the fetus. In seven chronically catheterized late-gestation fetal sheep (127-131 days' gestation), we studied fetal blood gas, hemodynamic, and thermal responses to 10-minute total umbilical cord occlusion. Ten-minute umbilical cord occlusion resulted in marked hypoxia/ischemia, with oxygen content decreasing from 6.5 +/- 0.4 to 0.6 +/- 0.1 vol% and lactate concentration increasing from 1.8 +/- 0.2 to 10.7 +/- 0.7 mmol/L. During this period, the fetuses showed reductions in heart rate from 163.5 +/- 3.4 to 97.1 +/- 5.4 beats/min, mean arterial pressure from 39.4 +/- 2.1 to 21.2 +/- 2.5 mm Hg, cerebral blood flow from 101.3% +/- 8.9% to 49.7% +/- 10.3%, and cerebral heat production from 95.0% +/- 6.3% to 29.6% +/- 4.8%. During cord occlusion, cerebral blood flow was pressure passive from the fourth minute onward. The reduction in cerebral heat production preceded the reduction in perfusion pressure and cerebral blood flow. Recovery of cerebral blood flow and heat production to control values was incomplete for more than 60 minutes after restoration of umbilical flow. Ten-minute total umbilical cord occlusion results in major reductions in cerebral blood flow and heat production. Autoregulation of cerebral blood flow was lost within 4 minutes of occlusion, probably as a result of hypoxia, combined with hypotension. The fact that the reduction in cerebral heat production preceded and exceeded the reduction in blood flow may suggest active down-regulation of cerebral metabolism, the mechanism of which is unclear at present.

  17. Methodological study investigating long term laser Doppler measured cerebral blood flow changes in a permanently occluded rat stroke model.

    PubMed

    Eve, David J; Musso, James; Park, Dong-Hyuk; Oliveira, Cathy; Pollock, Kenny; Hope, Andrew; Baradez, Marc-Olivier; Sinden, John D; Sanberg, Paul R

    2009-05-30

    Cerebral blood flow is impaired during middle cerebral artery occlusion in the rat model of stroke. However, the long term effects on cerebral blood flow following occlusion have received little attention. We examined cerebral blood flow in both sides at multiple time points following middle cerebral artery occlusion of the rat. The bilateral cerebral blood flow in young male Sprague Dawley rats was measured at the time of occlusion, as well as 4, 10 and 16 weeks after occlusion. Under the present experimental conditions, the difference between the left and right side's cerebral blood flow was observed to appear to switch in direction in a visual oscillatory fashion over time in the sham-treated group, whereas the occluded animals consistently showed left side dominance. One group of rats was intraparenchymally transplanted with a human neural stem cell line (CTX0E03 cells) known to have benefit in stroke models. Cerebral blood flow in the lesioned side of the cell-treated group was observed to be improved compared to the untreated rats and to demonstrate a similar oscillatory nature as that observed in sham-treated animals. These findings suggest that multiple bilateral monitoring of cerebral blood flow over time can show effects of stem cell transplantation efficiently as well as functional tests in an animal stroke model.

  18. [Comparative proteome analysis of blood plasma of patients with early-stage chronic cerebral ischemia].

    PubMed

    Kisrieva, Y S; Petushkova, N A; Samenkova, N F; Kuznetsova, G P; Larina, O V; Zavialova, M G; Teryaeva, N B; Belyaev, A Y; Karuzina, I I

    2016-07-01

    In the present study, we explored the technology of liquid chromatography-mass spectrometry (HPLC-MS/MS) for the proteome analysis of blood plasma of patients with early chronic cerebral ischemia. Analysis of mass-spectrometer data carried out in automatic mode using the software Progenesis LS-MS. As a result of this study identified 43 proteins. The differences identified in the study group compared with the control in 7 proteins. It was found that in the early stages of chronic cerebral ischemia proteome changes in blood plasma affect proteins related to the immune system, the system for the maintenance of hemostasis and lipid metabolism.

  19. Regional cerebral blood flow in dialysis encephalopathy and primary degenerative dementia

    SciTech Connect

    Mathew, R.J.; Rabin, P.; Stone, W.J.; Wilson, W.H.

    1985-07-01

    Regional cerebral blood flow (CBF) was measured in patients with dialysis encephalopathy, primary degenerative dementia, dialysis patients with no central nervous system (CNS) complications, and normal controls. Both groups of dialysis patients (with and without CNS complications) demonstrated higher CBF values, and the dementia patients, lower CBF values than the controls. The dialysis patients had lower hematocrit, which correlated inversely with the cerebral blood flow. No such correlations were present in normals and patients with primary degenerative dementia. The dialysis patients and controls obtained similar CBF when the flow values were adjusted for the differences in hematocrit.

  20. Cerebral cortical neurons with activity linked to central neurogenic spontaneous and evoked elevations in cerebral blood flow

    NASA Technical Reports Server (NTRS)

    Golanov, E. V.; Reis, D. J.

    1996-01-01

    We recorded neurons in rat cerebral cortex with activity relating to the neurogenic elevations in regional cerebral blood flow (rCBF) coupled to stereotyped bursts of EEG activity, burst-cerebrovascular wave complexes, appearing spontaneously or evoked by electrical stimulation of rostral ventrolateral medulla (RVL) or fastigial nucleus (FN). Of 333 spontaneously active neurons only 15 (5%), in layers 5-6, consistently (P < 0.05, chi-square) increased their activity during the earliest potential of the complex, approximately 1.3 s before the rise of rCBF, and during the minutes-long elevation of rCBF elicited by 10 s of stimulation of RVL or FN. The results indicate the presence of a small population of neurons in deep cortical laminae whose activity correlates with neurogenic elevations of rCBF. These neurons may function to transduce afferent neuronal signals into vasodilation.

  1. Cerebral cortical neurons with activity linked to central neurogenic spontaneous and evoked elevations in cerebral blood flow

    NASA Technical Reports Server (NTRS)

    Golanov, E. V.; Reis, D. J.

    1996-01-01

    We recorded neurons in rat cerebral cortex with activity relating to the neurogenic elevations in regional cerebral blood flow (rCBF) coupled to stereotyped bursts of EEG activity, burst-cerebrovascular wave complexes, appearing spontaneously or evoked by electrical stimulation of rostral ventrolateral medulla (RVL) or fastigial nucleus (FN). Of 333 spontaneously active neurons only 15 (5%), in layers 5-6, consistently (P < 0.05, chi-square) increased their activity during the earliest potential of the complex, approximately 1.3 s before the rise of rCBF, and during the minutes-long elevation of rCBF elicited by 10 s of stimulation of RVL or FN. The results indicate the presence of a small population of neurons in deep cortical laminae whose activity correlates with neurogenic elevations of rCBF. These neurons may function to transduce afferent neuronal signals into vasodilation.

  2. Cerebral Blood Flow Heterogeneity in Preterm Sheep: Lack of Physiological Support for Vascular Boundary Zones in Fetal Cerebral White Matter

    PubMed Central

    McClure, Melissa; Riddle, Art; Manese, Mario; Luo, Ning Ling; Rorvik, Dawn A.; Kelly, Katherine A.; Barlow, Clyde H.; Kelly, Jeffrey J.; Vinecore, Kevin; Roberts, Colin; Hohimer, A. Roger; Back, Stephen A.

    2011-01-01

    Periventricular white matter (PVWM) injury is the leading cause of chronic neurological disability in survivors of prematurity. To address the role of cerebral ischemia in the pathogenesis of this injury, we tested the hypothesis that immaturity of spatially distal vascular “end” or “border” zones predisposes the PVWM to be more susceptible to falls in cerebral blood flow (CBF) than more proximal regions, such as the cerebral cortex. We used fluorescently-labeled microspheres to quantify regional CBF in situ in the 0.65 gestation fetal sheep in histopathologically-defined 3-dimensional regions by means of post hoc digital dissection and co-registration algorithms. Basal flow in PVWM was significantly lower than gyral white matter and cerebral cortex, but was equivalent in superficial, middle and deep PVWM. Absolute and relative CBF (expressed as percentage of basal) CBF did not differ during ischemia or reperfusion between the PVWM and more superficial gyral white matter or cortex. Moreover, CBF during ischemia and reperfusion was equivalent at three distinct levels of the PVWM. Absolute and relative CBF during ischemia and reperfusion was not predictive of the severity of PVWM injury, as defined by TUNEL staining. However, the magnitude of ischemia to the cerebral cortex directly correlated with lesion severity (r= −0.48, p<.05). Hence, the PVWM did not display unique CBF disturbances that accounted for the distribution of injury. These results suggest that previously-defined cellular-maturational factors have a greater influence on the vulnerability of PVWM to ischemic injury than the presence of immature vascular-boundary zones. PMID:18091757

  3. Cerebral blood flow - Comparison of ground-based and spaceflight data and correlation with space adaptation syndrome

    NASA Technical Reports Server (NTRS)

    Bagian, James P.; Hackett, Peter

    1991-01-01

    The relationship between the cerebral blood flow velocity and the space adaptation syndrome (SAS), which includes symptoms of motion sickness, stuffy head, and/or headaches, was investigated by measuring (using a transcranial Doppler device) differences between the preflight and the inflight cerebral blood flow velocity in crew members who were motion sick and in those who were not sick during a flight aboard KC-135. It was found that the cerebral artery bloodflow inflight did not differ significantly from that recorded preflight, nor did the severity of SAS symptoms correlate directly with the cerebral blood flow.

  4. Sensitivity of neural-hemodynamic coupling to alterations in cerebral blood flow during hypercapnia

    PubMed Central

    Huppert, Theodore J.; Jones, Phill B.; Devor, Anna; Dunn, Andrew K.; Teng, Ivan C.; Dale, Anders M.; Boas, David A.

    2009-01-01

    The relationship between measurements of cerebral blood oxygenation and neuronal activity is highly complex and depends on both neurovascular and neurometabolic biological coupling. While measurements of blood oxygenation changes via optical and MRI techniques have been developed to map functional brain activity, there is evidence that the specific characteristics of these signals are sensitive to the underlying vascular physiology and structure of the brain. Since baseline blood flow and oxygen saturation may vary between sessions and across subjects, functional blood oxygenation changes may be a less reliable indicator of brain activity in comparison to blood flow and metabolic changes. In this work, we use a biomechanical model to examine the relationships between neural, vascular, metabolic, and hemodynamic responses to parametric whisker stimulation under both normal and hypercapnic conditions in a rat model. We find that the relationship between neural activity and oxy- and deoxyhemoglobin changes is sensitive to hypercapnia-induced changes in baseline cerebral blood flow. In contrast, the underlying relationships between evoked neural activity, blood flow, and model-estimated oxygen metabolism changes are unchanged by the hypercapnic challenge. We conclude that evoked changes in blood flow and cerebral oxygen metabolism are more closely associated with underlying evoked neuronal responses. PMID:19725749

  5. Sensitivity of neural-hemodynamic coupling to alterations in cerebral blood flow during hypercapnia

    NASA Astrophysics Data System (ADS)

    Huppert, Theodore J.; Jones, Phill B.; Devor, Anna; Dunn, Andrew K.; Teng, Ivan C.; Dale, Anders M.; Boas, David A.

    2009-07-01

    The relationship between measurements of cerebral blood oxygenation and neuronal activity is highly complex and depends on both neurovascular and neurometabolic biological coupling. While measurements of blood oxygenation changes via optical and MRI techniques have been developed to map functional brain activity, there is evidence that the specific characteristics of these signals are sensitive to the underlying vascular physiology and structure of the brain. Since baseline blood flow and oxygen saturation may vary between sessions and across subjects, functional blood oxygenation changes may be a less reliable indicator of brain activity in comparison to blood flow and metabolic changes. In this work, we use a biomechanical model to examine the relationships between neural, vascular, metabolic, and hemodynamic responses to parametric whisker stimulation under both normal and hypercapnic conditions in a rat model. We find that the relationship between neural activity and oxy- and deoxyhemoglobin changes is sensitive to hypercapnia-induced changes in baseline cerebral blood flow. In contrast, the underlying relationships between evoked neural activity, blood flow, and model-estimated oxygen metabolism changes are unchanged by the hypercapnic challenge. We conclude that evoked changes in blood flow and cerebral oxygen metabolism are more closely associated with underlying evoked neuronal responses.

  6. Abnormal cerebral blood flow patterns in preterm infants with a large patent ductus arteriosus.

    PubMed

    Martin, C G; Snider, A R; Katz, S M; Peabody, J L; Brady, J P

    1982-10-01

    To determine whether there are significant alterations in cerebral blood flow patterns in infants with a patent ductus arteriosus and whether these alterations correlate with alterations in aortic blood flow, we performed range-gated pulsed-Doppler examinations of the aorta and cerebral arteries in 20 infants. Ten infants had a PDA and ten control infants did not. We analyzed these flow patterns quantitatively by calculating the pulsatility index (peak systolic frequency minus trough diastolic frequency)/peak systolic frequency. In the ten control infants and in three infants with a small PDA, there was no significant diastolic flow in the descending aorta; flow in the cerebral arteries was antegrade throughout systole and diastole (PI = 0.75 +/- 0.03 for control infants and 0.73 +/- 0.07 for small PDA infants). In seven infants with a large PDA, there was retrograde diastolic flow in the descending aorta. This pattern was not seen after PDA closure. In the cerebral arteries of the seven infants with a large PDA, diastolic flow was retrograde in three and decreased or absent in four, and PI was significantly higher (PI = 0.96 +/- 0.06. P less than 0.001 vs controls). After PDA closure, cerebral diastolic flow was antegrade in all seven infants (PI = 0.74 +/- 0.04). We conclude that a large PDA can cause abnormal flow patterns in the descending aorta and cerebral arteries. These flow patterns may predispose these infants to CNS ischemia or intraventricular hemorrhage.

  7. Cerebral blood flow decreases with time whereas cerebral oxygen consumption remains stable during hypothermic cardiopulmonary bypass in humans

    SciTech Connect

    Prough, D.S.; Rogers, A.T.; Stump, D.A.; Roy, R.C.; Cordell, A.R.; Phipps, J.; Taylor, C.L. )

    1991-02-01

    Recent investigations demonstrate that cerebral blood flow (CBF) progressively declines during hypothermic, nonpulsatile cardiopulmonary bypass (CPB). If CBF declines because of brain cooling, the cerebral metabolic rate for oxygen (CMRO2) should decline in parallel with the reduction in CBF. Therefore we studied the response of CBF, the cerebral arteriovenous oxygen content difference (A-VDcereO2) and CMRO2 as a function of the duration of CPB in humans. To do this, we compared the cerebrovascular response to changes in the PaCO2. Because sequential CBF measurements using xenon 133 (133Xe) clearance must be separated by 15-25 min, we hypothesized that a time-dependent decline in CBF would accentuate the CBF reduction caused by a decrease in PaCO2, but would blunt the CBF increase associated with a rise in PaCO2. We measured CBF in 25 patients and calculated the cerebral arteriovenous oxygen content difference using radial arterial and jugular venous bulb blood samples. Patients were randomly assigned to management within either a lower (32-48 mm Hg) or higher (50-71 mm Hg) range of PaCO2 uncorrected for temperature. Each patient underwent two randomly ordered sets of measurements, one at a lower PaCO2 and the other at a higher PaCO2 within the respective ranges. Cerebrovascular responsiveness to changes in PaCO2 was calculated as specific reactivity (SR), the change in CBF divided by the change in PaCO2, expressed in mL.100 g-1.min-1.mm Hg-1.

  8. Production of 20-HETE and its role in autoregulation of cerebral blood flow.

    PubMed

    Gebremedhin, D; Lange, A R; Lowry, T F; Taheri, M R; Birks, E K; Hudetz, A G; Narayanan, J; Falck, J R; Okamoto, H; Roman, R J; Nithipatikom, K; Campbell, W B; Harder, D R

    2000-07-07

    In the brain, pressure-induced myogenic constriction of cerebral arteriolar muscle contributes to autoregulation of cerebral blood flow (CBF). This study examined the role of 20-HETE in autoregulation of CBF in anesthetized rats. The expression of P-450 4A protein and mRNA was localized in isolated cerebral arteriolar muscle of rat by immunocytochemistry and in situ hybridization. The results of reverse transcriptase-polymerase chain reaction studies revealed that rat cerebral microvessels express cytochrome P-450 4A1, 4A2, 4A3, and 4A8 isoforms, some of which catalyze the formation of 20-HETE from arachidonic acid. Cerebral arterial microsomes incubated with [(14)C]arachidonic acid produced 20-HETE. An elevation in transmural pressure from 20 to 140 mm Hg increased 20-HETE concentration by 6-fold in cerebral arteries as measured by gas chromatography/mass spectrometry. In vivo, inhibition of vascular 20-HETE formation with N-methylsulfonyl-12, 12-dibromododec-11-enamide (DDMS), or its vasoconstrictor actions using 15-HETE or 20-hydroxyeicosa-6(Z),15(Z)-dienoic acid (20-HEDE), attenuated autoregulation of CBF to elevations of arterial pressure. In vitro application of DDMS, 15-HETE, or 20-HEDE eliminated pressure-induced constriction of rat middle cerebral arteries, and 20-HEDE and 15-HETE blocked the vasoconstriction action of 20-HETE. Taken together, these data suggest an important role for 20-HETE in the autoregulation of CBF.

  9. 807C/T polymorphism of platelet glycoprotein Ia gene is associated with cerebral hemorrhage in a Chinese population.

    PubMed

    Zeng, Yi; Zhang, Le; Hu, Zhiping; Yang, Qidong; Ma, Mingming; Liu, Baoqiong; Xia, Jian; Xu, Hongwei; Liu, Yunhai; Du, Xiaoping

    2016-08-01

    Platelet glycoprotein (GP) mediated the role of platelet in coagulation. Platelet GP Ia 807C/T is the only GP polymorphism associated with the expression levels of GP Ia/IIa (the platelet collagen receptor). Recently, the GP Ia 807C/T polymorphism has been reported to have no association with cerebral hemorrhage (CH) in two studies pertained to Caucasian populations. The purpose of this study is to evaluate the association between platelet GP Ia 807C/T polymorphism and CH in a Han Chinese population. We performed genotype analysis for platelet GP Ia 807C/T polymorphism in a case-control study involving 195 patients with CH and 116 age- and sex-matched controls. In contrast to previous reports, we found that the frequencies of GP Ia 807C/T T allele, CT and TT genotype were much higher in CH patients than in controls (33.9% vs. 22.8%, p = 0.004; 45.5% and 11.1% vs. 40.4% and 2.6%, p = 0.022). Logistic regression analysis revealed that the presence of GP Ia 807C/T C allele and CC genotype were both associated with a decreased risk of CH compared with T allele, CT and TT genotypes, respectively (adjusted odds ratio [OR] = 0.565, 95% CI: 0.384-0.887, p = 0.005; adjusted OR = 0.172, 95% CI: 0.043-0.639, p = 0.009; adjusted OR = 0.254, 95% CI: 0.085-0.961, p = 0.041, respectively). These findings indicated that platelet GP Ia 807C/T polymorphism could be a protective factor of CH in the Chinese population.

  10. Early whole-brain CT perfusion for detection of patients at risk for delayed cerebral ischemia after subarachnoid hemorrhage.

    PubMed

    Malinova, Vesna; Dolatowski, Karoline; Schramm, Peter; Moerer, Onnen; Rohde, Veit; Mielke, Dorothee

    2016-07-01

    OBJECT This prospective study investigated the role of whole-brain CT perfusion (CTP) studies in the identification of patients at risk for delayed ischemic neurological deficits (DIND) and of tissue at risk for delayed cerebral infarction (DCI). METHODS Forty-three patients with aneurysmal subarachnoid hemorrhage (aSAH) were included in this study. A CTP study was routinely performed in the early phase (Day 3). The CTP study was repeated in cases of transcranial Doppler sonography (TCD)-measured blood flow velocity (BFV) increase of > 50 cm/sec within 24 hours and/or on Day 7 in patients who were intubated/sedated. RESULTS Early CTP studies revealed perfusion deficits in 14 patients, of whom 10 patients (72%) developed DIND, and 6 of these 10 patients (60%) had DCI. Three of the 14 patients (21%) with early perfusion deficits developed DCI without having had DIND, and the remaining patient (7%) had neither DIND nor DCI. There was a statistically significant correlation between early perfusion deficits and occurrence of DIND and DCI (p < 0.0001). A repeated CTP was performed in 8 patients with a TCD-measured BFV increase > 50 cm/sec within 24 hours, revealing a perfusion deficit in 3 of them (38%). Two of the 3 patients (67%) developed DCI without preceding DIND and 1 patient (33%) had DIND without DCI. In 4 of the 7 patients (57%) who were sedated and/or comatose, additional CTP studies on Day 7 showed perfusion deficits. All 4 patients developed DCI. CONCLUSIONS Whole-brain CTP on Day 3 after aSAH allows early and reliable identification of patients at risk for DIND and tissue at risk for DCI. Additional CTP investigations, guided by TCD-measured BFV increase or persisting coma, do not contribute to information gain.

  11. Quantifying regional cerebral blood flow by N-isopropyl-P-[I-123]iodoamphetamine (IMP) using a ring type single-photon emission computed tomography system

    SciTech Connect

    Takahashi, N.; Odano, I.; Ohkubo, M.

    1994-05-01

    We developed a more accurate quantitative measurement of regional cerebral blood flow (rCBF) with the microsphere model using N-isopropyl-p-[I-123] iodoamphetamine (IMP) and a ring type single photon emission computed tomography (SPECT) system. SPECT studies were performed in 17 patients with brain diseases. A dose of 222 MBq (6 mCi) of [I-123]IMP was injected i.v., at the same time a 5 min period of arterial blood withdrawal was begun. SPECT data were acquired from 25 min to 60 min after tracer injection. For obtaining the brain activity concentration at 5 min after IMP injection, total brain counts collections and one minute period short time SPECT studies were performed at 5, 20, and 60 min. Measurement of the values of rCBF was calculated using short time SPECT images at 5 min (rCBF), static SPECT images corrected with total cerebral counts (rCBF{sub Ct}.) and those corrected with reconstructed counts on short time SPECT images (rCBF{sub Cb}). There was a good relationship (r=0.69) between rCBF and rCBF{sub Ct}, however, rCBF{sub Ct} tends to be underestimated in high flow areas and overestimated in low flow areas. There was better relationship between rCBF and rCBF{sub Cb}(r=0.92). The overestimation and underestimation shown in rCBF{sub Ct} was considered to be due to the correction of reconstructed counts using a total cerebral time activity curve, because of the kinetic behavior of [I-123]IMP was different in each region. We concluded that more accurate rCBF values could be obtained using the regional time activity curves.

  12. Cerebral Blood Flow Estimation Using Classification Techniques On A Sequence Of Low Resolution Tomographic Evolutive Images

    NASA Astrophysics Data System (ADS)

    Chan, Marie; Aguilar-Martin, Joseph; Boulanouar, Kader; Celsis, Pierre; Marc-Vergnes, Jean P.

    1989-05-01

    In order to improve the performance of the instrumental variable method (IVM) in calculating regional cerebral blood flow (rCBF) using Single Photon Emission Computed Tomography (SPELT), and inert diffusible tracer such as 133Xe, we use Learning Algorithms for Multivariate Data Analysis (LAMDA) to classify the voxels of the images of local concentrations in the brain. The LAMDA method correctly distinguished between extra and intra-cerebral voxels. However the topography of the intra-cerebral classes did not match the Regions Of Interest (ROI) defined on an anatomical basis. Provided that all the intra-cerebral classes contaminated by bone and air passage artefact were rejected, the results given by the NM are in good agreement with those derived by the bolus distribution principle. We thus conclude that LAMDA methods can improve the reliability of images of CBF estimates.

  13. Measurement of cerebral blood flow using phase contrast magnetic resonance imaging and duplex ultrasonography.

    PubMed

    Khan, Muhammad Ayaz; Liu, Jie; Tarumi, Takashi; Lawley, Justin Stevan; Liu, Peiying; Zhu, David C; Lu, Hanzhang; Zhang, Rong

    2017-02-01

    Phase contrast magnetic resonance imaging (PC-MRI) and color-coded duplex ultrasonography (CDUS) are commonly used for measuring cerebral blood flow in the internal carotid (ICA) and vertebral arteries. However, agreement between the two methods has been controversial. Recent development of high spatial and temporal resolution blood vessel wall edge-detection and wall-tracking methods with CDUS increased the accuracy and reliability of blood vessel diameter, hence cerebral blood flow measurement. The aim of this study was to compare the improved CDUS method with 3 T PC-MRI for cerebral blood flow measurements. We found that cerebral blood flow velocity measured in the ICA was lower using PC-MRI than CDUS (left ICA: PC-MRI, 18.0 ± 4.2 vs. CDUS, 25.6 ± 8.6 cm/s; right ICA: PC-MRI, 18.5 ± 4.8 vs. CDUS, 26.6 ± 6.7 cm/s, both p < 0.01). However, ICA diameters measured using PC-MRI were larger (left ICA: PC-MRI, 4.7 ± 0.50 vs. CDUS, 4.1 ± 0.46 mm; right ICA: PC-MRI, 4.5 ± 0.49 vs. CDUS, 4.0 ± 0.45 mm, both p < 0.01). Cerebral blood flow velocity measured in the left vertebral artery with PC-MRI was also lower than CDUS, but no differences in vertebral artery diameter were observed between the methods. Dynamic changes and/or intrinsic physiological fluctuations may have caused these differences in vessel diameter and velocity measurements between the methods. However, estimation of volumetric cerebral blood flow was similar and correlated between the methods despite the presence of large individual differences. These findings support the use of CDUS for cerebral blood flow measurements in the ICA and vertebral artery.

  14. Perfusion-diffusion compartmental models describe cerebral helium kinetics at high and low cerebral blood flows in sheep.

    PubMed

    Doolette, David J; Upton, Richard N; Grant, Cliff

    2005-03-01

    This study evaluated the relative importance of perfusion and diffusion mechanisms in compartmental models of blood:tissue helium exchange in the brain. Helium has different physiochemical properties from previously studied gases, and is a common diluent gas in underwater diving where decompression schedules are based on theoretical models of inert gas kinetics. Helium kinetics across the cerebrum were determined during and after 15 min of helium inhalation, at separate low and high steady states of cerebral blood flow in seven sheep under isoflurane anaesthesia. Helium concentrations in arterial and sagittal sinus venous blood were determined using gas chromatographic analysis, and sagittal sinus blood flow was monitored continuously. Parameters and model selection criteria of various perfusion-limited or perfusion-diffusion compartmental models of the brain were estimated by simultaneous fitting of the models to the sagittal sinus helium concentrations for both blood flow states. Purely perfusion-limited models fitted the data poorly. Models that allowed a diffusion-limited exchange of helium between a perfusion-limited tissue compartment and an unperfused deep compartment provided better overall fit of the data and credible parameter estimates. Fit to the data was also improved by allowing countercurrent diffusion shunt of helium between arterial and venous blood. These results suggest a role of diffusion in blood:tissue helium equilibration in brain.

  15. Perfusion–diffusion compartmental models describe cerebral helium kinetics at high and low cerebral blood flows in sheep

    PubMed Central

    Doolette, David J; Upton, Richard N; Grant, Cliff

    2005-01-01

    This study evaluated the relative importance of perfusion and diffusion mechanisms in compartmental models of blood:tissue helium exchange in the brain. Helium has different physiochemical properties from previously studied gases, and is a common diluent gas in underwater diving where decompression schedules are based on theoretical models of inert gas kinetics. Helium kinetics across the cerebrum were determined during and after 15 min of helium inhalation, at separate low and high steady states of cerebral blood flow in seven sheep under isoflurane anaesthesia. Helium concentrations in arterial and sagittal sinus venous blood were determined using gas chromatographic analysis, and sagittal sinus blood flow was monitored continuously. Parameters and model selection criteria of various perfusion-limited or perfusion–diffusion compartmental models of the brain were estimated by simultaneous fitting of the models to the sagittal sinus helium concentrations for both blood flow states. Purely perfusion-limited models fitted the data poorly. Models that allowed a diffusion-limited exchange of helium between a perfusion-limited tissue compartment and an unperfused deep compartment provided better overall fit of the data and credible parameter estimates. Fit to the data was also improved by allowing countercurrent diffusion shunt of helium between arterial and venous blood. These results suggest a role of diffusion in blood:tissue helium equilibration in brain. PMID:15649976

  16. Regional cerebral blood flow response in gray matter heterotopia during finger tapping: an activation study with positron emission tomography.

    PubMed

    Hatazawa, J; Sasajima, T; Shimosegawa, E; Fujita, H; Okudera, T; Kanno, I; Mineura, K; Uemura, K

    1996-03-01

    We examined regional cerebral blood flow response in a patient with gray matter heterotopia located beneath the sensorimotor cortex during a finger tapping task. We found regional cerebral blood flow was specifically increased during contralateral finger tapping. This indicated the possibility of functional differentiation of the ectopic neurons despite incomplete migration.

  17. Regional cerebral blood flow measurement with intravenous ( sup 15 O)water bolus and ( sup 18 F)fluoromethane inhalation

    SciTech Connect

    Herholz, K.; Pietrzyk, U.; Wienhard, K.; Hebold, I.; Pawlik, G.; Wagner, R.; Holthoff, V.; Klinkhammer, P.; Heiss, W.D. )

    1989-09-01

    In 20 patients with ischemic cerebrovascular disease, classic migraine, or angiomas, we compared paired dynamic positron emission tomographic measurements of regional cerebral blood flow using both ({sup 15}O)water and ({sup 18}F)fluoromethane as tracers. Cerebral blood flow was also determined according to the autoradiographic technique with a bolus injection of ({sup 15}O)water. There were reasonable overall correlations between dynamic ({sup 15}O)water and ({sup 18}F)fluoromethane values for cerebral blood flow (r = 0.82) and between dynamic and autoradiographic ({sup 15}O)water values for cerebral blood flow (r = 0.83). We found a close correspondence between abnormal pathologic findings and visually evaluated cerebral blood flow tomograms obtained with the two tracers. On average, dynamic ({sup 15}O)water cerebral blood flow was 6% lower than that measured with ({sup 18}F)fluoromethane. There also was a general trend toward a greater underestimation with ({sup 15}O)water in high-flow areas, particularly in hyperemic areas, probably due to incomplete first-pass extraction of ({sup 15}O)water. Underestimation was not detected in low-flow areas or in the cerebellum. Absolute cerebral blood flow values were less closely correlated between tracers and techniques than cerebral blood flow patterns. The variability of the relation between absolute flow values was probably caused by confounding effects of the variation in the circulatory delay time. The autoradiographic technique was most sensitive to this type error.

  18. The interaction of carbon dioxide and hypoxia in the control of cerebral blood flow.

    PubMed

    Mardimae, Alexandra; Balaban, Dahlia Y; Machina, Matthew A; Battisti-Charbonney, Anne; Han, Jay S; Katznelson, Rita; Minkovich, Leonid L; Fedorko, Ludwik; Murphy, Patricia M; Wasowicz, Marcin; Naughton, Finola; Meineri, Massimiliano; Fisher, Joseph A; Duffin, James

    2012-10-01

    Both hypoxia and carbon dioxide increase cerebral blood flow (CBF), and their effective interaction is currently thought to be additive. Our objective was to test this hypothesis. Eight healthy subjects breathed a series of progressively hypoxic gases at three levels of carbon dioxide. Middle cerebral artery velocity, as an index of CBF; partial pressures of carbon dioxide and oxygen and concentration of oxygen in arterial blood; and mean arterial blood pressure were monitored. The product of middle cerebral artery velocity and arterial concentration of oxygen was used as an index of cerebral oxygen delivery. Two-way repeated measures analyses of variance (rmANOVA) found a significant interaction of carbon dioxide and hypoxia factors for both CBF and cerebral oxygen delivery. Regression models using sigmoidal dependence on carbon dioxide and a rectangular hyperbolic dependence on hypoxia were fitted to the data to illustrate this interaction. We concluded that carbon dioxide and hypoxia act synergistically in their control of CBF so that the delivery of oxygen to the brain is enhanced during hypoxic hypercapnia and, although reduced during normoxic hypocapnia, can be restored to normal levels with progressive hypoxia.

  19. Brainstem control of cerebral blood flow and application to acute vasospasm following experimental subarachnoid hemorrhage.

    PubMed

    Cetas, J S; Lee, D R; Alkayed, N J; Wang, R; Iliff, J J; Heinricher, M M

    2009-10-06

    Symptomatic ischemia following aneurysmal subarachnoid hemorrhage (SAH) is common but poorly understood and inadequately treated. Severe constriction of the major arteries at the base of the brain, termed vasospasm, traditionally has been thought to be a proximal event underlying these ischemias, although microvascular changes also have been described. The vast majority of studies aimed at understanding the pathogenesis of ischemic deficits, and vasospasm have focused on the interaction of the "spasmogen" of the extravasated blood with the smooth muscle and endothelium of the arteries. This has led to a comparative neglect of the contribution of the CNS to the maintenance of cerebral perfusion. In the present study, we focused on the role of the rostral ventromedial medulla (RVM) in modulating cerebral perfusion at rest and following an experimental SAH in the rat. Changes in cerebral blood flow (CBF) were measured using laser-Doppler flowmetry and three-dimensional optical microangiography. Focal application of a GABA(A) receptor agonist and antagonist was used to respectively inactivate and activate the RVM. We show here that the RVM modulates cerebral blood flow under resting conditions, and further, contributes to restoration of cerebral perfusion following a high-grade SAH. Failure of this brainstem compensatory mechanism could be significant for acute perfusion deficits seen in patients following subarachnoid hemorrhage.

  20. The effects of oxiracetam (CT-848) on local cerebral glucose utilization after focal cerebral ischemia in rats.

    PubMed

    Hokonohara, T; Sako, K; Shinoda, Y; Tomabechi, M; Yonemasu, Y

    1992-02-01

    The effects of oxiracetam on the reduction of brain metabolism induced by focal cerebral ischemia were investigated by measuring local cerebral glucose utilization (LCGU) in rats 24 hr after left middle cerebral artery occlusion. Focal cerebral ischemia reduced LCGU in the entire ipsilateral cortex, the greatest reduction being in the lateral parts of the frontoparietal cortex. LCGU was slightly reduced in the contralateral cortex; this reduction was considered to be caused by diaschisis. Oxiracetam was administered intraperitoneally for 3 days prior to middle cerebral artery occlusion. In the ipsilateral cortex, LCGU reduction was minimized in the ischemic center areas by oxiracetam at a dose of 400 mg/kg and in more extensive areas, by a dose of 800 mg/kg. Moreover, oxiracetam at a dose of 800 mg/kg enhanced metabolism impaired by diaschisis in the caudal areas of the contralateral cortex. These findings suggest that oxiracetam minimizes the reduction of brain function induced by ischemia and may therefore be useful in the treatment of cerebrovascular disease.

  1. Assessment of Cerebral Blood Flow with Micro-Doppler Vascular Reduces the Risk of Ischemic Stroke During the Clipping of Intracranial Aneurysms.

    PubMed

    Pereira, Benedito J A; Holanda, Vanessa M; Giudicissi-Filho, Miguel; Borba, Luiz Alencar B; de Holanda, Carlos Vanderlei M; de Oliveira, Jean G

    2015-12-01

    To analyze the impact of the introduction of Micro-Doppler vascular (MDV) as a method of cerebral blood flow analysis during microsurgical clipping of intracranial aneurysms to check the partial occlusion of the aneurysm and the occurrence of stenosis by comparing these results with those provided by the postoperative digital subtraction angiography (DSA) scan as well as the occurrence of ischemic infarction on the postoperative computed tomography (CT) images. We reviewed retrospectively the last 50 patients operated on before the introduction of the MDV (group 1) compared with the first 50 patients operated on using this technique (group 2). Nine (18%) of the 50 patients evaluated in the group 1 showed a new hypodensity in the postoperative CT images, whereas only 2 (4%) patients showed infarction in the group 2 (P = 0.02). In addition, in the group 1, 10 (20%) patients presented unexpected findings on DSA images (residual aneurysms, stenosis, and arterial occlusion), whereas in the group 2, those unexpected DSA findings were observed in only 3 (6%) patients (P = 0.023). MDV is an excellent method for cerebral blood flow assessment during the microsurgical clipping of intracranial aneurysms, reducing the unexpected angiographic results (residual aneurysms, stenosis, and arterial occlusion), as well as reducing the incidence of ischemic infarction on postoperative CT images, evidence of the positive impact of this method in the microsurgical treatment of intracranial aneurysms. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Intensive blood pressure lowering increases cerebral blood flow in older subjects with hypertension.

    PubMed

    Tryambake, Dinesh; He, Jiabao; Firbank, Michael J; O'Brien, John T; Blamire, Andrew M; Ford, Gary A

    2013-06-01

    Hypertension is associated with reduced cerebral blood flow (CBF). Intensive (<130/80 mm Hg) blood pressure (BP) lowering in older people might give greater reduction in cardiovascular risk, but there are concerns that this might produce hypoperfusion which may precipitate falls and possibly stroke. We determined the effect of intensive compared with usual BP lowering on CBF in hypertensive older subjects. Individuals aged >70 years with a history of systolic hypertension on 1 or no BP lowering drugs were recruited from primary care (n=37; age, 75±4 years; systolic BP, >150 mm Hg) and randomized to receive intensive (target BP, <130/80 mm Hg) or usual (target BP, <140/85 mm Hg) BP lowering for 12 weeks, with reviews every 2 weeks. CBF, determined using 3T arterial spin labeling MRI, and 24-hour ambulatory BP were performed at baseline and after 12 weeks of treatment. Baseline BP (ambulatory or in clinic) and baseline gray matter CBF were not significantly different between the groups. After treatment, BP was reduced significantly in both groups but fell more in the intensive group (26/17 versus 15/5 mm Hg; P<0.01). Over the same period, gray matter CBF increased significantly in the intensive group (7±11 mL/min per 100 g; P=0.013) but was unchanged in the usual BP target group (-3±9 mL/min per 100 g; P=0.23); P<0.01 for comparison. Intensive BP lowering in older people with hypertension increases CBF, compared with BP lowering to usual target. These findings suggest hypertension in older people shifts the autoregulatory CBF curve rightward and downward and is reversible with BP lowering.

  3. Prolonged disturbances of regional cerebral blood flow in transient ischemic attacks

    SciTech Connect

    Hartmann, A.

    1985-11-01

    Regional cerebral blood flow (rCBF) was measured over both hemispheres in 20 patients with unilateral transient ischemic attacks (TIA) of the territory of the internal carotid artery on the day of the TIA. rCBF was estimated with the nontraumatic Xenon 133-inhalation technique using the initial slope index. 13 patients experienced their first TIA, 7 had several attacks. In 14 patients the first rCBF-measurement was performed during the presentation of clinical symptoms. The 2nd rCBF-measurement was done on day 2, the last one on day 7. Scans of the 15 patients studied with CT were normal. On day 1 mean rCBF of the TIA-side was significantly lower than that of the contralateral hemispheres. 22% of all areas showed a significant reduction of flow compared to mean rCBF. Mean rCBF of both the TIA- and the contralateral side was significantly reduced compared to the bi-hemispheric mean rCBF of a control group with no history of TIA or completed strokes but at least 2 risk factors for cerebrovascular disease. Whereas mean rCBF did not change in the contralateral side it increased significantly (+6.9%) in the TIA-side from day 1 to day 2 but not from there to day 7. This is reflected by the increase of the total number of ROI with normal flow from day 1 to day 2. Considering the actual flow and the flow course of that tissue which was believed to be responsible for the clinical symptoms the following regional patterns were observed: normal rCBF in 6 patients; early return to normal concomitant to the clinical course (n = 4).

  4. Evaluation of cerebral blood flow in acute ischemic stroke patients with atrial fibrillation: A sonographic study.

    PubMed

    Su, Yu-Chin; Lim, Siew-Na; Yang, Fu-Yi; Lin, Shinn-Kuang

    2017-04-01

    Although cerebral emboli are a frequent cause of cardiogenic stroke, the possibility of a reduction in cerebral perfusion consequent to arrhythmia or impaired cardiac function should be considered in patients with atrial fibrillation (AF). We reviewed sonographic studies and clinical features of patients with acute ischemic stroke. A total of 144 patients with AF and 144 age- and sex-matched patients with small vessel occlusion but without AF were included. Patients with AF had significantly lower peak systolic velocity (PSV), mean velocity, flow volume (p < 0.001), and end-diastolic velocity (p = 0.035) of the internal carotid artery (ICA); significantly lower cerebral blood flow (p < 0.001); and lower flow velocities of the middle cerebral artery (p < 0.01) than patients with small vessel occlusion but without AF. In patients with AF, there was an inverse linear correlation between ICA end-diastolic velocity, mean velocity (p < 0.001), flow volume (p = 0.025), middle cerebral artery flow velocities (p < 0.05), and age. Cardiac ejection fraction had a positive linear correlation with ICA PSV (p = 0.016) but an inverse correlation with the heart rate (p = 0.009). There was a significant decline in PSV (p = 0.002), resistance index (p < 0.001), and flow volume (p = 0.0121) of the ICA as well as cerebral blood flow (p = 0.009) as the heart rate increased. Cerebral blood flow is markedly reduced in ischemic stroke patients with AF as compared with that in patients with small vessel disease but without AF. Copyright © 2016. Published by Elsevier B.V.

  5. Effect of pregnancy on autoregulation of cerebral blood flow in anterior versus posterior cerebrum.

    PubMed

    Cipolla, Marilyn J; Bishop, Nicole; Chan, Siu-Lung

    2012-09-01

    Severe preeclampsia and eclampsia are associated with brain edema that forms preferentially in the posterior cerebral cortex possibly because of decreased sympathetic innervation of posterior cerebral arteries and less effective autoregulation during acute hypertension. In the present study, we examined the effect of pregnancy on the effectiveness of cerebral blood flow autoregulation using laser Doppler flowmetry and edema formation by wet:dry weight in acute hypertension induced by phenylephrine infusion in the anterior and posterior cerebrum from nonpregnant (n=8) and late-pregnant (n=6) Sprague-Dawley rats. In addition, we compared the effect of pregnancy on sympathetic innervation by tyrosine hydroxylase staining of posterior and middle cerebral arteries (n=5-6 per group) and endothelial and neuronal NO synthase expression using quantitative PCR (n=3 per group). In nonpregnant animals, there was no difference in autoregulation between the anterior and posterior cerebrum. However, in late-pregnant animals, the threshold of cerebral blood flow autoregulation was shifted to lower pressures in the posterior cerebrum, which was associated with increased neuronal NO synthase expression in the posterior cerebral cortex versus anterior. Compared with the nonpregnant state, pregnancy increased the threshold of autoregulation in both brain regions that was related to decreased expression of endothelial NO synthase. Lastly, acute hypertension during pregnancy caused greater edema formation in both brain cortices that was not attributed to changes in sympathetic innervation. These findings suggest that, although pregnancy shifted the cerebral blood flow autoregulatory curve to higher pressures in both the anterior and posterior cortices, it did not protect from edema during acute hypertension.

  6. EFFECT OF PREGNANCY ON AUTOREGULATION OF CEREBRAL BLOOD FLOW IN ANTERIOR VERSUS POSTERIOR CEREBRUM

    PubMed Central

    Cipolla, Marilyn J.; Bishop, Nicole; Chan, Siu-Lung

    2012-01-01

    Severe pre/eclampsia are associated with brain edema that forms preferentially in the posterior cerebral cortex possibly due to decreased sympathetic innervation of posterior cerebral arteries and less effective autoregulation during acute hypertension. In the present study, we examined the effect of pregnancy on the effectiveness of cerebral blood flow autoregulation using laser Doppler flowmetry and edema formation by wet:dry weight in acute hypertension induced by phenylephrine infusion in the anterior and posterior cerebrum from nonpregnant (n=8) and late-pregnant (n=6) Sprague Dawley rats. In addition, we compared the effect of pregnancy on sympathetic innervation by tyrosine hydroxylase staining of posterior and middle cerebral arteries (n=5–6/group) and endothelial and neuronal nitric oxide synthase expression using quantitative polymerase chain reaction (n=3/group). In nonpregnant animals, there was no difference in autoregulation between anterior and posterior cerebrum. However, in late-pregnant animals, the threshold of cerebral blood flow autoregulation was shifted to lower pressures in the posterior cerebrum, which was associated with increased neuronal nitric oxide synthase expression in the posterior cerebral cortex vs. anterior. Compared to the nonpregnant state, pregnancy increased the threshold of autoregulation in both brain regions that was related to decreased expression of endothelial nitric oxide synthase. Lastly, acute hypertension during pregnancy caused greater edema formation in both brain cortices that was not due to changes in sympathetic innervation. These findings suggest that although pregnancy shifted the cerebral blood flow autoregulatory curve to higher pressures in both the anterior and posterior cortices, it did not protect from edema during acute hypertension. PMID:22824983

  7. Interaction of red blood cells adjacent to and within a thrombus in experimental cerebral ischaemia.

    PubMed

    van der Spuy, Wendy J; Pretorius, Etheresia

    2013-01-01

    Cerebral ischaemia is associated with altered platelet and fibrin network ultrastructure indicating increased coagulation activity and resistance to fibrinolysis; which may lead to the occlusion of blood vessels. Recently, it has been shown that the addition of red blood cells to plasma has a significant effect on the structural and mechanical properties of fibrin clots and is associated with lytic resistance of thrombi. Whole blood was collected from pre-ischaemic control Sprague Dawley rats and those in which experimental cerebral ischaemia was induced by hyperglycaemic two-vessel occlusion, for the ultrastructural investigation of whole blood thrombi by scanning electron microscopy. Post-ischaemic groups were terminated at 2h, 24h and 48h subsequent to reperfusion; which were time points selected for the demonstration of initial inflammation upon neural injury, maximal neural injury and onset of regeneration. Subsequent to ischaemic insult, red blood cells transformed from normal discoid shape to form projections which allowed them to interact both with each other and with fibrin fibres in various manners. Researches have in recent years shown that inclusion of red blood cells in experimental coagula results in delayed fibrinolysis and lytic resistance. This paper shows the morphological alterations at cellular level which may elucidate the structural and mechanical strength of these clots. Through the extension of projections, red blood cells become intertwined within a thrombus to stabilise and strengthen its structure. The tighter these mechanical bonds, the more resistant thrombi are to lysis, an established characteristic of thrombi in cerebral ischaemia. © 2013.

  8. Noninvasive cerebral blood oxygenation monitoring: clinical test of multiwavelength optoacoustic system

    NASA Astrophysics Data System (ADS)

    Petrov, Y. Y.; Prough, D. S.; Petrova, I.; Patrikeev, I. A.; Cicenaite, I.; Esenaliev, R. O.

    2007-02-01

    Continuous monitoring of cerebral blood oxygenation is critically important for treatment of patients with life-threatening conditions like severe brain injury or during cardiac surgery. We designed and built a novel multiwavelength optoacoustic system for noninvasive, continuous, and accurate monitoring of cerebral blood oxygenation. We use an Optical Parametric Oscillator as a light source. We successfully tested the system in vitro as well as in vivo in large animals (sheep) through thick tissues overlying blood vessels which drain venous blood out of the brain (e.g., superior sagittal sinus or jugular vein). Here we present the results of clinical tests of the system for continuous noninvasive cerebral blood oxygenation monitoring in the internal jugular vein of healthy volunteers. We applied our custom-built optoacoustic probe (which incorporated a wide-band acoustic transducer and an optical fiber) to the neck area overlying the internal jugular vein. We performed measurements with volunteers at 18 wavelengths in the near-infrared spectral range. Despite a thick layer of overlying connective tissue and low energy used in the experiments, we recorded signals with high signal-to-noise ratios for all volunteers. We found that the temporal (independent of signal amplitude) parameters of recorded profiles for different levels of blood oxygenation correlated well with the spectrum of effective attenuation coefficients of blood.

  9. Preliminary Investigation of Cerebral Blood Flow and Amyloid Burden in Veterans With and Without Combat-Related Traumatic Brain Injury.

    PubMed

    Ponto, Laura L Boles; Brashers-Krug, Thomas M; Pierson, Ronald K; Menda, Yusuf; Acion, Laura; Watkins, G Leonard; Sunderland, John J; Koeppel, Julie A; Jorge, Ricardo E

    2016-01-01

    This study aimed to examine global and regional cerebral blood flow and amyloid burden in combat veterans with and without traumatic brain injury (TBI). Cerebral blood flow (in milliliters per minute per 100 mL) was measured by quantitative [(15)O]water, and amyloid burden was measured by [(11)C]PIB imaging. Mean global cerebral blood flow was significantly lower in veterans with TBI compared with non-TBI veterans. There were essentially no differences between groups for globally normalized regional cerebral blood flow. Amyloid burden did not differ between TBI and non-TBI veterans. Veterans who have suffered a TBI have significantly lower cerebral blood flow than non-TBI controls but did not manifest increased levels of amyloid, globally or regionally.

  10. Optical measurement of mouse strain differences in cerebral blood flow using indocyanine green

    PubMed Central

    Kang, Hye-Min; Sohn, Inkyung; Kim, Seunggyu; Kim, Daehwan; Jung, Junyang; Jeong, Joo-Won; Park, Chan

    2015-01-01

    C57BL/6 mice have more cerebral arterial branches and collaterals than BALB/c mice. We measured and compared blood flow dynamics of the middle cerebral artery (MCA) in these two strains, using noninvasive optical imaging with indocyanine green (ICG). Relative maximum fluorescence intensity (Imax) and the time needed for ICG to reach Imax in the MCA of C57BL/c were lower than that in BALB/c mice. Moreover, the mean transit time was significantly lower in C57BL/6 than in BALB/c mice. These data suggest that the higher number of arterial branches and collaterals in C57BL/6 mice yields a lower blood flow per cerebral artery. PMID:25833343

  11. Impaired cerebral vascular blood flow in the premature infant.

    PubMed

    Bell, P L; Ellerbee, S

    1993-06-01

    Approximately 40% to 60% of infants born prior to 32 weeks' gestation experience an IVH. The impact of unregulated CBF precipitating an IVH has ramifications far beyond the walls of the neonatal intensive care unit. Infants who survive alterations in CBF may experience impaired neurologic development. Cerebral ischemia can lead to poor articulation, dysphasia, attention deficit, low intelligence quotient, dyspraxia, dyssynergia, spasticity, and short-term memory dysfunction. The neurologic and intellectual development of these premature infants must continue to be a crucial factor in planning their nursing care.

  12. Inconsistent detection of changes in cerebral blood volume by near infrared spectroscopy in standard clinical tests.

    PubMed

    Canova, D; Roatta, S; Bosone, D; Micieli, G

    2011-06-01

    The attractive possibility of near infrared spectroscopy (NIRS) to noninvasively assess cerebral blood volume and oxygenation is challenged by the possible interference from extracranial tissues. However, to what extent this may affect cerebral NIRS monitoring during standard clinical tests is ignored. To address this issue, 29 healthy subjects underwent a randomized sequence of three maneuvers that differently affect intra- and extracranial circulation: Valsalva maneuver (VM), hyperventilation (HV), and head-up tilt (HUT). Putative intracranial ("i") and extracranial ("e") NIRS signals were collected from the forehead and from the cheek, respectively, and acquired together with cutaneous plethysmography at the forehead (PPG), cerebral blood velocity from the middle cerebral artery, and arterial blood pressure. Extracranial contribution to cerebral NIRS monitoring was investigated by comparing Beer-Lambert (BL) and spatially resolved spectroscopy (SRS) blood volume indicators [the total hemoglobin concentration (tHb) and the total hemoglobin index, (THI)] and by correlating their changes with changes in extracranial circulation. While THIe and tHbe generally provided concordant indications, tHbi and THIi exhibited opposite-sign changes in a high percentage of cases (VM: 46%; HV: 31%; HUT: 40%). Moreover, tHbi was correlated with THIi only during HV (P < 0.05), not during VM and HUT, while it correlated with PPG in all three maneuvers (P < 0.01). These results evidence that extracranial circulation may markedly affect BL parameters in a high percentage of cases, even during standard clinical tests. Surface plethysmography at the forehead is suggested as complementary monitoring helpful in the interpretation of cerebral NIRS parameters.

  13. Increased Cerebral Blood Flow Velocity in Children with Mild Sleep-Disordered Breathing

    PubMed Central

    Hill, Catherine M.; Hogan, Alexandra M.; Onugha, Nwanneka; Harrison, Dawn; Cooper, Sara; McGrigor, Victoria J.; Datta, Avijit; Kirkham, Fenella J.

    2007-01-01

    Objective Sleep-disordered breathing describes a spectrum of upper airway obstruction in sleep from simple primary snoring, estimated to affect 10% of preschool children, to the syndrome of obstructive sleep apnea. Emerging evidence has challenged previous assumptions that primary snoring is benign. A recent report identified reduced attention and higher levels of social problems and anxiety/depressive symptoms in snoring children compared with controls. Uncertainty persists regarding clinical thresholds for medical or surgical intervention in sleep-disordered breathing, underlining the need to better understand the pathophysiology of this condition. Adults with sleep-disordered breathing have an increased risk of cerebrovascular disease independent of atherosclerotic risk factors. There has been little focus on cerebrovascular function in children with sleep-disordered breathing, although this would seem an important line of investigation, because studies have identified abnormalities of the systemic vasculature. Raised cerebral blood flow velocities on transcranial Doppler, compatible with raised blood flow and/or vascular narrowing, are associated with neuropsychological deficits in children with sickle cell disease, a condition in which sleep-disordered breathing is common. We hypothesized that there would be cerebral blood flow velocity differences in sleep-disordered breathing children without sickle cell disease that might contribute to the association with neuropsychological deficits. Design Thirty-one snoring children aged 3 to 7 years were recruited from adenotonsillectomy waiting lists, and 17 control children were identified through a local Sunday school or as siblings of cases. Children with craniofacial abnormalities, neuromuscular disorders, moderate or severe learning disabilities, chronic respiratory/cardiac conditions, or allergic rhinitis were excluded. Severity of sleep-disordered breathing in snoring children was categorized by attended

  14. Cerebral O2 metabolism and cerebral blood flow in humans during deep and rapid-eye-movement sleep.

    PubMed

    Madsen, P L; Schmidt, J F; Wildschiødtz, G; Friberg, L; Holm, S; Vorstrup, S; Lassen, N A

    1991-06-01

    It could be expected that the various stages of sleep were reflected in variation of the overall level of cerebral activity and thereby in the magnitude of cerebral metabolic rate of oxygen (CMRO2) and cerebral blood flow (CBF). The elusive nature of sleep imposes major methodological restrictions on examination of this question. We have now measured CBF and CMRO2 in young healthy volunteers using the Kety-Schmidt technique with 133Xe as the inert gas. Measurements were performed during wakefulness, deep sleep (stage 3/4), and rapid-eye-movement (REM) sleep as verified by standard polysomnography. Contrary to the only previous study in humans, which reported an insignificant 3% reduction in CMRO2 during sleep, we found a deep-sleep-associated statistically highly significant 25% decrease in CMRO2, a magnitude of depression according with studies of glucose uptake and reaching levels otherwise associated with light anesthesia. During REM sleep (dream sleep) CMRO2 was practically the same as in the awake state. Changes in CBF paralleled changes in CMRO2 during both deep and REM sleep.

  15. Postcarotid endarterectomy cerebral hyperperfusion can be prevented by minimizing intraoperative cerebral ischemia and strict postoperative blood pressure control under continuous sedation.

    PubMed

    Kawamata, Takakazu; Okada, Yoshikazu; Kawashima, Akitsugu; Yoneyama, Taku; Yamaguchi, Kohji; Ono, Yuko; Hori, Tomokatsu

    2009-03-01

    Cerebral hyperperfusion syndrome is a major complication after carotid endarterectomy (CEA). We investigated whether our strategy of minimizing intraoperative cerebral ischemia and strict postoperative blood pressure control under continuous sedation prevented postoperative hyperperfusion. Eighty consecutive patients undergoing CEA were studied. A shunt was used in all patients during CEA. All patients were managed postoperatively under continuous sedation for as long as 48 hours on the basis of the regional cerebral blood flow (rCBF) measured immediately after CEA. Postoperative hyperperfusion was assessed, on the basis of the cerebral blood flow study under sedation (propofol) after CEA, either as a greater than 30% increase in rCBF compared with the contralateral side, or a greater than 100% increase in the corrected rCBF (calculated from percentage reduction of the contralateral rCBF induced by propofol) compared with preoperative values. No patient developed cerebral hyperperfusion syndrome. Postoperative hyperperfusion was found at very low rates (2.5% in the middle cerebral artery territory and 1.3% in the anterior cerebral artery territory by definition 1, and 0% in both territories by definition 2). Ratios of regional oxygen saturation after internal carotid artery clamping to preclamp baseline values were greater than 0.9 in 78 of 80 patients, indicating very mild intraoperative cerebral ischemia. Parameters related to cerebral ischemia during CEA, such as regional oxygen saturation, internal carotid artery cross-clamping duration, and stump pressure (index), did not affect the incidence of postoperative hyperperfusion. The present study suggests that minimizing intraoperative cerebral ischemia using a shunt, followed by strict postoperative blood pressure control under continuous sedation, can prevent post-CEA hyperperfusion.

  16. Effects of mild exercise on cytokines and cerebral blood flow in chronic fatigue syndrome patients.

    PubMed Central

    Peterson, P K; Sirr, S A; Grammith, F C; Schenck, C H; Pheley, A M; Hu, S; Chao, C C

    1994-01-01

    Chronic fatigue syndrome (CFS) is an idiopathic disorder characterized by fatigue that is markedly exacerbated by physical exertion. In the present study, we tested the hypothesis that mild exercise (walking 1 mph [1 mile = 1.609 km] for 30 min) would provoke serum cytokine and cerebral blood flow abnormalities of potential pathogenic importance in CFS. Interleukin-1 beta, interleukin-6, and tumor necrosis factor alpha were nondetectable in sera of CFS patients (n = 10) and healthy control subjects (n = 10) pre- and postexercise. At rest, serum transforming growth factor beta (TGF-beta) levels were elevated in the CFS group compared with the control group (287 +/- 18 versus 115 +/- 5 pg/ml, respectively; P < 0.01). Serum TGF-beta and cerebral blood flow abnormalities, detected by single-photon emission-computed tomographic scanning, were accentuated postexercise in the CFS group. Although these findings were not significantly different from those in the control group, the effect of exercise on serum TGF-beta and cerebral blood flow appeared magnified in the CFS patients. Results of this study encourage future research on the interaction of physical exertion, serum cytokines, and cerebral blood flow in CFS that will adopt a more rigorous exercise program than the one used in this study. PMID:7496949

  17. Effects of ethamsylate on cerebral blood flow velocity in premature babies.

    PubMed Central

    Rennie, J M; Lam, P K

    1989-01-01

    Cerebral blood flow velocity and cardiac output were measured with ultrasound before and 30 minutes after the administration of ethamsylate in a double blind placebo controlled study of 19 very low birthweight infants. No differences were found before or after treatment in either group. PMID:2647043

  18. Comparison of Umbilical Cord Milking and Delayed Cord Clamping on Cerebral Blood Flow in Term Neonates.

    PubMed

    Jaiswal, Prateek; Upadhyay, Amit; Gothwal, Sunil; Chaudhary, Hema; Tandon, Ashutosh

    2015-10-01

    To compare the effect of umbilical cord milking (UCM) and delayed cord clamping (DCC) on cerebral blood flow in term neonates. This randomized controlled trial was conducted at a teaching hospital in India during 2012 to 2013. Two hundred newborns (>36wk) were randomized to UCM and DCC groups. UCM was done on 25cm of cord length. In DCC group, clamping was delayed by 60 to 90s. Resistive Index (RI), Pulsatility Index (PI) and cerebral blood flow velocities of middle cerebral artery (MCA) were measured at 24 to 48h of life. Baseline characteristics and hemodynamic parameters were comparable. Mean PI [1.18 (0.26)] and RI [0.65 (0.08)] in UCM group was comparable to mean PI [1.18 (0.25)] and RI [0.65 (0.08)] in DCC group. The peak systolic velocity and end diastolic velocity (cm/s) of blood flow in MCA for UCM group were 34.94 (11.82) and 11.71 (4.75) respectively, while in DCC group they were 37.24 (12.63) and 13.07 (4.78) (p 0.23 and 0.07) respectively. Indices among growth retarded babies were not different. DCC and UCM had similar effect on cerebral blood flow velocities and Doppler indices in MCA, in term neonates.

  19. Decreased Cerebral Blood Flow in Chronic Pediatric Mild TBI: An MRI Perfusion Study

    PubMed Central

    Wang, Yang; West, John D.; Bailey, Jessica N.; Westfall, Daniel R.; Xiao, Hui; Arnold, Todd W.; Kersey, Patrick A.; Saykin, Andrew J.; McDonald, Brenna C.

    2015-01-01

    We evaluated cerebral blood flow (CBF) in chronic pediatric mild traumatic brain injury (mTBI) using arterial spin labeling (ASL) magnetic resonance imaging perfusion. mTBI patients showed lower CBF than controls in bilateral frontotemporal regions, with no between-group cognitive differences. Findings suggest ASL may be useful to assess functional abnormalities in pediatric mTBI. PMID:25649779

  20. Studies of the Processing of Single Words Using Positron Tomographic Measures of Cerebral Blood Flow Change.

    DTIC Science & Technology

    1987-01-01

    BLOOD FLOW CHANGE Steven E. Petersen, Peter T. Fox, Michael I. Posner, Marcus Raichle McDonnell Center for Studies of Higher Brain Function...Single Words Using Positron Emission Tomographic Measurements of Cerebral Blood Flow Change *= ’I PERSONAL AUTHOR(S) * Petersen, Steven E. 13a. TYPE OF...CHANGE Steven E. Petersen, Peter T. Fox, Michael I. Posner, Marcus E. Raichle INTRODUCTION Language is an essential characteristic of the human

  1. Inspiratory Resistance Delays the Reporting of Symptoms with Central Hypovolemia: Association with Cerebral Blood Flow

    DTIC Science & Technology

    2007-07-01

    were exposed to lower-body negative pressure (LBNP) until the presence of symptoms while breathing through either an active ITD (7 cmH2O impedance ) or...from several investigations have demonstrated the benefits of an inspiratory impedance threshold device (ITD) in elevating cerebral perfusion pressure...standard ECG, and beat-to-beat arterial systolic (SBP) and diastolic (DBP) blood pressures via infrared finger plethysmography with a Finometer blood

  2. [Role of diencephalic structures in the regulation of cerebral blood flow].

    PubMed

    Shotter, A V; Sheliakin, A M; Kaasik, A E

    1988-03-01

    The effects of electric stimulation of the thalamus, hypothalamus and septum upon the CBF, pO2 of brain tissue, EEG, general arterial pressure and pneumogram, were studied in 74 rabbits with implanted cerebral electrodes. The stimulation mostly resulted in an increase in local blood flow sometimes accompanied by a decrease in cortical blood flow. Other parameters under study changed infrequently and insignificantly. The regulation of the CBF seems to be maintained by intracerebral mechanisms.

  3. Radiohalogenated thienylethylamine derivatives for evaluating local cerebral blood flow

    DOEpatents

    Goodman, Mark M.; Knapp, Jr., Furn F.

    1990-01-01

    Radiopharmaceuticals useful in brain imaging comprising radiohalogenated thienylethylamine derivatives. The compounds are 5-halo-thiophene-2-isopropyl amines able to cross the blood-brain barrier and be retained for a sufficient length of time to allow the evaluation or regional blood flow by radioimaging of the brain.

  4. Radiohalogenated thienylethylamine derivatives for evaluating local cerebral blood flow

    SciTech Connect

    Goodman, M.M.; Knapp, F.F. Jr.

    1990-02-13

    This patent describes radiopharmaceuticals useful in brain imaging. They comprise radiohalogenated thienylethylamine derivatives. The compounds are 5-halo-thiophene-2-isopropyl amines able to cross the blood-brain barrier and be retained for a sufficient length of time to allow the evaluation or regional blood flow by radioimaging of the brain.

  5. The temporal profile of cerebral blood flow and tissue metabolites indicates sustained metabolic depression after experimental subarachnoid hemorrhage in rats.

    PubMed

    Westermaier, Thomas; Jauss, Alina; Eriskat, Jörg; Kunze, Ekkehard; Roosen, Klaus

    2011-01-01

    Derangement of cerebral metabolism occurs after various insults such as ischemia, traumatic brain injury, and subarachnoid hemorrhage (SAH). To investigate the course of cerebral blood flow and metabolic parameters in the first hours after experimental SAH. Sixteen Sprague-Dawley rats were subjected to SAH using the endovascular filament model or served as controls (8 rats in each group). Local cerebral blood flow and intracranial pressure were measured continuously. Microdialysis samples were acquired in 30-minute intervals for 6 hours after SAH. Concentrations of glucose, lactate, pyruvate, and glutamate were determined. After induction of SAH, cerebral perfusion pressure and local cerebral blood flow sharply decreased. The decrease in local cerebral blood flow exceeded the decrease in cerebral perfusion pressure throughout the observation period. Glutamate concentrations in microdialysis samples increased sixfold and recovered to baseline levels. Lactate concentrations immediately increased after SAH, recovered incompletely, and remained above the levels of control animals until the end of the sampling period. Pyruvate concentrations showed a delayed increase starting 2 hours after SAH. The course of cerebral blood flow after SAH resembles global ischemia followed by a continuous low-flow state caused by a sudden decrease in cerebral perfusion pressure and acute vasoconstriction. The courses of lactate and pyruvate concentrations indicate a persistently deranged aerobic metabolism.

  6. Blood pressure reduction and noncontrast CT markers of intracerebral hemorrhage expansion.

    PubMed

    Morotti, Andrea; Boulouis, Gregoire; Romero, Javier M; Brouwers, H Bart; Jessel, Michael J; Vashkevich, Anastasia; Schwab, Kristin; Afzal, Mohammad Rauf; Cassarly, Christy; Greenberg, Steven M; Martin, Reneé Hebert; Qureshi, Adnan I; Rosand, Jonathan; Goldstein, Joshua N

    2017-08-08

    To validate various noncontrast CT (NCCT) predictors of hematoma expansion in a large international cohort of ICH patients and investigate whether intensive blood pressure (BP) treatment reduces ICH growth and improves outcome in patients with these markers. We analyzed patients enrolled in the Antihypertensive Treatment of Acute Cerebral Hemorrhage II (ATACH-II) randomized controlled trial. Participants were assigned to intensive (systolic BP <140 mm Hg) vs standard (systolic BP <180 mm Hg) treatment within 4.5 hours from onset. The following NCCT markers were identified: intrahematoma hypodensities, black hole sign, swirl sign, blend sign, heterogeneous hematoma density, and irregular shape. ICH expansion was defined as hematoma growth >33% and unfavorable outcome was defined as modified Rankin Scale score >3 at 90 days. Logistic regression was used to identify predictors of ICH expansion and explore the association between NCCT signs and clinical benefit from intensive BP treatment. A total of 989 patients were included (mean age 62 years, 61.9% male), of whom 186/869 experienced hematoma expansion (21.4%) and 361/952 (37.9%) had unfavorable outcome. NCCT markers independently predicted ICH expansion (all p < 0.01) with overall accuracy ranging from 61% to 78% and good interrater reliability (k > 0.6 for all markers). There was no evidence of an interaction between NCCT markers and benefit from intensive BP reduction (all p for interaction >0.10). NCCT signs reliably identify ICH patients at high risk of hematoma growth. However, we found no evidence that patients with these markers specifically benefit from intensive BP reduction. NCT01176565. © 2017 American Academy of Neurology.

  7. Different CT perfusion algorithms in the detection of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

    PubMed

    Cremers, Charlotte H P; Dankbaar, Jan Willem; Vergouwen, Mervyn D I; Vos, Pieter C; Bennink, Edwin; Rinkel, Gabriel J E; Velthuis, Birgitta K; van der Schaaf, Irene C

    2015-05-01

    Tracer delay-sensitive perfusion algorithms in CT perfusion (CTP) result in an overestimation of the extent of ischemia in thromboembolic stroke. In diagnosing delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH), delayed arrival of contrast due to vasospasm may also overestimate the extent of ischemia. We investigated the diagnostic accuracy of tracer delay-sensitive and tracer delay-insensitive algorithms for detecting DCI. From a prospectively collected series of aSAH patients admitted between 2007-2011, we included patients with any clinical deterioration other than rebleeding within 21 days after SAH who underwent NCCT/CTP/CTA imaging. Causes of clinical deterioration were categorized into DCI and no DCI. CTP maps were calculated with tracer delay-sensitive and tracer delay-insensitive algorithms and were visually assessed for the presence of perfusion deficits by two independent observers with different levels of experience. The diagnostic value of both algorithms was calculated for both observers. Seventy-one patients were included. For the experienced observer, the positive predictive values (PPVs) were 0.67 for the delay-sensitive and 0.66 for the delay-insensitive algorithm, and the negative predictive values (NPVs) were 0.73 and 0.74. For the less experienced observer, PPVs were 0.60 for both algorithms, and NPVs were 0.66 for the delay-sensitive and 0.63 for the delay-insensitive algorithm. Test characteristics are comparable for tracer delay-sensitive and tracer delay-insensitive algorithms for the visual assessment of CTP in diagnosing DCI. This indicates that both algorithms can be used for this purpose.

  8. Changes in cerebral oxygen saturation and blood flow during hypoxic gas ventilation therapy in HLHS and CoA/IAA complex with markedly increased pulmonary blood flow.

    PubMed

    Toiyama, Kentaro; Hamaoka, Kenji; Oka, Tatsujiro; Kobayashi, Naho; Noritake, Kanae; Kato, Ryuichi; Kawai, Yoko; Ozawa, Seiichiro; Nishida, Masashi; Itoi, Toshiyuki

    2010-10-01

    Hypoxic gas ventilation therapy has recently been performed to prevent post-birth increased pulmonary blood flow in cases of congenital heart diseases with increased pulmonary blood flow. However, how the oxygen supply to the tissues changes during breathing a hypoxic gas mixture, remains unknown. The changes in cerebral oxygen saturation and blood supply during hypoxic gas ventilation therapy using a nitrogen gas mixture were studied. Cerebral regional oxygen saturation (cerebral rSO(2)) was measured by near-infrared spectroscopy, and changes in middle cerebral artery (MCA) blood flow and an index of vascular resistance (RI) were assessed in 8 consecutive patients having congenital heart diseases with increased pulmonary blood flow. In all patients, urinary volume increased significantly, and the respiratory rate showed a clear decrease. Percutaneous oxygen saturation showed no significant change. The average of cerebral rSO(2) was 67.3% before hypoxic gas ventilation, but increased to 69.4%, 69.1%, and 70.7% within 1, 12, and 24 h after initiation of treatment, respectively. MCA blood flow significantly increased in the diastolic phase, and RI significantly improved from 0.80 to 0.68 within 12 h after initiation of therapy. These results indicate that hypoxic gas ventilation therapy does not decrease cerebral oxygen saturation, but safely improves the cerebral blood supply in cases of congenital heart diseases with increased pulmonary blood flow. 

  9. Effect of age and vascular anatomy on blood flow in major cerebral vessels.

    PubMed

    Amin-Hanjani, Sepideh; Du, Xinjian; Pandey, Dilip K; Thulborn, Keith R; Charbel, Fady T

    2015-02-01

    Measurement of volume flow rates in major cerebral vessels can be used to evaluate the hemodynamic effects of cerebrovascular disease. However, both age and vascular anatomy can affect flow rates independent of disease. We prospectively evaluated 325 healthy adult volunteers using phase contrast quantitative magnetic resonance angiography to characterize these effects on cerebral vessel flow rates and establish clinically useful normative reference values. Flows were measured in the major intracranial and extracranial vessels. The cohort ranged from 18 to 84 years old, with 157 (48%) females. All individual vessel flows and total cerebral blood flow (TCBF) declined with age, at 2.6 mL/minute per year for TCBF. Basilar artery (BA) flow was significantly decreased in individuals with one or both fetal posterior cerebral arteries (PCAs). Internal carotid artery flows were significantly higher with a fetal PCA and decreased with a hypoplastic anterior cerebral artery. Indexing vessel flows to TCBF neutralized the age effect, but anatomic variations continued to impact indexed flow in the BA and internal carotid artery. Variability in normative flow ranges were reduced in distal vessels and by examining regional flows. Cerebral vessel flows are affected by age and cerebrovascular anatomy, which has important implications for interpretation of flows in the disease state.

  10. Effects of 1 MAC desflurane on cerebral metabolism, blood flow and carbon dioxide reactivity in humans.

    PubMed

    Mielck, F; Stephan, H; Buhre, W; Weyland, A; Sonntag, H

    1998-08-01

    We investigated the cerebral haemodynamic effects of 1 MAC desflurane anaesthesia in nine male patients scheduled for elective coronary bypass grafting. For the measurement of cerebral blood flow (CBF) a modified Kety-Schmidt saturation technique with argon as inert tracer gas was used. Measurements of CBF were made before induction of anaesthesia and 30 min after induction under normocapnic, hypocapnic and hypercapnic conditions in sequence. Changes in mean arterial pressure after induction of anaesthesia and during the course of the study were minimized using norepinephrine infusion. In comparison with the awake state under normocapnic conditions, desflurane reduced mean cerebral metabolic rate of oxygen (CMRO2) by 51% and mean cerebral metabolic rate of glucose (CMRglc) by 35%. Concomitantly, CBF was significantly reduced by 22%; jugular venous oxygen saturation (SjvO2) increased from 58 to 74%. Hypo- and hypercapnia caused a 22% decrease and a 178% increase in CBF, respectively. These findings may be interpreted as the result of two opposing mechanisms: cerebral vasoconstriction induced by a reduction of cerebral metabolism and a direct vasodilator effect of desflurane. CBF alterations under variation of PaCO2 indicate that cerebrovascular carbon dioxide reactivity is not impaired by application of 1 MAC desflurane.

  11. Investigation of the cerebral hemodynamic response function in single blood vessels by functional photoacoustic microscopy

    NASA Astrophysics Data System (ADS)

    Liao, Lun-De; Lin, Chin-Teng; Shih, Yen-Yu I.; Lai, Hsin-Yi; Zhao, Wan-Ting; Duong, Timothy Q.; Chang, Jyh-Yeong; Chen, You-Yin; Li, Meng-Lin

    2012-06-01

    The specificity of the hemodynamic response function (HRF) is determined spatially by the vascular architecture and temporally by the evolution of hemodynamic changes. Here, we used functional photoacoustic microscopy (fPAM) to investigate single cerebral blood vessels of rats after left forepaw stimulation. In this system, we analyzed the spatiotemporal evolution of the HRFs of the total hemoglobin concentration (HbT), cerebral blood volume (CBV), and hemoglobin oxygen saturation (SO2). Changes in specific cerebral vessels corresponding to various electrical stimulation intensities and durations were bilaterally imaged with 36×65-μm2 spatial resolution. Stimulation intensities of 1, 2, 6, and 10 mA were applied for periods of 5 or 15 s. Our results show that the relative functional changes in HbT, CBV, and SO2 are highly dependent not only on the intensity of the stimulation, but also on its duration. Additionally, the duration of the stimulation has a strong influence on the spatiotemporal characteristics of the HRF as shorter stimuli elicit responses only in the local vasculature (smaller arterioles), whereas longer stimuli lead to greater vascular supply and drainage. This study suggests that the current fPAM system is reliable for studying relative cerebral hemodynamic changes, as well as for offering new insights into the dynamics of functional cerebral hemodynamic changes in small animals.

  12. Effects of Yahom on the regional cerebral blood flow in rat using fluorescence videomicroscopy.

    PubMed

    Jariyapongskul, Amporn; Pathumraj, Suthiluk; Niimi, Hideyuki

    2006-01-01

    This study was conducted to investigate effects of Yahom on the regional cerebral blood flow (rCBF) in rats using fluorescence videomicroscopy. Male Wistar Furth rats weighing 200-250 g were used, and divided into three groups: experimental I, II and control groups. The experimental I and II groups received single oral administration of Yahom 2 and 4 g/kg.bw, and topical application of Yahom on the pial cerebral cortex, respectively, while the control group received oral administration of 1 ml of 5% Tween. The rCBF was monitored using laser Doppler flowmetry at different periods (5-120 minutes) after the administration of Yahom or Tween. The mean arterial pressure (MAP) was measured through a femoral artery. The cerebral microcirculation was observed and recorded under an intravital fluorescence videomicroscopic system. The arteriolar diameter was measured based on the recorded videomicroscopic images. The MAP and rCBF increased after the oral administration of Yahom, while they did not alter in the control group. The maximum responses of MAP and rCBF were approximately 16% and 33% at 45 min and 30 min after the administration of Yahom 4 g/kg.bw, respectively. The topical application of Yahom induced vasodilation in the pial microvessels. In conclusion, single oral administration of Yahom may increase the regional cerebral blood flow under the effect of cerebral microvascular vasodilation.

  13. A prospective, multicenter pilot study investigating the utility of flat detector derived parenchymal blood volume maps to estimate cerebral blood volume in stroke patients.

    PubMed

    Fiorella, David; Turk, Aquilla; Chaudry, Imran; Turner, Raymond; Dunkin, Jared; Roque, Clemente; Sarmiento, Marily; Deuerling-Zheng, Yu; Denice, Christine M; Baumeister, Marlene; Parker, Adrian T; Woo, Henry H

    2014-07-01

    Newer flat panel angiographic detector (FD) systems have the capability to generate parenchymal blood volume (PBV) maps. The ability to generate these maps in the angiographic suite has the potential to markedly expedite the triage and treatment of patients with acute ischemic stroke. The present study compares FP-PBV maps with cerebral blood volume (CBV) maps derived using standard dynamic CT perfusion (CTP) in a population of patients with stroke. 56 patients with cerebrovascular ischemic disease at two participating institutions prospectively underwent both standard dynamic CTP imaging followed by FD-PBV imaging (syngo Neuro PBV IR; Siemens, Erlangen, Germany) under a protocol approved by both institutional review boards. The feasibility of the FD system to generate PBV maps was assessed. The radiation doses for both studies were compared. The sensitivity and specificity of the PBV technique to detect (1) any blood volume deficit and (2) a blood volume deficit greater than one-third of a vascular territory, were defined using standard dynamic CTP CBV maps as the gold standard. Of the 56 patients imaged, PBV maps were technically adequate in 42 (75%). The 14 inadequate studies were not interpretable secondary to patient motion/positioning (n=4), an injection issue (n=2), or another reason (n=8). The average dose for FD-PBV was 219 mGy (median 208) versus 204 mGy (median 201) for CT-CBV. On CT-CBV maps 26 of 42 had a CBV deficit (61.9%) and 15 (35.7%) had a deficit that accounted for greater than one-third of a vascular territory. FD-PBV maps were 100% sensitive and 81.3% specific to detect any CBV deficit and 100% sensitive and 62.9% specific to detect any CBV deficit of greater than one-third of a territory. PBV maps can be generated using FP systems. The average radiation dose is similar to a standard CTP examination. PBV maps have a high sensitivity for detecting CBV deficits defined by conventional CTP. PBV maps often overestimate the size of CBV deficits. We

  14. Oxygen Supplementation is Effective in Attenuating Maternal Cerebral Blood Deoxygenation After Spinal Anesthesia for Cesarean Section.

    PubMed

    Hirose, Noriya; Kondo, Yuko; Maeda, Takeshi; Suzuki, Takahiro; Yoshino, Atsuo; Katayama, Yoichi

    2016-01-01

    The purpose of this study was to measure changes in maternal cerebral blood oxygenation using near-infrared spectroscopy (NIRS) for 15 min after spinal anesthesia performed for cesarean section, and to determine the efficacy of supplemental oxygen in maintaining maternal cerebral blood oxygenation. Thirty patients were randomly assigned to either receive 100% oxygen via a facemask at a constant flow rate of 3 l/min throughout the study (O2 group), or were evaluated without supplemental oxygen (Air group). Changes in cerebral blood oxygenation were evaluated using the following parameters: oxy-hemoglobin (Hb), deoxy-Hb, and total-Hb concentrations, as well as tissue oxygen index (TOI), measured over the forehead by NIRS. Mean arterial pressure (MAP) and heart rate (HR) were also recorded throughout the study. Mean oxy-Hb, total-Hb, TOI, and MAP in both groups decreased significantly from baseline values (P<0.05). The reduction in oxy-Hb and TOI in the Air group was significantly greater than that in the O2 group (oxy-Hb: -4.72 vs. -2.96 μmol/l; P<0.05, TOI: -6.82 vs. -1.68%; P<0.01); however, there were no significant differences in the reduction of total-Hb and MAP between the groups. Mean deoxy-Hb in the Air group was significantly higher than that in the O2 group (0.02 vs. -1.01 μmol/l; P<0.05). The results of the present study demonstrate that oxygen supplementation attenuates cerebral blood deoxygenation secondary to the reduction in cerebral blood flow following spinal anesthesia.

  15. Cerebral blood flow and cerebrovascular reactivity after inhibition of nitric oxide synthesis in conscious goats.

    PubMed Central

    Fernández, N.; García, J. L.; García-Villalón, A. L.; Monge, L.; Gómez, B.; Diéguez, G.

    1993-01-01

    1. The role of nitric oxide in the cerebral circulation under basal conditions and after vasodilator stimulation was studied in instrumented, conscious goats, by examining the action of inhibiting endogenous nitric oxide production with NG-nitro-L-arginine methyl ester (L-NAME). 2. In 6 unanaesthetized goats, blood flow to one brain hemisphere (electromagnetically measured), systemic arterial blood pressure and heart rate were continuously recorded. L-NAME (35 mg kg-1 by i.v. bolus) decreased resting cerebral blood flow by 43 +/- 3%, increased mean arterial pressure by 21 +/- 2%, and decreased heart rate by 41 +/- 2%; cerebrovascular resistance increased by 114 +/- 13% (P < 0.01); the immediate addition of i.v. infusion of L-NAME (0.15-0.20 mg kg-1 during 60-80 min) did not significantly modify these effects. Cerebral blood flow recovered at 72 h, arterial pressure and cerebrovascular resistance at 48 h, and heart rate at 6 days after L-NAME treatment. 3. A second treatment with L-NAME scheduled as above reproduced the immediate haemodynamic effects of the first treatment, which (except bradycardia) reversed with L-arginine (200-300 mg kg-1 by i.v. bolus). 4. Acetylcholine (0.01-0.3 micrograms), sodium nitroprusside (3-100 micrograms) and diazoxide (0.3-9 mg), injected into the cerebral circulation of 5 conscious goats, produced dose-dependent increases in cerebral blood flow, and decreases in cerebrovascular resistance; sodium nitroprusside (30 and 100 micrograms) also caused hypotension and tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8220904

  16. Disodium cromoglycate, a mast-cell stabilizer, alters postradiation regional cerebral blood flow in primates

    SciTech Connect

    Cockerham, L.G.; Doyle, T.F.; Pautler, E.L.; Hampton, J.D.

    1986-01-01

    Early transient incapacitation (ETI) is the complete cessation of performance during the first 30 min after radiation exposure, and performance decrement (PD) is a reduction in performance at the same time. Supralethal doses of radiation have been shown to produce a marked decrease in regional cerebral blood flow in primates concurrent with systemic hypotension and a dramatic release of mast-cell histamine. In an attempt to elucidate mechanisms underlying the radiation-induced ETI/PD phenomena and the postradiation decrease in cerebral blood flow, primates were given the mast-cell stabilizers disodium cromoglycate (DSCG) or BRL 22321 before exposure to 100 Gy whole-body gamma radiation. Hypothalamic and cortical blood flows were measured by hydrogen clearance, before and after radiation exposure. Systemic blood pressures were determined simultaneously. The data indicated that DSCG was successful in diminishing postradiation decrease in cerebral blood flow. Irradiated animals pretreated with DSCG, showed only a 10% decrease in hypothalamic blood flow 60 min postradiation, while untreated, irradiated animals showed a 57% decrease. The cortical blood flow of DSCG treated, irradiated animals showed a triphasic response, with a decrease of 38% at 10 min postradiation, then a rise to 1% below baseline at 20 min, followed by a fall to 42% below baseline by 50 min postradiation. In contrast, the untreated, irradiated animals showed a steady decrease in cortical blood flow to 79% below baseline by 50 min postradiation. There was no significant difference in blood-pressure response between the treated and untreated, irradiated animals. Systemic blood pressure showed a 60% decrease at 10 min postradiation, falling to a 71% decrease by 60 min.

  17. Cerebral blood volume and blood flow at varying arterial carbon dioxide tension levels in rabbits during propofol anesthesia.

    PubMed

    Cenic, A; Craen, R A; Howard-Lech, V L; Lee, T Y; Gelb, A W

    2000-06-01

    There are little data on the effects of propofol on cerebral blood volume (CBV). We studied the effects of changes in PaCO(2) on CBV and cerebral blood flow (CBF) during propofol anesthesia in eight New Zealand white rabbits. We also investigated the effects of propofol over time on CBV and CBF during normocapnia (control group). At normocapnia, the mean (+/- SD) CBV and CBF values were 2.41 +/- 0.68 mL/100 g and 56 +/- 28 mL/100 g/min, respectively,. When PaCO(2) was reduced from 41 to 27 mm Hg, no significant change in either CBV or CBF was observed (P > 0.10). However, increasing PaCO(2) from 41 to 58 mm Hg resulted in a 30% increase in CBV (3.08 +/- 0.86 mL/100 g, P < 0.05) and a 91% increase in CBF (97 +/- 39 mL/100 g/min, P < 0.01). In the control group, there were no significant changes in CBV and CBF (P > 0.10) during 2 h of propofol anesthesia. These results indicate that, during propofol anesthesia, cerebrovascular reactivity of blood flow and blood volume is maintained during hypercapnia but is markedly diminished during hypocapnia. During propofol anesthesia in rabbits with normal brains, a reduction in the arterial carbon dioxide level may not always be accompanied by a reduction in brain blood flow and blood volume.

  18. Characterization and differentiation of body fluids, putrefaction fluid, and blood using Hounsfield unit in postmortem CT.

    PubMed

    Zech, Wolf-Dieter; Jackowski, Christian; Buetikofer, Yanik; Kara, Levent

    2014-09-01

    The purpose of the present study was to evaluate the ranges of Hounsfield unit (HU) found in body fluids, putrefaction fluids, and blood on postmortem CT and how these ranges are affected by postmortem interval, temperatures, and CT beam energy. Body fluids, putrefaction fluids, and blood from a total of 53 corpses were analyzed to determine the ranges of HU values from postmortem CT images that were taken prior to autopsy. The fluids measured in CT images were obtained at autopsy and examined in terms of macroscopic and microscopic appearances. Body fluids and blood were also collected in plastic bottles, which were subjected to CT scans at different beam energies (80-130 kV) and at various fluid temperatures (4 to 40 °C). At a postmortem interval of 1 to 4 days, the ranges of HU values of the serous fluids (13-38 HU) and the nonsedimented blood (40-88 HU) did not overlap. In the sedimented blood, the upper serum layer exhibited HU value ranges that overlapped with those of the serous fluids. The putrefaction fluids exhibited a range of HU values between 80 and -130 HU. Elevated HU values were observed in fluids with accretive cell impurities. HU values decreased slightly with increasing temperature and CT beam energy. We concluded that serous fluids and blood in fresh corpses can be characterized and differentiated from each other based on HU value ranges. In contrast, body fluids in decomposed corpses cannot be differentiated by their HU value ranges. Different beam energies and corpse temperatures had only minor influences on HU value ranges and therefore should not be obstacles to the differentiation and characterization of body fluids and blood.

  19. [Differential effects of isoflurane and nitrous oxide on cerebral blood flow, metabolism and electrocorticogram after incomplete cerebral ischemia in the rat].

    PubMed

    Ishikawa, T; Maekawa, T; Shinohara, K; Sakabe, T; Takeshita, H

    1989-07-01

    Differential effects of isoflurane (ISOF) and N2O on cerebral blood flow, metabolism and electrocorticogram (ECoG) were examined in rats subjected to 15 min-incomplete cerebral ischemia. In the first study, regional cerebral blood flow (rCBF) and ECoG were measured during and after ischemia. In the second study, local cerebral blood flow (LCBF) and glucose utilization (LCGU) were determined at 60 min after reperfusion. In the N2O group, rCBF in both the cerebral cortex and hippocampus decreased significantly to less than 10% of the pre-ischemic value during ischemia, and it increased to 170% at 10 min after reperfusion. The ECoG became flat during ischemia and reappeared at 21 min after reperfusion. In the ISOF group, rCBF decreased significantly to 25% during ischemia and returned to the preischemic value after reperfusion. The ECoG became flat during ischemia and reappeared at 14 min. In the N2O group, LCBFs decreased significantly to 40-50% of the pre-ischemic values in the forebrain. LCGUs decreased significantly to 30-50% in all structures of the forebrain. In the ISOF group, LCBFs decreased significantly to 60-80% in the forebrain, but were not different in other structures. LCGUs did not differ from pre-ischemic values in all structures except for in the thalamus and habenula. These results may indicate cerebral protective effects of ISOF on incomplete cerebral ischemia in rats.

  20. Cerebral blood flow imaging using time-series analysis of indocyanine green molecular dynamics in mice

    NASA Astrophysics Data System (ADS)

    Ku, Taeyun; Lee, Jungsul; Choi, Chulhee

    2010-02-01

    Measurement of cerebral perfusion is important for study of various brain disorders such as stroke, epilepsy, and vascular dementia; however, efficient and convenient methods which can provide quantitative information about cerebral blood flow are not developed. Here we propose an optical imaging method using time-series analysis of dynamics of indocyanine green (ICG) fluorescence to generate cerebral blood flow maps. In scalp-removed mice, ICG was injected intravenously, and 740nm LED light was illuminated for fluorescence emission signals around 820nm acquired by cooled-CCD. Time-lapse 2-dimensional images were analyzed by custom-built software, and the maximal time point of fluorescent influx in each pixel was processed as a blood flow-related parameter. The generated map exactly reflected the shape of the brain without any interference of the skull, the dura mater, and other soft tissues. This method may be further applicable for study of other disease models in which the cerebral hemodynamics is changed either acutely or chronically.

  1. Cerebral blood flow abnormalities in children with sickle cell disease: a systematic review.

    PubMed

    Behpour, Amir M; Shah, Prakesh S; Mikulis, David J; Kassner, Andrea

    2013-03-01

    A systematic review was performed to assess whether cerebral blood flow with different imaging modalities could identify brain abnormalities in children with sickle cell disease where structural magnetic resonance imaging and transcranial Doppler velocity appeared normal. A total of 11 studies were identified which reported cerebral blood flow abnormalities alongside structural magnetic resonance imaging or transcranial Doppler velocity abnormalities in patients with sickle cell disease. Potential for bias was assessed with the quality assessment of diagnostic accuracy studies scale in addition to treatment bias. Subjects of each study were categorized into patients with and without stroke. The prevalence of abnormalities for each modality was then separately calculated in each group. The included studies had mostly moderate degrees of bias. The prevalence of blood flow abnormalities compared with structural magnetic resonance imaging abnormalities was equal to or lower in patients with stroke and equal to or greater in patients without stroke. Blood flow abnormalities were more prevalent than transcranial Doppler abnormalities in four studies of patients without stroke and in one study of patients with stroke. The studies suggest that the assessment of cerebral blood flow in sickle cell disease can be of potential value in addressing brain abnormalities at the tissue level; however, further studies are warranted.

  2. Transcranial Doppler-Based Surrogates for Cerebral Blood Flow: A Statistical Study

    PubMed Central

    Hart, Joseph; Novak, Vera; Saunders, Charles; Gremaud, Pierre A.

    2016-01-01

    It is commonly assumed that perfusion in a given cerebral territory can be inferred from Blood Flow Velocity (BFV) measurements in the corresponding stem artery. In order to test this hypothesis, we construct a cerebral blood flow (CBF) estimator based on transcranial Doppler (TCD) blood flow velocity and ten other easily available patient characteristics and clinical parameters. A total of 261 measurements were collected from 88 older patients. The estimator is based on local regression (Random Forest). Its performance is analyzed against baseline CBF from 3-D pseudocontinuous arterial spin labeling (pCASL) magnetic resonance imaging (MRI). Patient specific CBF predictions are of poor quality (r = 0.41 and p-value = 4.5 × 10−12); the hypothesis is thus not clearly supported by evidence. PMID:27880813

  3. Simultaneous two-photon imaging of cerebral oxygenation and capillary blood flow in atherosclerotic mice

    NASA Astrophysics Data System (ADS)

    Lu, Xuecong; Li, Baoqiang; Moeini, Mohammad; Lesage, Frédéric

    2017-02-01

    Gradual changes in brain microvasculature and cerebral capillary blood flow occurring with atherosclerosis may significantly contribute to cognition decline due to their role in brain tissue oxygenation. However, previous stud- ies of the relationship between cerebral capillary blood flow and brain tissue oxygenation are limited. This study aimed to investigate vascular and concomitant changes in brain tissue pO2 with atherosclerosis. Experiments in young healthy C57B1/6 mice (n=6 , WT), young atherosclerotic mice (n=6 , ATX Y) and old atherosclerotic mice (n=6 , ATX O) were performed imaging on the left sensory-motor cortex at resting state under urethane (1.5 g/kg) anesthesia using two-photon fluorescence microscopy. The results showed that pO2 around capillaries, correlated with red blood cell (RBC) flux, increased with atherosclerosis.

  4. Transcranial Doppler-Based Surrogates for Cerebral Blood Flow: A Statistical Study.

    PubMed

    Hart, Joseph; Novak, Vera; Saunders, Charles; Gremaud, Pierre A

    2016-01-01

    It is commonly assumed that perfusion in a given cerebral territory can be inferred from Blood Flow Velocity (BFV) measurements in the corresponding stem artery. In order to test this hypothesis, we construct a cerebral blood flow (CBF) estimator based on transcranial Doppler (TCD) blood flow velocity and ten other easily available patient characteristics and clinical parameters. A total of 261 measurements were collected from 88 older patients. The estimator is based on local regression (Random Forest). Its performance is analyzed against baseline CBF from 3-D pseudocontinuous arterial spin labeling (pCASL) magnetic resonance imaging (MRI). Patient specific CBF predictions are of poor quality (r = 0.41 and p-value = 4.5 × 10-12); the hypothesis is thus not clearly supported by evidence.

  5. Effect of stimulation of trigeminal ganglion on regional cerebral blood flow in cats

    SciTech Connect

    Goadsby, P.J.; Duckworth, J.W. )

    1987-08-01

    Regional cerebral blood flow was studied in the cat, with and without trigeminal ganglion stimulation, by the intravenous injection of the tracer ({sup 14}C)iodoantipyrine and subsequent regional brain dissection. Electrical activation of the trigeminal ganglion led to a selective increase in regional blood flow in the frontal and parietal cortex that was bilateral without change in the posterior cortex, deep cerebral nuclei, white matter, or brain stem. Unilateral intracranial section of the facial nerve blocked the response in the ipsilateral frontal and parietal cortex, whereas bilateral facial nerve section blocked the contralateral frontal cortical response. The contralateral parietal cortical increase in blood flow was not affected by facial nerve section and may thus represent the result of metabolic activation of sensory cortex.

  6. Cerebral blood flow response to changes in arterial carbon dioxide tension during hypothermic cardiopulmonary bypass in children

    SciTech Connect

    Kern, F.H.; Ungerleider, R.M.; Quill, T.J.; Baldwin, B.; White, W.D.; Reves, J.G.; Greeley, W.J. )

    1991-04-01

    We examined the relationship of changes in partial pressure of carbon dioxide on cerebral blood flow responsiveness in 20 pediatric patients undergoing hypothermic cardiopulmonary bypass. Cerebral blood flow was measured during steady-state hypothermic cardiopulmonary bypass with the use of xenon 133 clearance methodology at two different arterial carbon dioxide tensions. During these measurements there was no significant change in mean arterial pressure, nasopharyngeal temperature, pump flow rate, or hematocrit value. Cerebral blood flow was found to be significantly greater at higher arterial carbon dioxide tensions (p less than 0.01), so that for every millimeter of mercury rise in arterial carbon dioxide tension there was a 1.2 ml.100 gm-1.min-1 increase in cerebral blood flow. Two factors, deep hypothermia (18 degrees to 22 degrees C) and reduced age (less than 1 year), diminished the effect carbon dioxide had on cerebral blood flow responsiveness but did not eliminate it. We conclude that cerebral blood flow remains responsive to changes in arterial carbon dioxide tension during hypothermic cardiopulmonary bypass in infants and children; that is, increasing arterial carbon dioxide tension will independently increase cerebral blood flow.

  7. Cerebral blood flow response to hypoglycemia is altered in patients with type 1 diabetes and impaired awareness of hypoglycemia.

    PubMed

    Wiegers, Evita C; Becker, Kirsten M; Rooijackers, Hanne M; von Samson-Himmelstjerna, Federico C; Tack, Cees J; Heerschap, Arend; de Galan, Bastiaan E; van der Graaf, Marinette

    2016-01-01

    It is unclear whether cerebral blood flow responses to hypoglycemia are altered in people with type 1 diabetes and impaired awareness of hypoglycemia. The aim of this study was to investigate the effect of hypoglycemia on both global and regional cerebral blood flow in type 1 diabetes patients with impaired awareness of hypoglycemia, type 1 diabetes patients with normal awareness of hypoglycemia and healthy controls ( n = 7 per group). The subjects underwent a hyperinsulinemic euglycemic-hypoglycemic glucose clamp in a 3 T MR system. Global and regional changes in cerebral blood flow were determined by arterial spin labeling magnetic resonance imaging, at the end of both glycemic phases. Hypoglycemia generated typical symptoms in patients with type 1 diabetes and normal awareness of hypoglycemia and healthy controls, but not in patients with impaired awareness of hypoglycemia. Conversely, hypoglycemia increased global cerebral blood flow in patients with impaired awareness of hypoglycemia, which was not observed in the other two groups. Regionally, hypoglycemia caused a redistribution of cerebral blood flow towards the thalamus of both patients with normal awareness of hypoglycemia and healthy controls, consistent with activation of brain regions associated with the autonomic response to hypoglycemia. No such redistribution was found in the patients with impaired awareness of hypoglycemia. An increase in global cerebral blood flow may enhance nutrient supply to the brain, hence suppressing symptomatic awareness of hypoglycemia. Altogether these results suggest that changes in cerebral blood flow during hypoglycemia contribute to impaired awareness of hypoglycemia.

  8. The Effects of Body Mass Index on Cerebral Blood Flow Velocity

    PubMed Central

    Selim, Magdy; Jones, Richard; Novak, Peter; Zhao, Peng; Novak, Vera

    2008-01-01

    Objective Obesity is a risk factor for cerebrovascular disease. We aimed to determine the effects of high body mass index (BMI) on cerebral blood flow regulation in patients with type-2 diabetes mellitus, hypertension, and stroke. Methods We analyzed data from 90 controls, 30 diabetics, 45 hypertensives, and 32 ischemic stroke patients who underwent transcranial Doppler for evaluation of blood flow velocities (BFV) in the middle cerebral arteries (MCA) and cerebrovascular resistance (CVR) during supine rest and head-up tilt. This study was a cross –sectional analysis. We used a structural equation multiple indicators modeling to determine the effects of BMI and other background variables (age, sex, race, smoking, alcohol use, and systolic blood pressure) on cerebral BFV. Results Higher BMI (p=0.02) and age (p=0.004) were associated with lower mean BFV during baseline, independent of diagnosis of diabetes mellitus, hypertension or stroke, and after adjusting for all background variables and vessel diameters. Men, especially those with stroke, had a lower mean BFV than women (p = 0.01). CVR increased with BMI (p=0.001) at baseline and during head-up tilt (p=0.02), and was elevated in obese subjects (p=0.004) compared to normal weight subjects across all groups. Interpretation High BMI is associated with a reduction in cerebral BFV and increased CVR. These findings indicate that obesity can adversely affect cerebral blood flow and resistance in cerebrovascular bed, independent of diagnosis of type-2 diabetes, hypertension or stroke. Obesity may contribute to cerebromicrovascular disease, and affect clinical functional outcomes of older population. PMID:18726054

  9. Impairment of cerebral blood flow regulation in astronauts with orthostatic intolerance after flight.

    PubMed

    Blaber, Andrew P; Goswami, Nandu; Bondar, Roberta L; Kassam, Mahmood S

    2011-07-01

    We investigated cerebral blood flow regulation in astronauts before and after flights. We hypothesized that autoregulation would be different before flight and after flight between nonfinishers and the finishers of a stand test. Twenty-seven astronauts from shuttle missions lasting 8 to 16 days underwent a 10-minute stand test: 10 days before flight, 1 to 2 hours and 3 days after landing. Mean blood flow velocity of the middle cerebral artery (MCA) was measured using transcranial Doppler; Mean arterial pressure was measured using a Finapres (Ohmeda, Englewood, CO) and was adjusted to the level of the MCA (BP(MCA)). Cross-spectral power, gain, phase, and coherence were determined for the relation between BP(MCA) and the cerebrovascular resistance index mean blood flow velocity/BP(MCA). BP(MCA) was reduced with stand (P<0.001). Differences between finishers and nonfinishers (P=0.011) and over test days (P=0.004) were observed. Cerebrovascular conductance was affected by stand (P<0.001), by group (P<0.001) with a group by stand, and test day interaction (P<0.01). Preflight data suggest that the nonfinishers were operating at a higher cerebral vasodilation than finishers for a given BP(MCA), and on landing day the nonfinishers had a greater decrease in mean blood flow velocity as a function of BP(MCA) with standing compared to finishers and preflight. There was a significant interaction effect of gender over the test days and from supine to stand (P=0.035). Our results indicate that the cause of presyncope in astronauts may be related to a mismatch of cerebral blood flow with blood pressure. Astronaut gender may also play a role in susceptibility to orthostatic intolerance after flight.

  10. Radiohalogenated thienylethylamine derivatives for evaluating local cerebral blood flow

    SciTech Connect

    Goodman, M.M.; Knapp, F.F. Jr.

    1988-12-22

    An improved method of chemical synthesis of radiohalogenated thienylethylamine derivatives useful in brain imaging is described. These 5-halo-thiophene-2-isopropyl amines readily cross the blood- brain barrier and are retained in the brain for a sufficient length of time to allow evaluation of regional blood flow in the cerebrum. The advantages of the invention include a simpler synthesis route and a final compound which is less diluted with nonradioactive halogen. Use of this invention will allow clearer radioimaging or lower radiation doses to the patient, depending on the objective. 2 figs., 1 tab. (MHB)

  11. [Transfontanellar Doppler ultrasound measurement of cerebral blood velocity before and after surgical treatment of hydrocephalus].

    PubMed

    de Assis, M C; Machado, H R

    1999-09-01

    Twenty-seven children with hydrocephalus of different etiologies diagnosed by clinical examination, neurosonography and computerized brain tomography were submitted to transfontanellar US-Doppler evaluation for measurement of blood flow velocity and for the calculation of resistance index (RI) in the anterior and middle cerebral arteries and internal carotids. All children were submitted to evaluation before surgery and on the 1st, 30th and 60th postoperative days. We conclude that neurosonography and US-Doppler technique is useful for determination of hydrocephalus, indication and control of cerebrospinal fluid shunts and monitoring of changes in RI, comparing data obtained immediately before and after surgery and during the late postoperative period. The results obtained when comparing the RI values for the various arteries during the different stages of the study also permitted us to conclude that the anterior cerebral arteries are representative of the maximal alterations that occur in cerebral vascular resistance in pediatric patients with hydrocephalus.

  12. Rheoencephalogram Reflects Cerebral Blood Flow Autoregulation in Pigs

    DTIC Science & Technology

    2007-01-01

    function are strongly interrelated. Although the mechanism which is caused by arteriosclerosis . At the same time, these of this complex system is not well...determined to be useful diagnostic monitoring purposes. CBF AR is defined as the for monitoring ICP and arteriosclerosis [3]. phenomenon that makes blood

  13. Carotid and cerebral CT angiography using low volume of iodinated contrast material and low tube voltage.

    PubMed

    Kayan, M; Demirtas, H; Türker, Y; Kayan, F; Çetinkaya, G; Kara, M; Orhan Çelik, A; Umul, A; Yılmaz, Ö; Recep Aktaş, A

    2016-11-01

    (2013.11mAs±195.92 [SD]) and in group B (2096.64 mAs±309.03 [SD]) (P<0.05). Carotid and cerebral CTA examinations using 128-section CT can be successfully obtained using an imaging protocol that combines low voltage and 50% reduction in the volume of iodinated contrast material. This provides good image quality with low radiation dose. Copyright © 2016 Editions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  14. Altered phase interactions between spontaneous blood pressure and flow fluctuations in type 2 diabetes mellitus: Nonlinear assessment of cerebral autoregulation

    NASA Astrophysics Data System (ADS)

    Hu, Kun; Peng, C. K.; Huang, Norden E.; Wu, Zhaohua; Lipsitz, Lewis A.; Cavallerano, Jerry; Novak, Vera

    2008-04-01

    Cerebral autoregulation is an important mechanism that involves dilatation and constriction in arterioles to maintain relatively stable cerebral blood flow in response to changes of systemic blood pressure. Traditional assessments of autoregulation focus on the changes of cerebral blood flow velocity in response to large blood pressure fluctuations induced by interventions. This approach is not feasible for patients with impaired autoregulation or cardiovascular regulation. Here we propose a newly developed technique-the multimodal pressure-flow (MMPF) analysis, which assesses autoregulation by quantifying nonlinear phase interactions between spontaneous oscillations in blood pressure and flow velocity during resting conditions. We show that cerebral autoregulation in healthy subjects can be characterized by specific phase shifts between spontaneous blood pressure and flow velocity oscillations, and the phase shifts are significantly reduced in diabetic subjects. Smaller phase shifts between oscillations in the two variables indicate more passive dependence of blood flow velocity on blood pressure, thus suggesting impaired cerebral autoregulation. Moreover, the reduction of the phase shifts in diabetes is observed not only in previously-recognized effective region of cerebral autoregulation (<0.1 Hz), but also over the higher frequency range from ˜0.1 to 0.4 Hz. These findings indicate that type 2 diabetes mellitus alters cerebral blood flow regulation over a wide frequency range and that this alteration can be reliably assessed from spontaneous oscillations in blood pressure and blood flow velocity during resting conditions. We also show that the MMPF method has better performance than traditional approaches based on Fourier transform, and is more suitable for the quantification of nonlinear phase interactions between nonstationary biological signals such as blood pressure and blood flow.

  15. Anaphylactic shock decreases cerebral blood flow more than what would be expected from severe arterial hypotension.

    PubMed

    Davidson, Julien; Zheng, Feng; Tajima, Keiko; Barthel, Grégoire; Alb, Ionel; Tabarna, Adriana; Thornton, Simon N; Lambert, Maud; Longrois, Dan; Audibert, Gérard; Malinovsky, Jean-Marc; Mertes, Paul-Michel

    2012-10-01

    The effects of acute reduction in arterial blood pressure in severe anaphylactic shock (AS) on cerebral blood flow are of paramount importance to be investigated. We studied cerebral circulation and oxygenation in a model of severe AS and compared it with a pharmacologically induced arterial hypotension of similar magnitude. Anaphylactic shock was induced by 1 mg intravenous ovalbumin (OVA) in sensitized rats. Rats were randomized to three groups: (i) no resuscitation (OVA; n = 10) (ii) intravenous volume expansion (10 mL in 10 min after OVA injection) (OVA + VE; n = 10); (iii) control hypotension (100 μg of nicardipine followed by continuous infusion of 1 mg · 100 g · h intravenously; NICAR; n = 10). Mean arterial pressure (MAP), carotid blood flow (CBF), cardiac output, cerebral cortical blood flow (CCBF; estimated by laser Doppler technique), and cerebral tissue oxygen pressure (PtiO2) were recorded over the 15 min following AS induction in all three groups. Results are expressed as mean (SD). One minute after OVA or nicardipine injection, there was a rapid and significant 50% decrease in MAP from basal values. In the OVA group, AS severely altered systemic and cerebral hemodynamics in 5 min: 93% (SD, 4%) decrease in CBF, 66% (SD, 8%) in CCBF, and 44% (SD, 8%) in PtiO2; the decrease in CBF was significantly (P < 0.05) attenuated in the OVA + VE group; however, CCBF and PtiO2 were not statistically different in the OVA versus OVA + VE groups. On the contrary, nicardipine-induced hypotension had only a limited impact on CBF, cardiac output, CCBF, and PtiO2 for a similar MAP decrease. There was a linear relation between CCBF and blood pressure in the OVA (regression slope: 0.87 [SD, 0.06]; median r = 0.81) but not in the NICAR group (regression slope: 0.23 [SD, 0.32]; median r = 0.33). Anaphylactic shock resulted in severe impairment of cerebral blood flow and oxygenation, beyond what could be expected from the level of arterial hypotension.

  16. Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position.

    PubMed

    Buget, Mehmet Ilke; Atalar, Ata Can; Edipoglu, Ipek Saadet; Sungur, Zerrin; Sivrikoz, Nukhet; Karadeniz, Meltem; Saka, Esra; Kucukay, Suleyman; Senturk, Mert N

    2016-01-01

    The aim of the study were to demonstrate the possible hemodynamic changes and cerebral blood flow alterations in patients who were positioned from supine to beach chair position; and to detect if the position change causes any cortical activity alteration as measured by the 4-channeled electroencephalography monitor. 35 patients were included. Before the induction, mean arterial pressure and patient state index values were recorded (T0). After the intubation, doppler-ultrasonography of the patients' internal carotid and vertebral arteries were evaluated to acquire cerebral blood flow values from the formula. In supine position, mean arterial pressure, patient state index and cerebral blood flow values were recorded (T1) and the patient was positioned to beach chair position. After 5min all measurements were repeated (T2). Measurements of patient state index and mean arterial pressure were repeated after 20 (T3), and 40 (T4)min. There was a significant decrease between T0 and T1 in heart rate (80.5±11.6 vs. 75.9±14.4beats/min), MAP (105.8±21.9 vs. 78.9±18.4mmHg) and PSI (88.5±8.3 vs. 30.3±9.7) (all p<0.05). Mean arterial pressure decreased significantly after position change, and remained decreased, compared to T1. The overall analysis of patient state index values (T1-T4) showed no significant change; however, comparing only T1 and T2 resulted in a statically significant decrease in patient state index. There was a significant decrease in cerebral blood flow after beach chair position. Beach chair position was associated with a decrease in cerebral blood flow and patient state index values. Patient state index was affected by the gravitational change of the cerebral blood flow; however, both factors were not directly correlated to each other. Moreover, the decrease in patient state index value was transient and returned to normal values within 20min. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights

  17. [Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position].

    PubMed

    Buget, Mehmet Ilke; Atalar, Ata Can; Edipoglu, Ipek Saadet; Sungur, Zerrin; Sivrikoz, Nukhet; Karadeniz, Meltem; Saka, Esra; Kucukay, Suleyman; Senturk, Mert N

    2016-01-01

    The aim of the study were to demonstrate the possible hemodynamic changes and cerebral blood flow alterations in patients who were positioned from supine to beach chair position; and to detect if the position change causes any cortical activity alteration as measured by the 4-channeled electroencephalography monitor. 35 patients were included. Before the induction, mean arterial pressure and patient state index values were recorded (T0). After the intubation, doppler-ultrasonography of the patients' internal carotid and vertebral arteries were evaluated to acquire cerebral blood flow values from the formula. In supine position, mean arterial pressure, patient state index and cerebral blood flow values were recorded (T1) and the patient was positioned to beach chair position. After 5min all measurements were repeated (T2). Measurements of patient state index and mean arterial pressure were repeated after 20 (T3), and 40 (T4)min. There was a significant decrease between T0 and T1 in heart rate (80.5±11.6 vs. 75.9±14.4beats/min), MAP (105.8±21.9 vs. 78.9±18.4mmHg) and PSI (88.5±8.3 vs. 30.3±9.7) (all p<0.05). Mean arterial pressure decreased significantly after position change, and remained decreased, compared to T1. The overall analysis of patient state index values (T1-T4) showed no significant change; however, comparing only T1 and T2 resulted in a statically significant decrease in patient state index. There was a significant decrease in cerebral blood flow after beach chair position. Beach chair position was associated with a decrease in cerebral blood flow and patient state index values. Patient state index was affected by the gravitational change of the cerebral blood flow; however, both factors were not directly correlated to each other. Moreover, the decrease in patient state index value was transient and returned to normal values within 20min. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights

  18. MRI study of cerebral, retinal and choroidal blood flow responses to acute hypertension.

    PubMed

    Li, Guang; Shih, Yen-Yu Ian; Kiel, Jeffrey W; De La Garza, Bryan H; Du, Fang; Duong, Timothy Q

    2013-07-01

    Blood flow (BF) in many tissues is stable during significant fluctuations in systemic arterial blood pressure or perfusion pressure under normal conditions. The regulatory mechanisms responsible for this non-passive BF behavior include both local and neural control mechanisms. This study evaluated cerebral BF (CBF), retinal BF (RBF) and choroidal BF (ChBF) responses to acute blood pressure increases in rats using magnetic resonance imaging (MRI). A transient increase in blood pressure inside the MRI scanner was achieved by mechanically inflating a balloon catheter to occlude the descending aorta near the diaphragm. We verified the rat model of mechanical occlusion and MRI approach by first measuring blood-flow regulatory responses to changing BP in the brain under normoxia and hypercapnia where the phenomenon is well documented. Retinal and choroidal blood-flow responses to transient increased arterial pressure were then investigated. In response to an acute increase in blood pressure, RBF exhibited autoregulatory behavior and ChBF exhibited baroregulation similar to that seen in the cerebral circulation. This approach may prove useful to investigate retinal and choroidal vascular dysregulation in rat models of retinal diseases with suspected vascular etiology. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Changes in Cerebral Blood Flow in Patients with Familial Mediterranean Fever.

    PubMed

    Çetin, Gözde; Utku, Uygar; Atilla, Nurhan; Gişi, Kadir; Sayarlioğlu, Mehmet

    2017-06-01

    It is known that there is a relationship between systemic inflammation and atherosclerosis. Atherosclerosis is one of the best-known causes of cerebrovascular diseases. The aim of this study was to assess cerebral blood flow velocity using transcranial Doppler (TCD) ultrasonography in patients with familial Mediterranean fever (FMF). A total of 30 patients aged from 20 to 50 years with FMF were enrolled in the FMF group consecutively. The control group (non-FMF group) consisted of 30 age- and sex-matched randomly selected patients without FMF who had other diagnoses such as fibromyalgia and did not have risk factors for atherosclerosis. Bilateral peak-systolic, end-diastolic, and mean blood flow velocities in the middle cerebral artery (MCA), values of Gosling's pulsatility index, and values of Pourcelot's resistance index were recorded using TCD ultrasonography by a neurosonologist blinded to the FMF and control groups. There were 30 participants in the FMF group in remission (male/female: 4/26, mean age: 34.7±5.9 years) and 30 participants in the control group (male/female: 4/26, mean age: 32.3±4.7 years). C-reactive protein levels and bilateral blood flow velocities in the MCA were significantly higher in the FMF group than in the control group. This study suggests that persistent clinical and subclinical inflammation in patients with FMF causes an increase in cerebral blood flow velocities. Our findings provide an insight into this association between FMF and cerebrovascular diseases.

  20. Evidence of redistribution of cerebral blood flow during treatment for an intracranial arteriovenous malformation

    SciTech Connect

    Batjer, H.H.; Purdy, P.D.; Giller, C.A.; Samson, D.S. )

    1989-10-01

    The presence of an intracranial arteriovenous malformation has a dramatic impact on local circulatory dynamics. Treatment of some arteriovenous malformations can result in disastrous hyperemic states caused by redistribution of previously shunted blood. This report describes serial hemodynamic measurements of both cerebral blood flow and flow velocity in 3 patients during treatment for arteriovenous malformations. Measurements of cerebral blood flow were made by computed tomographic scan employing the stable xenon inhalation technique; flow velocity, including autoregulatory characteristics, was measured by transcranial Doppler ultrasonogram. Substantial hyperemia developed in one patient (Case 1) after resection and in another (Case 3) after embolization. Embolization resulted in restoration of normal regional cerebral blood flow in a patient who demonstrated hypoperfusion before treatment (Case 2). In Patient 1, postoperative hyperemia was associated with persistently elevated flow velocities, and may have been accompanied by hemispheric neurological deficits. Sequential hemodynamic measurements may predict patients at risk of perioperative complications, and may become useful clinical guidelines for the extent and timing of embolization and for the timing of surgery after intracranial hemorrhage or preoperative embolization procedures.

  1. Interhemispheric comparisons of cerebral blood flow velocity changes during mental tasks with transcranial Doppler sonography.

    PubMed

    Lin, Tzu-Kang; Ryu, Shan-Jin; Hsu, Peng-Wei

    2009-11-01

    The purpose of this study was to evaluate hemispheric asymmetry of cerebral blood flow changes during various mental tests by applying transcranial Doppler sonography (TCD) to simultaneously monitor bilateral cerebral blood flow velocity changes. Twenty-one participants without cerebrovascular disease performed 3 left hemispheric tasks (reading, calculation, and color scaling) and 3 right hemispheric tasks (face recognition, space imagination, and line orientation). Mean velocities of the rest and performing periods did not differ significantly between the left and right hemispheric tasks. Although greater acceleration of blood flow velocity was observed on the left than on the right in most of the 6 tasks except line orientation (mean left - right ratio difference [D(l-r)] ranged from -0.018 to 0.071), this difference was larger for left hemispheric tasks (mean D(l-r) ranged from 0.050 to 0.071) than right hemispheric tasks (mean D(l-r) ranged from -0.018 to 0.034; P < .001). Further comparisons of each pair of (ie, left and right) hemispheric tasks revealed that the most suitable left and right hemispheric tasks to show hemispheric asymmetry were reading and line orientation, respectively (P < .001). Hemispheric asymmetry of cerebral blood flow changes during mental tests is demonstrable with TCD only when comparing the D(l-r) in response to suitable paired left and right hemispheric tasks.

  2. Effect of adenosine triphosphate and some derivatives on cerebral blood flow and metabolism.

    PubMed Central

    Forrester, T; Harper, A M; MacKenzie, E T; Thomson, E M

    1979-01-01

    1. Responses of cerebral blood vessels to peri- and intravascular doses of ATP (adenosine triphosphate) and some derivatives were studied in cat and baboon. 2. Perivascular application of ATP to cat pial arterioles gave a threshold dilatory effect at a concentration of 10(-11) M. This figure is comparable to the amount of ATP calculated to be released from electrically stimulated brain slices. 3. It is concluded that adenine nucleotides have a major role to play in the local control of cerebral blood flow. 4. Intracarotid injection of ATP showed a calculated threshold effect at 4 x 10(8) M in the cat and 4 x 10(-9) M in the baboon. 5. The threshold response of the vasculature to intracarotid adenosine lay between 4 x 10(-7) M and 4 x 10(-6) M in the baboon. Little effect was produced with AMP, pyrophosphate and inorganic phosphate. 6. Intracarotid ATP increased the oxygen consumption of the baboon brain parenchyma. This effect was attributed in part to an elevation of the cellular cyclic AMP levels. 7. Osmotic disruption of the blood-brain barrier in baboon did not affect the vasodilatory or metabolic effect of intracarotid ATP. 8. It is postulated that circulating purine compounds mediate a form of metabolic communication inthe body. Also, release of purine compounds from active local nerves might influence cerebral blood flow. PMID:119042

  3. Measurement of local cerebral blood flow with (/sup 14/C)iodoantipyrine in the mouse

    SciTech Connect

    Jay, T.M.; Lucignani, G.; Crane, A.M.; Jehle, J.; Sokoloff, L.

    1988-02-01

    Local cerebral blood flow was measured in the mouse by means of the (/sup 14/C)iodoantipyrine method. This method has been previously used in the monkey, dog, cat, and rat, but its application to small mammals such as the mouse requires special attention to potential sources of error. The small size of the mouse brain requires special attention to the rapid removal and freezing of the brain to minimize effects of postmortem diffusion of tracer in the tissue. Because of the relatively low diameter/length ratios of the catheters needed for arterial sampling in small animals, substantial errors can occur in the determination of the time course of the (/sup 14/C)iodoantipyrine concentration in the arterial blood unless corrections for lag time and dead space washout in the catheter are properly applied. Local cerebral blood flow was measured in seven awake mice with appropriate care to minimize these sources of error. The values were found to vary from 48 ml/100 g/min in the corpus callosum to 198 ml/100 g/min in the inferior colliculus. The results demonstrate that the (/sup 14/C)iodoantipyrine method can be used to measure local cerebral blood flow in the mouse and that the values in that species are, in general, somewhat higher than those in the rat.

  4. Cerebral blood flow modulation insufficiency in brain networks in multiple sclerosis: A hypercapnia MRI study.

    PubMed

    Marshall, Olga; Chawla, Sanjeev; Lu, Hanzhang; Pape, Louise; Ge, Yulin

    2016-12-01

    Cerebrovascular reactivity measures vascular regulation of cerebral blood flow and is responsible for maintaining healthy neurovascular coupling. Multiple sclerosis exhibits progressive neurodegeneration and global cerebrovascular reactivity deficits. This study investigates varied degrees of cerebrovascular reactivity impairment in different brain networks, which may be an underlying cause for functional changes in the brain, affecting long-distance projection integrity and cognitive function; 28 multiple sclerosis and 28 control subjects underwent pseudocontinuous arterial spin labeling perfusion MRI to measure cerebral blood flow under normocapnia (room air) and hypercapnia (5% carbon dioxide gas mixture) breathing. Cerebrovascular reactivity, measured as normocapnic to hypercapnic cerebral blood flow percent increase normalized by end-tidal carbon dioxide change, was determined from seven functional networks (default mode, frontoparietal, somatomotor, visual, limbic, dorsal, and ventral attention networks). Group analysis showed significantly decreased cerebrovascular reactivity in patients compared to controls within the default mode, frontoparietal, somatomotor, and ventral attention networks after multiple comparison correction. Regression analysis showed a significant correlation of cerebrovascular reactivity with lesion load in the default mode and ventral attention networks and with gray matter atrophy in the default mode network. Functional networks in multiple sclerosis patients exhibit varied amounts of cerebrovascular reactivity deficits. Such blood flow regulation abnormalities may contribute to functional communication disruption in multiple sclerosis.

  5. Low Alberta Stroke Program Early CT score (ASPECTS) associated with malignant middle cerebral artery infarction.

    PubMed

    MacCallum, Caroline; Churilov, Leonid; Mitchell, Peter; Dowling, Richard; Yan, Bernard

    2014-01-01

    Early decompressive hemicraniectomy following malignant middle cerebral artery (MCA) infarction reduces mortality and improves clinical outcome. Imaging predictors of malignant infarction may serve as 'red flags', prompting intensive neurological monitoring and timely intervention. Our objective is to investigate whether lower ASPECTS (Alberta Stroke Program Early CT Score) is associated with malignant MCA infarction. A retrospective cohort study of all patients with MCA territory ischemic strokes who were admitted to the Royal Melbourne Hospital (RMH) between 1 January 2009 and 31 December 2009 (226 patients included). The main outcome measures were ASPECTS on admission for each patient and the development of malignant MCA infarction. One-hundred-and-eight patients out of 226 (48%) developed malignant MCA infarction. Good (>0.8) inter-rater agreement between observers scoring ASPECTS was observed using weighted kappa, intra-class correlation coefficient and Lin's concordance coefficients. Using receiver operating characteristic (ROC) curve analysis, we validated that ASPECTS 7 was the optimal cut-off score to determine progression to malignant infarction, providing 50% sensitivity and 86% specificity. One hundred and fifty six patients had ASPECTS >7 (69%) and 70 patients had ASPECTS ≤7 (31%). Patients with ASPECTS ≤7 were significantly younger than those with ASPECTS >7, with the median age of each group being 72.5 and 78 respectively (p = 0.02); otherwise the groups were well-matched. With ASPECTS ≤7, 54 out of 70 patients (77%) developed malignant MCA infarction, compared with 54 out of 156 patients (35%) with ASPECTS >7 (age-adjusted OR = 0.12, 95% CI: 0.06, 0.25; p < 0.0001). If ASPECTS ≤7 is a positive result, then the positive predictive value is 77% and the negative predictive value is 65%. The median ASPECTS for developing malignant MCA infarction was 7.5 (IQR: 5 to 10), while the median ASPECTS for not developing MCA infarction was 10 (IQR: 8 to

  6. Screening for Cognitive Impairment by Model Assisted Cerebral Blood Flow Estimation.

    PubMed

    Lassila, Toni; Di Marco, Luigi Yuri; Mitolo, Micaela; Iaia, Vincenzo; Levedianos, Giorgio; Venneri, Annalena; Frangi, Alejandro F

    2017-10-05

    Alzheimer's disease (AD) is a progressive and debilitating neurodegenerative disease; a major health concern in the ageing population with an estimated prevalence of 46 million dementia cases worldwide. Early diagnosis is therefore crucial so mitigating treatments can be initiated at an early stage. Cerebral hypoperfusion has been linked with blood-brain barrier dysfunction in the early stages of AD, and screening for chronic cerebral hypoperfusion in individuals has been proposed for improving the early diagnosis of AD. However, ambulatory measurements of cerebral blood flow are not routinely carried out in the clinical setting. In this study, we combine physiological modelling with Holter blood pressure monitoring and carotid ultrasound imaging to predict 24-hour cerebral blood flow (CBF) profiles in individuals. One hundred and three participants (53 with mild cognitive impairment (MCI), 50 healthy controls) underwent model-assisted prediction of 24-hour CBF. Model-predicted CBF and neuropsychological tests were features in lasso regression models for MCI diagnosis. A CBF-enhanced classifier for diagnosing MCI performed better, area-under-the-curve (AUC) = 0.889 (95%-CI: 0.800 to 0.978), than a classifier based only on the neuropsychological test scores, AUC = 0.818 (95%-CI: 0.643 to 0.992). An additional cohort of 25 participants (11 MCI, 14 healthy) was recruited to perform model validation by arterial spin-labelling magnetic resonance imaging and to establish a link between measured CBF and that predicted by the model. Ultrasound imaging and ambulatory blood pressure measurements enhanced with physiological modelling can improve MCI diagnosis accuracy.

  7. Effect of Vestibular Impairment on Cerebral Blood Flow Response to Dynamic Roll Tilt

    NASA Technical Reports Server (NTRS)

    Serrador, J. M.; Black, F. O.; Schlgel, Todd T.; Lipsitz, L. A.; Wood, S. J.

    2008-01-01

    Change to upright posture results in reductions in cerebral perfusion pressure due to hydrostatic pressure changes related to gravity. Since vestibular organs, specifically the otoliths, provide information on position relative to gravity, vestibular inputs may assist in adaptation to the upright posture. The goal of this study was to examine the effect of direct vestibular stimulation on cerebral blood flow (CBF). To examine the role of otolith inputs we screened 165 subjects for vestibular function and classified subjects as either normal or impaired based on ocular torsion. Ocular torsion, an indication of otolith function, was assessed during sinusoidal roll tilt of 20 degrees at 0.01 Hz (100 sec per cycle). Subjects with torsion one SD below the mean were classified as impaired while subjects one SD above the mean were considered normal. During one session subjects were placed in a chair that was sinusoidally rotated 25 degrees in the roll plane at five frequencies: 0.25 & 0.125 Hz for 80 sec, 0.0625 Hz for 160 sec and 0.03125 Hz and 0.015625 Hz for 320 sec. During testing, CBF (transcranial Doppler), blood pressure (Finapres), and end tidal CO2 (Puritan Bennet) were measured continuously. Ocular torsion was assessed from infrared images of the eyes. All rotations were done in the dark with subjects fixated on a red LED directly at the center of rotation. In the normal group, dynamic tilt resulted in significant changes in both blood pressure and cerebral blood flow velocity that was related to the frequency of stimulus. In contrast the impaired group did not show similar patterns. As expected normal subjects demonstrated significant ocular torsion that was related to stimulus frequency while impaired subjects had minimal changes. These data suggest that vestibular inputs have direct effects on cerebral blood flow regulation during dynamic tilt. Supported by NASA.

  8. Effect of Vestibular Impairment on Cerebral Blood Flow Response to Dynamic Roll Tilt

    NASA Technical Reports Server (NTRS)

    Serrador, J. M.; Black, F. O.; Schlgel, Todd T.; Lipsitz, L. A.; Wood, S. J.

    2008-01-01

    Change to upright posture results in reductions in cerebral perfusion pressure due to hydrostatic pressure changes related to gravity. Since vestibular organs, specifically the otoliths, provide information on position relative to gravity, vestibular inputs may assist in adaptation to the upright posture. The goal of this study was to examine the effect of direct vestibular stimulation on cerebral blood flow (CBF). To examine the role of otolith inputs we screened 165 subjects for vestibular function and classified subjects as either normal or impaired based on ocular torsion. Ocular torsion, an indication of otolith function, was assessed during sinusoidal roll tilt of 20 degrees at 0.01 Hz (100 sec per cycle). Subjects with torsion one SD below the mean were classified as impaired while subjects one SD above the mean were considered normal. During one session subjects were placed in a chair that was sinusoidally rotated 25 degrees in the roll plane at five frequencies: 0.25 & 0.125 Hz for 80 sec, 0.0625 Hz for 160 sec and 0.03125 Hz and 0.015625 Hz for 320 sec. During testing, CBF (transcranial Doppler), blood pressure (Finapres), and end tidal CO2 (Puritan Bennet) were measured continuously. Ocular torsion was assessed from infrared images of the eyes. All rotations were done in the dark with subjects fixated on a red LED directly at the center of rotation. In the normal group, dynamic tilt resulted in significant changes in both blood pressure and cerebral blood flow velocity that was related to the frequency of stimulus. In contrast the impaired group did not show similar patterns. As expected normal subjects demonstrated significant ocular torsion that was related to stimulus frequency while impaired subjects had minimal changes. These data suggest that vestibular inputs have direct effects on cerebral blood flow regulation during dynamic tilt. Supported by NASA.

  9. The effect of carotid endarterectomy on cerebral blood flow and cognitive function.

    PubMed

    Ghogawala, Zoher; Amin-Hanjani, Sepideh; Curran, Jill; Ciarleglio, Maria; Berenstein, Alejandro; Stabile, Lauren; Westerveld, Michael

    2013-10-01

    The effect of carotid endarterectomy on cognitive function is not fully understood. This study aims to characterize changes in cerebral blood flow after carotid endarterectomy and to determine if patients with improvement in cerebral blood flow have improved cognitive function after endarterectomy. Cerebral blood flow was measured preoperatively and 1 month postoperatively using phase contrast magnetic resonance angiography. Preoperative flow impairment was defined as ipsilateral flow at least 20% less than contralateral flow. Improvement in flow was defined as an absolute increase of at least 0.10 in flow ratio from pre- to postoperative assessments. Patients underwent cognitive testing preoperatively and at 1, 6, and 12 months postoperatively. Twenty-four patients with unilateral carotid stenosis were enrolled from 3 sites. Preoperative internal carotid artery (ICA) and middle cerebral artery (MCA) flow impairment was observed in 50% and 22% of patients, respectively. Patients with preoperative flow impairment had an average of 0.25 and 0.16 absolute improvement in flow ratio in the ICA and MCA vessels, respectively; this was statistically significant for patients with baseline ICA flow impairment (P < .01). One hundred percent of patients with improvement in MCA flow had a significant improvement in attention compared to 56% of patients without MCA flow improvement (P = .06). Clinically significant improvements in all 4 cognitive domains were observed at 1 year (P < .01). Patients with baseline impairment of MCA blood flow were more likely to experience improvement in flow after revascularization. Improvement in MCA blood flow was associated with greater cognitive improvement in attention and executive functioning. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  10. Positron emission tomography in the newborn: extensive impairment of regional cerebral blood flow with intraventricular hemorrhage and hemorrhagic intracerebral involvement

    SciTech Connect

    Volpe, J.J.; Herscovitch, P.; Perlman, J.M.; Raichle, M.E.

    1983-11-01

    Positron emission tomography (PET) now provides the capability of measuring regional cerebral blood flow with high resolution and little risk. In this study, we utilized PET in six premature infants (920 to 1,200 g) with major intraventricular hemorrhage and hemorrhagic intracerebral involvement to measure regional cerebral blood flow during the acute period (5 to 17 days of age). Cerebral blood flow was determined after intravenous injection of H/sub 2/O, labeled with the positron-emitting isotope, /sup 15/O. Findings were similar and dramatic in all six infants. In the area of hemorrhagic intracerebral involvement, little or no cerebral blood flow was detected. However, in addition, surprisingly, a marked two- to fourfold reduction in cerebral blood flow was observed throughout the affected hemisphere, well posterior and lateral to the intracerebral hematoma, including cerebral white matter and, to a lesser extent, frontal, temporal, and parietal cortex. In the one infant studied a second time, ie, at 3 months of age, the extent and severity of the decreased cerebral blood flows in the affected hemisphere were similar to those observed on the study during the neonatal period. At the three autopsies, the affected left hemisphere showed extensive infarction, corroborating the PET scans. These observations, the first demonstration of the use of PET in the determination of regional cerebral blood flow in the newborn, show marked impairments in regional cerebral blood flow in the hemisphere containing an apparently restricted intracerebral hematoma, indicating that the hemorrhagic intracerebral involvement is only a component of a much larger lesion, ischemic in basic nature, ie, an infarction. This large ischemic lesion explains the poor neurologic outcome in infants with intraventricular hemorrhage and hemorrhagic intracerebral involvement.

  11. Blood flow in the cerebral venous system: modeling and simulation.

    PubMed

    Miraucourt, Olivia; Salmon, Stéphanie; Szopos, Marcela; Thiriet, Marc

    2017-04-01

    The development of a software platform incorporating all aspects, from medical imaging data, through three-dimensional reconstruction and suitable meshing, up to simulation of blood flow in patient-specific geometries, is a crucial challenge in biomedical engineering. In the present study, a fully three-dimensional blood flow simulation is carried out through a complete rigid macrovascular circuit, namely the intracranial venous network, instead of a reduced order simulation and partial vascular network. The biomechanical modeling step is carefully analyzed and leads to the description of the flow governed by the dimensionless Navier-Stokes equations for an incompressible viscous fluid. The equations are then numerically solved with a free finite element software using five meshes of a realistic geometry obtained from medical images to prove the feasibility of the pipeline. Some features of the intracranial venous circuit in the supine position such as asymmetric behavior in merging regions are discussed.

  12. Light controls cerebral blood flow in naive animals

    PubMed Central

    Rungta, Ravi L; Osmanski, Bruno-Félix; Boido, Davide; Tanter, Mickael; Charpak, Serge

    2017-01-01

    Optogenetics is increasingly used to map brain activation using techniques that rely on functional hyperaemia, such as opto-fMRI. Here we test whether light stimulation protocols similar to those commonly used in opto-fMRI or to study neurovascular coupling modulate blood flow in mice that do not express light sensitive proteins. Combining two-photon laser scanning microscopy and ultrafast functional ultrasound imaging, we report that in the naive mouse brain, light per se causes a calcium decrease in arteriolar smooth muscle cells, leading to pronounced vasodilation, without excitation of neurons and astrocytes. This photodilation is reversible, reproducible and energy-dependent, appearing at about 0.5 mJ. These results impose careful consideration on the use of photo-activation in studies involving blood flow regulation, as well as in studies requiring prolonged and repetitive stimulations to correct cellular defects in pathological models. They also suggest that light could be used to locally increase blood flow in a controlled fashion. PMID:28139643

  13. Cerebral Blood Volume ASPECTS Is the Best Predictor of Clinical Outcome in Acute Ischemic Stroke: A Retrospective, Combined Semi-Quantitative and Quantitative Assessment

    PubMed Central

    Padroni, Marina; Bernardoni, Andrea; Tamborino, Carmine; Roversi, Gloria; Borrelli, Massimo; Saletti, Andrea; De Vito, Alessandro; Azzini, Cristiano; Borgatti, Luca; Marcello, Onofrio; d’Esterre, Christopher; Ceruti, Stefano; Casetta, Ilaria; Lee, Ting-Yim; Fainardi, Enrico

    2016-01-01

    Introduction The capability of CT perfusion (CTP) Alberta Stroke Program Early CT Score (ASPECTS) to predict outcome and identify ischemia severity in acute ischemic stroke (AIS) patients is still questioned. Methods 62 patients with AIS were imaged within 8 hours of symptom onset by non-contrast CT, CT angiography and CTP scans at admission and 24 hours. CTP ASPECTS was calculated on the affected hemisphere using cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) maps by subtracting 1 point for any abnormalities visually detected or measured within multiple cortical circular regions of interest according to previously established thresholds. MTT-CBV ASPECTS was considered as CTP ASPECTS mismatch. Hemorrhagic transformation (HT), recanalization status and reperfusion grade at 24 hours, final infarct volume at 7 days and modified Rankin scale (mRS) at 3 months after onset were recorded. Results Semi-quantitative and quantitative CTP ASPECTS were highly correlated (p<0.00001). CBF, CBV and MTT ASPECTS were higher in patients with no HT and mRS≤2 and inversely associated with final infarct volume and mRS (p values: from p<0.05 to p<0.00001). CTP ASPECTS mismatch was slightly associated with radiological and clinical outcomes (p values: from p<0.05 to p<0.02) only if evaluated quantitatively. A CBV ASPECTS of 9 was the optimal semi-quantitative value for predicting outcome. Conclusions Our findings suggest that visual inspection of CTP ASPECTS recognizes infarct and ischemic absolute values. Semi-quantitative CBV ASPECTS, but not CTP ASPECTS mismatch, represents a strong prognostic indicator, implying that core extent is the main determinant of outcome, irrespective of penumbra size. PMID:26824672

  14. Vertigo-related cerebral blood flow changes on magnetic resonance imaging.

    PubMed

    Chang, Feiyan; Li, Zhongshi; Xie, Sheng; Liu, Hui; Wang, Wu

    2014-11-01

    A prospective study using magnetic resonance imaging on a consecutive cohort of patients with cervical vertigo. To quantitatively investigate the cerebral blood flow (CBF) changes associated with cervical vertigo by using 3-dimensional pseudocontinuous arterial spin labeling. Previous studies reported blood flow velocity reduction in posterior circulation during vertigo. However, the detailed information of CBF related to cervical vertigo has not been provided. A total of 33 patients with cervical vertigo and 14 healthy volunteers were recruited in this study. Three-dimensional pseudocontinuous arterial spin labeling was performed on each subject to evaluate the CBF before and after the cervical hyperextension-hyperflexion movement tests, which was used to induce cervical vertigo. Repeated-measures analysis of variance was conducted to assess the effect of subjects and tests. There were time effects of CBF in the territory of bilateral superior cerebellar artery, bilateral posterior cerebral artery, bilateral middle cerebral artery, and right anterior cerebral artery, but no group effect was observed. The analysis of CBF revealed a significant main effect of tests (P=0.024) and participants (P=0.038) in the dorsal pons. Cervical vertigo onset may be related to CBF reduction in the dorsal pons, which sequentially evokes the vestibular nuclei. 2.

  15. OBESITY INCREASES BLOOD PRESSURE, CEREBRAL VASCULAR REMODELING, AND SEVERITY OF STROKE IN THE ZUCKER RAT

    PubMed Central

    Osmond, Jessica M.; Mintz, James D.; Dalton, Brian; Stepp, David W.

    2009-01-01

    Obesity is a risk factor for stroke, but the mechanisms by which obesity increases stroke risk are unknown. Because microvascular architecture contributes to the outcome of stroke, we hypothesized that middle cerebral arteries (MCA) from obese Zucker rats (OZR) undergo inward remodeling and develop increased myogenic tone compared to lean Zucker rats (LZR). We further hypothesized that OZR have an increased infarct following cerebral ischemia and that changes in vascular structure and function correlate with the development of hypertension in OZR. Blood pressure was measured by telemetery in LZR and OZR from 6 to 17 weeks of age. Vessel structure and function were assessed in isolated MCAs. Stroke damage was assessed after ischemia was induced for 60 minutes followed by 24 hours of reperfusion. While mean arterial pressure (MAP) was similar between young rats (6–8 weeks old), MAP was higher in adult (14–17 weeks old) OZR than LZR. MCAs from OZR had a smaller lumen diameter and increased myogenic vasoconstriction compared to those from LZR. Following ischemia, infarction was 58% larger in OZR than LZR. Prior to the development of hypertension, MCA myogenic reactity and lumen diameter as well as infarct size were similar between young LZR and OZR. Our results indicate that the MCAs of OZR undergo structural remodeling and that these rats have greater cerebral injury following cerebral ischemia. These cerebrovascular changes correlate with the development of hypertension and suggest that the increased blood pressure may be the major determinant for stroke risk in obese individuals. PMID:19104000

  16. Reversible cerebral vasoconstriction syndrome following red blood cells transfusion: a case series of 7 patients.

    PubMed

    Liang, Hui; Xu, Ziqi; Zheng, Zhijun; Lou, Haiyan; Yue, Wei

    2015-04-22

    Reversible cerebral vasoconstriction syndrome (RCVS) is an infrequent disease characterized by severe headaches with or without focal neurological deficits or seizures and a reversible vasoconstriction of cerebral arteries. The Orpha number for RCVS is ORPHA284388. However, RCVS triggered by blood transfusion is rare. Here we provided the clinical, neuroimaging and outcome data of patients diagnosed with RCVS resulting from red blood cells transfusion. We retrospectively identified 7 patients presenting with RCVS after red blood cells transfusion from January 2010 to May 2014. The information on clinical features, neuroimaging and outcome were collected and analyzed. All 7 patients were Chinese women, with a mean age of 42 years (38-46). All the patients had severe anemia (Hb level < 6 g/dl) caused by primary menorrhagia due to uterine myoma (n = 5) or end-stage renal disease (n = 2) and severe anemia persisted for a average period of 4 months (2-6). Each patient received packed red blood cells transfusion (average: 1580 ml) over a period of 2-5 days. Blood transfusion increased the hemoglobin level by at least 4.5 g/dL from baseline. The neurological symptoms appeared a mean of 6.3 days (2-13) after the last blood transfusion. Headache was the most frequent symptom and seizure, transient or persistent neurological disorders were observed. Neuroimaging showed cortical subarachnoid hemorrhage (n = 2), focal intracerebral hemorrhage (n = 2), localized brain edema (n = 3), cerebral infarction (n = 1), and posterior reversible encephalopathy syndrome (n = 2). Cerebral vasoconstrictions were demonstrated by magnetic resonance angiography or cerebral angiography. Arterial constriction reversed in all patients within 1 to 3 months of follow-up after disease onset and no relapse was observed up to a mean of 17.1 ± 4.8 months of follow-up. RCVS is a rare complication as a result of blood transfusion in patients with chronic

  17. Assessment of cerebral blood flow autoregulation (CBF AR) with rheoencephalography (REG): studies in animals

    NASA Astrophysics Data System (ADS)

    Popovic, Djordje; Bodo, Michael; Pearce, Frederick; van Albert, Stephen; Garcia, Alison; Settle, Tim; Armonda, Rocco

    2013-04-01

    The ability of cerebral vasculature to regulate cerebral blood flow (CBF) in the face of changes in arterial blood pressure (SAP) or intracranial pressure (ICP) is an important guard against secondary ischemia in acute brain injuries, and official guidelines recommend that therapeutic decisions be guided by continuous monitoring of CBF autoregulation (AR). The common method for CBF AR monitoring, which rests on real-time derivation of the correlation coefficient (PRx) between slow oscillations in SAP and ICP is, however, rarely used in clinical practice because it requires invasive ICP measurements. This study investigated whether the correlation coefficient between SAP and the pulsatile component of the non-invasive transcranial bioimpedance signal (rheoencephalography, REG) could be used to assess the state and lower limit of CBF AR. The results from pigs and rhesus macaques affirm the utility of REG; however, additional animal and clinical studies are warranted to assess selectivity of automatic REG-based evaluation of CBF AR.

  18. Application of thinned-skull cranial window to mouse cerebral blood flow imaging using optical microangiography.

    PubMed

    Li, Yuandong; Baran, Utku; Wang, Ruikang K

    2014-01-01

    In vivo imaging of mouse brain vasculature typically requires applying skull window opening techniques: open-skull cranial window or thinned-skull cranial window. We report non-invasive 3D in vivo cerebral blood flow imaging of C57/BL mouse by the use of ultra-high sensitive optical microangiography (UHS-OMAG) and Doppler optical microangiography (DOMAG) techniques to evaluate two cranial window types based on their procedures and ability to visualize surface pial vessel dynamics. Application of the thinned-skull technique is found to be effective in achieving high quality images for pial vessels for short-term imaging, and has advantages over the open-skull technique in available imaging area, surgical efficiency, and cerebral environment preservation. In summary, thinned-skull cranial window serves as a promising tool in studying hemodynamics in pial microvasculature using OMAG or other OCT blood flow imaging modalities.

  19. The Cerebral Blood Flow Biomedical Informatics Research Network (CBFBIRN) data repository.

    PubMed

    Shin, David D; Ozyurt, I Burak; Brown, Gregory G; Fennema-Notestine, Christine; Liu, Thomas T

    2016-01-01

    Arterial spin labeling (ASL) MRI provides an accurate and reliable measure of cerebral blood flow (CBF). A rapidly growing number of CBF measures are being collected both in clinical and research settings around the world, resulting in a large volume of data across a wide spectrum of study populations and health conditions. Here, we describe a central CBF data repository with integrated processing workflows, referred to as the Cerebral Blood Flow Biomedical Informatics Research Network (CBFBIRN). The CBFBIRN provides an integrated framework for the analysis and comparison of CBF measures across studies and sites. In this work, we introduce the main capabilities of the CBFBIRN (data storage, processing, and sharing), describe what types of data are available, explain how users can contribute to the data repository and access existing data from it, and discuss our long-term plans for the CBFBIRN.

  20. Application of Thinned-Skull Cranial Window to Mouse Cerebral Blood Flow Imaging Using Optical Microangiography

    PubMed Central

    Wang, Ruikang K.

    2014-01-01

    In vivo imaging of mouse brain vasculature typically requires applying skull window opening techniques: open-skull cranial window or thinned-skull cranial window. We report non-invasive 3D in vivo cerebral blood flow imaging of C57/BL mouse by the use of ultra-high sensitive optical microangiography (UHS-OMAG) and Doppler optical microangiography (DOMAG) techniques to evaluate two cranial window types based on their procedures and ability to visualize surface pial vessel dynamics. Application of the thinned-skull technique is found to be effective in achieving high quality images for pial vessels for short-term imaging, and has advantages over the open-skull technique in available imaging area, surgical efficiency, and cerebral environment preservation. In summary, thinned-skull cranial window serves as a promising tool in studying hemodynamics in pial microvasculature using OMAG or other OCT blood flow imaging modalities. PMID:25426632

  1. The Cerebral Blood Flow Biomedical Informatics Research Network (CBFBIRN) Data Repository

    PubMed Central

    Shin, David D.; Ozyurt, I. Burak; Brown, Gregory G.; Fennema-Notestine, Christine; Liu, Thomas T.

    2015-01-01

    Arterial spin labeling (ASL) MRI provides an accurate and reliable measure of cerebral blood flow (CBF). A rapidly growing number of CBF measures are being collected both in clinical and research settings around the world, resulting in a large volume of data across a wide spectrum of study populations and health conditions. Here, we describe a central CBF data repository with integrated processing workflows, referred to as the Cerebral Blood Flow Biomedical Informatics Research Network (CBFBIRN). The CBFBIRN provides an integrated framework for the analysis and comparison of CBF measures across studies and sites. In this work, we introduce the main capabilities of the CBFBIRN (data storage, processing and sharing), describe what types of data are available, explain how users can contribute to the data repository and access existing data from it, and discuss our long term plans for the CBFBIRN. PMID:26032887

  2. Do GSM 900MHz signals affect cerebral blood circulation? A near-infrared spectrophotometry study

    NASA Astrophysics Data System (ADS)

    Wolf, Martin; Haensse, Daniel; Morren, Geert; Froehlich, Juerg

    2006-06-01

    Effects of GSM 900MHz signals (EMF) typical for a handheld mobile phone on the cerebral blood circulation were investigated using near-infrared spectrophotometry (NIRS) in a three armed (12W/kg, 1.2W/kg, sham), double blind, randomized crossover trial in 16 healthy volunteers. During exposure we observed borderline significant short term responses of oxyhemoglobin and deoxyhemoglobin concentration, which correspond to a decrease of cerebral blood flow and volume and were smaller than regular physiological changes. Due to the relatively high number of statistical tests, these responses may be spurious and require further studies. There was no detectable dose-response relation or long term response within 20min. The detection limit was a fraction of the regular physiological changes elicited by functional activation. Compared to previous studies using PET, NIRS provides a much higher time resolution, which allowed investigating the short term effects efficiently, noninvasively, without the use of radioactive tracers and with high sensitivity.

  3. Measurement of cerebral blood flow rate and its relationship with brain function using optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Liu, Jian; Wang, Yi; Zhao, Yuqian; Dou, Shidan; Ma, Yushu; Ma, Zhenhe

    2016-03-01

    Activity of brain neurons will lead to changes in local blood flow rate (BFR). Thus, it is important to measure the local BFR of cerebral cortex on research of neuron activity in vivo, such as rehabilitation evaluation after stroke, etc. Currently, laser Doppler flowmetry is commonly used for blood flow measurement, however, relatively low resolution limits its application. Optical coherence tomography (OCT) is a powerful noninvasive 3D imaging modality with high temporal and spatial resolutions. Furthermore, OCT can provide flow distribution image by calculating Doppler frequency shift which makes it possible for blood flow rate measurement. In this paper, we applied OCT to measure the blood flow rate of the primary motor cortex in rats. The animal was immobilized and anesthetized with isoflurane, an incision was made along the sagittal suture, and bone was exposed. A skull window was opened on the primary motor cortex. Then, blood flow rate changes in the primary motor cortex were monitored by our homemade spectral domain OCT with a stimulation of the passive movement of the front legs. Finally, we established the relationship between blood flow rate and the test design. The aim is to demonstrate the potential of OCT in the evaluation of cerebral cortex function.

  4. A radiographic study of circulatory times of the cerebral blood flow.

    PubMed

    Fagulă, J; Sulla, I

    1985-01-01

    The authors studied circulatory times of the cerebral blood flow by means of radiocirculography (RCG). The mean value of the RCG curve was 20 s in 27 examined control persons, 22 s (increase by 2 s) in 24 patients with light brain injury (commotio cerebri), 24 s (increase by 4 s) in 29 patients with severe injury (contusio cerebri et compressio cerebri), and 23 s (increase by 3 s) in 37 patients with brain tumor.

  5. Heritability and genome-wide associations studies of cerebral blood flow in the general population.

    PubMed

    Ikram, M Arfan; Zonneveld, Hazel I; Roshchupkin, Gennady; Smith, Albert V; Franco, Oscar H; Sigurdsson, Sigurdur; van Duijn, Cornelia; Uitterlinden, André G; Launer, Lenore J; Vernooij, Meike W; Gudnason, Vilmundur; Adams, Hieab Hh

    2017-06-19

    Cerebral blood flow is an important process for brain functioning and its dysregulation is implicated in multiple neurological disorders. While environmental risk factors have been identified, it remains unclear to what extent the flow is regulated by genetics. Here we performed heritability and genome-wide association analyses of cerebral blood flow in a population-based cohort study. We included 4472 persons free of cortical infarcts who underwent genotyping and phase-contrast magnetic resonance flow imaging (mean age 64.8 ± 10.8 years). The flow rate, cross-sectional area of the vessel, and flow velocity through the vessel were measured in the basilar artery and bilateral carotids. We found that the flow rate of the basilar artery is most heritable (h2 (SE) = 24.1 (9.8), p-value = 0.0056), and this increased over age. The association studies revealed two significant loci for the right carotid artery area (rs12546630, p-value = 2.0 × 10(-8)) and velocity (rs2971609, p-value = 1.4 × 10(-8)), with the latter showing a concordant effect in an independent sample (N = 1350, p-value = 0.057, meta-analyzed p-value = 2.5 × 10(-9)). These loci were also associated with other cerebral blood flow parameters below genome-wide significance, and rs2971609 lies in a known migraine locus. These findings establish that cerebral blood flow is under genetic control with potential relevance for neurological diseases.

  6. Computer simulation of cerebral blood flow in moyamoya and the results of surgical therapies.

    PubMed

    Charbel, F T; Misra, M; Clarke, M E; Ausman, J I

    1997-10-01

    Moyamoya is the disease which involves the terminal portions of the internal carotid or origins of the middle or anterior cerebral arteries. The posterior communicating arteries are also involved, but not the vertebrals or the basilar artery. The disease occurs more commonly in females than males and it has two age peaks at less than 10 and 40 years. Over the years many treatment options or procedures have been advocated for this disease either with direct bypasses or indirect revascularization procedures or both in combination. Whether one procedure is better than another is a matter of question and still to be determined. Along with it, there are various diagnostic and research work have been done for the etiology and the management of this disease. We have tried to implement a computer model of cerebral blood flow in order to assess and predict the flow in this disease process. At this time to know and predict the effectivity of certain types of offered treatment of Moyamoya disease is only to evaluate patients clinically with long term follow ups and at some interval after surgery with angiography or blood flow determinations. This study tries to focus on the use of computerized model of predicting cerebral blood flow which tries to assess the cerebral flow and decide which treatment option would be the best for a particular patient. After various computer simulations the blood flow following each treatment option is detected and the situation which offers the best treatment in a particular case is offered to the patient. To confirm the use of utility of this computer model a larger population of patients with Moyamoya disease need to be evaluated.

  7. Diffuse correlation spectroscopy for measurement of cerebral blood flow: future prospects

    PubMed Central

    Buckley, Erin M.; Parthasarathy, Ashwin B.; Grant, P. Ellen; Yodh, Arjun G.; Franceschini, Maria Angela

    2014-01-01

    Abstract. Diffuse correlation spectroscopy (DCS) is an emerging optical modality used to measure cortical cerebral blood flow. This outlook presents a brief overview of the technology, summarizing the advantages and limitations of the method, and describing its recent applications to animal, adult, and infant cohorts. At last, the paper highlights future applications where DCS may play a pivotal role individualizing patient management and enhancing our understanding of neurovascular coupling, activation, and brain development. PMID:25593978

  8. Inspiratory Resistance Delays the Reporting of Symptoms with Central Hypovolemia: Association with Cerebral Blood Flow

    DTIC Science & Technology

    2007-01-01

    were exposed to lower-body negative pressure (LBNP) until the presence of symptoms while breathing through either an active ITD (7 cmH2O impedance ) or...from several investigations have demonstrated the benefits of an inspiratory impedance threshold device (ITD) in elevating cerebral perfusion pressure... plethysmography with a Finometer blood pressure monitor (TNO- TPD; Biomedical Instrumentation, Amsterdam, The Netherlands). An appropriately sized

  9. Diffuse correlation spectroscopy for non-invasive, micro-vascular cerebral blood flow measurement

    PubMed Central

    Durduran, Turgut; Yodh, Arjun G.

    2013-01-01

    Diffuse correlation spectroscopy (DCS) uses the temporal fluctuations of near-infrared (NIR) light to measure cerebral blood flow (CBF) non-invasively. Here, we provide a brief history of DCS applications in brain with an emphasis on the underlying physical ideas, common instrumentation and validation. Then we describe recent clinical research that employs DCS-measured CBF as a biomarker of patient well-being, and as an indicator of hemodynamic and metabolic response to functional stimuli. PMID:23770408

  10. Diffuse optical correlation tomography of cerebral blood flow during cortical spreading depression in rat brain

    NASA Astrophysics Data System (ADS)

    Zhou, Chao; Yu, Guoqiang; Furuya, Daisuke; Greenberg, Joel; Yodh, Arjun; Durduran, Turgut

    2006-02-01

    Diffuse optical correlation methods were adapted for three-dimensional (3D) tomography of cerebral blood flow (CBF) in small animal models. The image reconstruction was optimized using a noise model for diffuse correlation tomography which enabled better data selection and regularization. The tomographic approach was demonstrated with simulated data and during in-vivo cortical spreading depression (CSD) in rat brain. Three-dimensional images of CBF were obtained through intact skull in tissues(~4mm) deep below the cortex.

  11. Influence on cerebral blood flow of infusion of sodium bicarbonate during respiratory acidosis and alkalosis in the dog.

    PubMed

    Arvidsson, S; Häggendal, E; Winsö, I

    1981-04-01

    In anaesthetized dogs, a mixed acid-base disturbance was induced by adding a pronounced metabolic alkaline to an established respiratory acidosis or alkalosis. Cerebral blood flow (CBF) was measured by the radioisotope washout method. In the hypocapnic dogs, the addition of metabolic alkalosis did not significantly change cerebral blood flow. In the hypercapnic dogs, the intravenous infusion of alkali led to a substantial reduction of cerebral blood flow, parallelled by a reduction of cerebrovenous oxygen tension. Acid-base analysis of cerebrospinal fluid (CSF) indicated an increased bicarbonate concentration. Hypercapnia is suggested to facilitate the passage of bicarbonate over the blood-brain barrier, leading to cerebral vasoconstriction by means of increased extravascular pH.

  12. Electroacupuncture induces acute changes in cerebral cortical miRNA profile, improves cerebral blood flow and alleviates neurological deficits in a rat model of stroke

    PubMed Central

    Zheng, Hai-zhen; Jiang, Wei; Zhao, Xiao-feng; Du, Jing; Liu, Pan-gong; Chang, Li-dan; Li, Wen-bo; Hu, Han-tong; Shi, Xue-min

    2016-01-01

    Electroacupuncture has been shown to improve cerebral blood flow in animal models of stroke. However, it is unclear whether electroacupuncture alters miRNA expression in the cortex. In this study, we examined changes in the cerebral cortical miRNA profile, cerebral blood flow and neurological function induced by electroacupuncture in a rat model of stroke. Electroacupuncture was performed at Renzhong (GV26) and Neiguan (PC6), with a frequency of 2 Hz, continuous wave, current intensity of 3.0 mA, and stimulation time of 1 minute. Electroacupuncture increased cerebral blood flow and alleviated neurological impairment in the rats. miRNA microarray profiling revealed that the vascular endothelial growth factor signaling pathway, which links cell proliferation with stroke, was most significantly affected by electroacupuncture. Electroacupuncture induced changes in expression of rno-miR-206-3p, rno-miR-3473, rno-miR-6216 and rno-miR-494-3p, and these changes were confirmed by quantitative real-time polymerase chain reaction. Our findings suggest that changes in cell proliferation-associated miRNA expression induced by electroacupuncture might be associated with the improved cerebral blood supply and functional recovery following stroke. PMID:28197190

  13. Cerebral Blood Flow Velocity and Periventricular White Matter Hyperintensities in Type 2 Diabetes

    PubMed Central

    Novak, Vera; Last, David; Alsop, David C.; Abduljalil, Amir M.; Hu, Kun; Lepicovsky, Lukas; Cavallerano, Jerry; Lipsitz, Lewis A.

    2007-01-01

    OBJECTIVE Diabetes increases the risk for cerebromicrovascular disease, possibly through its effects on blood flow regulation. The aim of this study was to assess the effects of type 2 diabetes on blood flow velocities (BFVs) in the middle cerebral arteries and to determine the relationship between white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) and BFVs. RESEARCH DESIGN AND METHODS We measured BFVs in 28 type 2 diabetic and 22 control subjects (aged 62.3 ± 7.2 years) using transcranial Doppler ultrasound during baseline, hyperventilation, and CO2 rebreathing. WMHs were graded, and their volume was quantified from fluid-attenuated inversion recovery images on a 3.0 Tesla MRI. RESULTS The diabetic group demonstrated decreased mean BFVs and increased cerebrovascular resistance during baseline, hypo- and hypercapnia (P < 0.0001), and impaired CO2 reactivity (P = 0.05). WMH volume was negatively correlated with baseline BFV (P < 0.0001). A regression model revealed that baseline BFVs were negatively associated with periventricular WMHs, HbA1c (A1C), and inflammatory markers and positively associated with systolic blood pressure (R2 = 0.86, P < 0.0001). CONCLUSIONS Microvascular disease in type 2 diabetes, which manifests as white matter abnormalities on MRI, is associated with reduced cerebral BFVs, increased resistance in middle cerebral arteries, and inflammation. These findings are clinically relevant as a potential mechanism for cerebrovascular disease in elderly with type 2 diabetes. PMID:16801574

  14. Transcranial imaging of functional cerebral hemodynamic changes in single blood vessels using in vivo photoacoustic microscopy

    PubMed Central

    Liao, Lun-De; Lin, Chin-Teng; Shih, Yen-Yu I; Duong, Timothy Q; Lai, Hsin-Yi; Wang, Po-Hsun; Wu, Robby; Tsang, Siny; Chang, Jyh-Yeong; Li, Meng-Lin; Chen, You-Yin

    2012-01-01

    Optical imaging of changes in total hemoglobin concentration (HbT), cerebral blood volume (CBV), and hemoglobin oxygen saturation (SO2) provides a means to investigate brain hemodynamic regulation. However, high-resolution transcranial imaging remains challenging. In this study, we applied a novel functional photoacoustic microscopy technique to probe the responses of single cortical vessels to left forepaw electrical stimulation in mice with intact skulls. Functional changes in HbT, CBV, and SO2 in the superior sagittal sinus and different-sized arterioles from the anterior cerebral artery system were bilaterally imaged with unambiguous 36 × 65-μm2 spatial resolution. In addition, an early decrease of SO2 in single blood vessels during activation (i.e., ‘the initial dip') was observed. Our results indicate that the initial dip occurred specifically in small arterioles of activated regions but not in large veins. This technique complements other existing imaging approaches for the investigation of the hemodynamic responses in single cerebral blood vessels. PMID:22472612

  15. Middle cerebral artery blood flow velocity in elite power athletes during maximal weight-lifting.

    PubMed

    Dickerman, R D; McConathy, W J; Smith, G H; East, J W; Rudder, L

    2000-06-01

    Cerebral blood flow velocity (CBFV) has been shown to significantly increase during dynamic exercise (running) secondary to increases in cardiac output. Static exercise (weight-lifting) induces supraphysiological arterial pressures up to 450/380 mmHg, and thus may alter CBFV. Catastrophic brain injuries such as stroke, cerebral hemorrhage, subarachnoid hemorrhage, retinal hemorrhage and retinal detachment have been associated with weight-lifting. A recent study has shown that intra-ocular pressure (IOP), which is an indirect measure of intracranial pressure, elevates to pathophysiologic levels during weight-lifting. Recent CBFV studies instituting Valsalva have demonstrated decreases in CBFV from 21%-52%. To date, no studies have examined CBFV during maximal weight-lifting to elucidate the cerebrovascular responses to extreme pressure alterations. We recruited nine elite power athletes, including a multi-world record holder in powerlifting, for a transcranial Doppler study of middle cerebral artery blood flow velocity at rest and during maximal weight-lifting. All subjects' resting blood flow velocities were within normal ranges (mean 64.4 +/- 9.5 cm sec2). Blood flow velocities were significantly (p < 0.0001) decreased in all subjects during maximal lifting (mean 48.4 +/- 10.1 cm sec2). Linear regression analysis demonstrated a significant inverse linear relationship in the net change of blood velocities from rest to maximal lift for each subject (r = 0.8585, p < 0.001). This study demonstrates that blood flow velocities are significantly decreased during heavy resistance training. The drop in CBFV during weight-lifting was significantly less than previous Valsalva studies, which likely reveals the cardiovascular, baroreflex, and cerebrovascular system adaptations occurring in these elite power athletes.

  16. Analysis of Cerebral Blood Flow from Small Rodents

    NASA Astrophysics Data System (ADS)

    Lehmpfuhl, Monika; Gaudnek, Andre; Hess, Andreas; Sibila, Michael

    The exact knowledge of the blood vessel geometry plays an important role, not only in clinical applications (stroke diagnosis, detection of stenosis), but also for detailed analysis of functional data, such as fMRI or optical imaging data. Here we focus on validating not only the geometry of the extracted vascular pattern, but also its function, namely the fluid dynamics. For validating angiographic data, phase contrast angiography (PC-MRA) sequences are used, as these data contain additionally to the morphological data rheological information. This rheological information can be used to validate the reconstructed geometric model of the vascular system, especially for the detection of missing vessels due to velocity changes in front of bifurcations.

  17. Comparison of the Effect of Vessel Size Imaging and Cerebral Blood Volume Derived from Perfusion MR Imaging on Glioma Grading.

    PubMed

    Kang, H-Y; Xiao, H-L; Chen, J-H; Tan, Y; Chen, X; Xie, T; Fang, J-Q; Wang, S; Yang, Y; Zhang, W-G

    2016-01-01

    Vascular proliferation is a major criterion for grading gliomas on the basis of histology. Relative cerebral blood volume can provide pathophysiologic information about glioma grading. Vessel size imaging, in some animals, can be used to estimate the microvascular caliber of a glioma, but its clinical use remains unclear. Herein, we aimed to compare the predictive power of relative cerebral blood volume and vessel size imaging in glioma grading, with grading based on histology. Seventy patients with glioma participated in the study; 30 patients underwent MR perfusion imaging with a spin-echo sequence and vessel size imaging with a gradient-echo and spin-echo sequence successively at 24-hour intervals before surgery. We analyzed the vessel size imaging values and relative cerebral blood volume of differently graded gliomas. The microvessel parameters were histologically evaluated and compared with those on MR imaging. The cutoff values of vessel size imaging and relative cerebral blood volume obtained from receiver operating characteristic curve analyses were used to predict glioma grading in another 40 patients. Vessel size imaging values and relative cerebral blood volume were both increased in high-grade gliomas compared with low-grade gliomas (P < .01). Moreover, vessel size imaging values had higher specificity and sensitivity in differentiating high-grade from low-grade gliomas compared with relative cerebral blood volume. In addition, a significant correlation was observed between vessel size imaging values and microvessel diameters (r > 0.8, P < .05) and between relative cerebral blood volume and microvessel area (r = 0.6579, P < .05). Most important, the use of vessel size imaging cutoff values to predict glioma grading was more accurate (100%) than use of relative cerebral blood volume (85%) values. Vessel size imaging can provide more accurate information on glioma grading and may serve as an effective biomarker for the prognosis of patients with gliomas

  18. Cerebrolysin effects on neurological outcomes and cerebral blood flow in acute ischemic stroke

    PubMed Central

    Amiri-Nikpour, Mohammad Reza; Nazarbaghi, Surena; Ahmadi-Salmasi, Babak; Mokari, Tayebeh; Tahamtan, Urya; Rezaei, Yousef

    2014-01-01

    Background Cerebrolysin, a brain-derived neuropeptide, has been shown to improve the neurological outcomes of stroke, but no study has demonstrated its effect on cerebral blood flow. This study aimed to determine the cerebrolysin impact on the neurological outcomes and cerebral blood flow. Methods In a randomized, double-blinded, placebo-controlled trial, 46 patients who had acute focal ischemic stroke were randomly assigned into two groups to receive intravenously either 30 mL of cerebrolysin diluted in normal saline daily for 10 days (n=23) or normal saline alone (n=23) adjunct to 100 mg of aspirin daily. All patients were examined using the National Institutes of Health Stroke Scale and transcranial Doppler to measure the mean flow velocity and pulsatility index (PI) of their cerebral arteries at baseline as well as on days 30, 60, and 90. Results The patients’ mean age was 60±9.7 years, and 51.2% of patients were male. The National Institutes of Health Stroke Scale was significantly lower in the cerebrolysin group compared with the placebo group on day 60 (median 10, interquartile range 9–11, P=0.008) and day 90 (median 11, interquartile range 10–13.5, P=0.001). The median of PI in the right middle cerebral artery was significantly lower in the cerebrolysin group compared with the placebo group on days 30, 60, and 90 (P<0.05). One patient in the cerebrolysin group and two patients in the placebo group died before day 30 (4.3% versus 8.7%). Conclusion Cerebrolysin can be useful to improve the neurological outcomes and the PI of middle cerebral artery in patients with acute focal ischemic stroke. PMID:25516711

  19. Inhibition of Rho Kinase (ROCK) Leads to Increased Cerebral Blood Flow and Stroke Protection

    PubMed Central

    Rikitake, Yoshiyuki; Kim, Hyung-Hwan; Huang, Zhihong; Seto, Minoru; Yano, Kazuo; Asano, Toshio; Moskowitz, Michael A.; Liao, James K.

    2009-01-01

    Background and Purpose Endothelium-derived nitric oxide (NO) plays a pivotal role in vascular protection. The Rho kinase (ROCK) inhibitor, hydroxyfasudil, prevents the downregulation of endothelial NO synthase (eNOS) under hypoxic conditions. However, it is unknown whether inhibition of ROCK can attenuate ischemia-induced endothelial dysfunction and tissue damage in vivo. Methods Human vascular endothelial cells were treated with increasing concentrations of hydroxyfasudil (0.1 to 100 μmol/L) and eNOS expression and activity were measured. To determine the physiological relevance of eNOS regulation by ROCK, we administered fasudil, which is metabolized to hydroxyfasudil in vivo, to mice for 2 days before subjecting them to middle cerebral artery occlusion. Cerebral blood flow, cerebral infarct size, and neurologic deficit were measured. Results In a concentration-dependent manner, hydroxyfasudil increased eNOS mRNA and protein expression, resulting in a 1.9- and 1.6-fold increase, respectively, at 10 μmol/L (P<0.05 for both). This correlated with a 1.5- and 2.3-fold increase in eNOS activity and NO production, respectively (P<0.05 for both). Fasudil increased cerebral blood flow to both ischemic and nonischemic brain areas, reduced cerebral infarct size by 33%, and improved neurologic deficit score by 37% (P<0.05). This correlated with inhibition of brain and vascular ROCK activity and increased eNOS expression and activity. Another ROCK inhibitor, Y-27632, also showed similar effects. The neuroprotective effects of fasudil were absent in eNOS-deficient mice. Conclusions These findings indicate that the neuroprotective effect of ROCK inhibition is mediated by endothelium-derived NO and suggest that ROCK may be an important therapeutic target for ischemic stroke. PMID:16141422

  20. [A five-element lumped-parameter model for cerebral blood flow autoregulation].

    PubMed

    Wang, Shengzhang; Yao, Wei; Ding, Guanghong

    2009-10-01

    Utilizing the third-order polynomial curve fitted to the experimental data, which represents the relationship between cerebral blood flow (CBF) and mean artery blood pressure (MABP), we constructed a lumped-parameter dynamic model with 5 elements. In this model; the resistance is not constants it is determined by the fitted curve. We simulated the process of CBF autoregulation numerically by solving the govern equation of this model and got quite accurate results. Furthermore, we studied the influence of hemodynamic parameters on the CBF autoregulation by this model and proved that the characteristic resistance is the most important factor.

  1. Initial Slope Index of Total Cerebral Blood Flow Measured by Hydrogen Clearance: A Pragmatic Evaluation

    DTIC Science & Technology

    1975-06-01

    An initial slope index of total cerebral blood flow, measured by hydrogen clearance from torcular blood, shows high correlation with flows calculated by bicompartmental analysis. In 247 flow measurements done on 41 rhesus monkeys, a linear regression analysis between these two methods of calculating flow shows a correlation coefficient of 0.9280 with a standard error about y values of plus or minus 7.63. The initial slope index is not only faster to calculate but does not require that a steady state be maintained for 10 minutes.

  2. Effect of propofol post-treatment on blood-brain barrier integrity and cerebral edema after transient cerebral ischemia in rats.

    PubMed

    Lee, Jae Hoon; Cui, Hui Song; Shin, Seo Kyung; Kim, Jeong Min; Kim, So Yeon; Lee, Jong Eun; Koo, Bon-Nyeo

    2013-11-01

    Although propofol has been reported to offer neuroprotection against cerebral ischemia injury, its impact on cerebral edema following ischemia is not clear. The objective of this investigation is to evaluate the effects of propofol post-treatment on blood-brain barrier (BBB) integrity and cerebral edema after transient cerebral ischemia and its mechanism of action, focusing on modulation of aquaporins (AQPs), matrix metalloproteinases (MMPs), and hypoxia inducible factor (HIF)-1α. Cerebral ischemia was induced in male Sprague-Dawley rats (n = 78) by occlusion of the right middle cerebral artery for 1 h. For post-treatment with propofol, 1 mg kg(-1) min(-1) of propofol was administered for 1 h from the start of reperfusion. Nineteen rats undergoing sham surgery were also included in the investigation. Edema and BBB integrity were assessed by quantification of cerebral water content and extravasation of Evans blue, respectively, following 24 h of reperfusion. In addition, the expression of AQP-1, AQP-4, MMP-2, and MMP-9 was determined 24 h after reperfusion and the expression of HIF-1α was determined 8 h after reperfusion. Propofol post-treatment significantly reduced cerebral edema (P < 0.05) and BBB disruption (P < 0.05) compared with the saline-treated control. The expression of AQP-1, AQP-4, MMP-2, and MMP-9 at 24 h and of HIF-1α at 8 h following ischemia/reperfusion was significantly suppressed in the propofol post-treatment group (P < 0.05). Propofol post-treatment attenuated cerebral edema after transient cerebral ischemia, in association with reduced expression of AQP-1, AQP-4, MMP-2, and MMP-9. The decreased expression of AQPs and MMPs after propofol post-treatment might result from suppression of HIF-1α expression.

  3. Insights into cerebrospinal fluid and cerebral blood flows in infants and young children.

    PubMed

    Capel, Cyrille; Makki, Malek; Gondry-Jouet, Catherine; Bouzerar, Roger; Courtois, Véronique; Krejpowicz, Bénédicte; Balédent, Olivier

    2014-12-01

    This study investigates the craniospinal flows of blood and cerebrospinal fluid using phase-contrast magnetic resonance imaging (MRI) on 23 control neonates and infants (5 d-68 mo old). Mean arterial cerebral blood flow increased with age of infant from 180 mL/min after birth to 1330 mL/min around 6 years of age. This corresponds to 51 mL/min/100 g and 95 mL/min/100 g, respectively. Cervical cerebrospinal fluid stroke volume increased from 38 × 10(-3) mL to 752 × 10(-3) mL per cardiac cycle. After arterial systolic blood inflow, we observed a delay of the venous outflow that was always preceded by cerebrospinal fluid flushing out through the spinal canal. These results highlighted the importance of compliance of the spinal compartment and the interaction of blood and cerebrospinal fluid dynamics. The capacity of the spinal compartment to receive intracranial cerebrospinal fluid in presence of fontanels was demonstrated. We provide reference values to understand the physiology of cerebrospinal fluid and cerebral blood.

  4. Assessment of Pre- and Post-Operative Cerebral Perfusion in Anterior Circulation Intracranial Aneurysm Clipping Patients at Hospital Sungai Buloh Using CT Perfusion Scan and Correlations to Fisher, Navarro and WFNS Scores.

    PubMed

    Ghani, Ailani Ab; Nayan, Saiful Azli Mat; Kandasamy, Regunath; Ghani, Abdul Rahman Izani; Rosman, Azmin Kass

    2017-02-01

    Intracranial aneurysms may rupture and are typically associated with high morbidity and mortality, commonly due to vasospasm after rupture. Once the aneurysm ruptures, the patient's cerebral blood flow may be disturbed during the acute phase, affecting cerebral circulation and thus cerebral perfusion prior to the onset of vasospasm. Fisher and Navarro scores are used to predict vasospasm, while World Federation of Neurosurgical Societies (WFNS) scores are used to predict patient outcomes. Several score modifications are available to obtain higher sensitivity and specificity for the prediction of vasospasm development, but these scores are still unsuccessful. Alternatively, cerebral CT perfusion scan (CTP) is a non-invasive method for measuring cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) in regions of interests (ROI) to obtain the cerebral perfusion status as well as detecting vasospasm. A total of 30 patients' data with clipped anterior circulation intracranial aneurysms admitted to the hospital between 1 January 2013 and 30 June 2014, were collected from the hospital's electronic database. The data collected included patients' admissions demographic profiles, Fisher, Navarro and WFNS scores; and their immediate pre- and post-operative CTP parameters. This study found a significant increase in post-operative MTT (pre- and post-operative MTT) were 9.75 (SD = 1.31) and 10.44 (SD = 1.56) respectively, (P < 0.001)) as well as a significant reduction in post-operative CBF (pre- and post-operative mean CBF were 195.29 (SD = 24.92) and 179.49 (SD = 31.17) respectively (P < 0.001)). There were no significant differences in CBV. There were no significant correlations between the pre- and post-operative CTP parameters and Fisher, Navarro or WFNS scores. Despite the interest in using Fisher, Navarro and WFNS scores to predict vasospasm and patient outcomes for ruptured intracranial aneurysms, this study found no significant correlations

  5. Optimization of kiloelectron volt settings in cerebral and cervical dual-energy CT angiography determined with virtual monoenergetic imaging.

    PubMed

    Schneider, David; Apfaltrer, Paul; Sudarski, Sonja; Nance, John W; Haubenreisser, Holger; Fink, Christian; Schoenberg, Stefan O; Henzler, Thomas

    2014-04-01

    Dual-energy computed tomography (DECT) offers various fields of application, especially in angiography using virtual monoenergetic imaging. The aim of this study was to evaluate objective image quality indices of calculated low-kiloelectron volt monoenergetic DECT angiographic cervical and cerebral data sets compared to virtual 120-kV polyenergetic images. Forty-one patients (21 men, mean age 58 ± 14) who underwent DECT angiography of the cervical (n = 7) or cerebral vessels (n = 34) were retrospectively included in this study. Data acquired with the 80 and 140 kVp tube using dual-source CT technology were subsequently used to calculate low