Cerebral hemodynamics following internal maxillary artery ligation in the goat

1975 ◽  
Vol 38 (5) ◽  
pp. 942-945 ◽  
Author(s):  
D. J. Miletich ◽  
A. D. Ivankovic ◽  
R. F. Albrecht ◽  
E. T. Toyooka

Changes in cerebral and extracerebral blood flow in the goat after ligation of the internal maxillary artery and deliberate thrombosis of the extracerebral arteries (buccinator, ethmoidal, and ophthalmic) with thrombin were compared to changes seen in animals after internal maxillary artery ligation only and in normal animals where no surgical manipulations were performed. Blood flow was measured by injecting 51-Cr-labeled microspheres into the internal maxillary artery via a catheter placed into the temporal artery. Analysis of the radioactivity in extracerebral and intracerebral tissues indicated that when the internal maxillary artery is ligated and the extracerebral arteries are thrombosed, virtually all of the blood flow from the carotid artery is destined from the brain. However, if only the internal maxillary artery is ligated nearly one-fourth of the blood flow from the maxillary travels to extra-cerebral tissues. In normal animals, it was determined that only one-fourth of the blood flow in the internal maxillary is destined for the cerebral circulation. Results from this study indicate that if the former method is employed an accurate measure of cerebral blood flow is possible without the complications of extra-cerebral flow. If the latter technique is used care must be taken in evaluating cerebral blood flow since a large component of extra-cerebral blood flow is present.

1989 ◽  
Vol 71 (Supplement) ◽  
pp. A162 ◽  
Author(s):  
Karen S. Bender ◽  
Billie L. Short ◽  
L. Kyle Walker ◽  
Christine A. Gleason ◽  
Richard J. Traystman

1979 ◽  
Vol 51 (5) ◽  
pp. 628-640 ◽  
Author(s):  
George L. Bohmfalk ◽  
Jim L. Story ◽  
Willis E. Brown ◽  
Arthur E. Marlin

✓ Three patients with central nervous system symptoms due to subclavian steal syndrome were treated with proximal vertebral to common carotid artery transposition. Neurological symptoms were relieved or improved in all three, with no decrease in blood pressure or pulse in the ipsilateral upper extremity. The colorful history of this syndrome is reviewed, and the various surgical approaches to its treatment are discussed. Although the literature suggests that the commonly used carotid to subclavian artery bypass graft and other similar extrathoracic procedures are generally safe and effective for relief of symptoms of the steal, there is also evidence that these bypasses may fail to restore antegrade flow in the vertebral artery, and, in fact, may steal from the carotid artery. Thus, the blood flow provided to the brain by these procedures may be hardly more than that provided by vertebral artery ligation, whereas the principal effect is to restore blood flow into the upper extremity. Vertebral artery ligation alone has been used in 20 patients, with neurological improvement in all cases and production of persistent intermittent brachial claudication in only one. These considerations and our patient experience suggest that a relatively simple operation, proximal vertebral to common carotid artery transposition, which emphasizes restoration of flow to the brain rather than to the upper extremity, may be preferable for most patients with neurological symptoms of subclavian steal syndrome.


1977 ◽  
Vol 232 (5) ◽  
pp. H495-H499
Author(s):  
M. Manrique ◽  
E. Alborch ◽  
J. M. Delgado

Cerebral blood flow, heart rate, arterial blood pressure, and behavior were studied in conscious goats during electrical stimulation of the diencephalon and mesencephalon. Stimulation of the subthalamic area produced a considerable increase in ipsilateral cerebral blood flow and heart rate, accompanied by either a small or a large increase in systemic arterial blood pressure. Cardiovascular effects were associated with changes in alertness. The increase in cerebral blood flow was partially abolished by previous administration of atropine directly into the internal maxillary artery. Stimulation of the mesencephalic reticular formation caused a marked increase in blood pressure with no change or with some decrease in cerebral blood flow. After administration of phentolamine into the internal maxillary artery, stimulation produced increase in cerebral blood flow. The behavioral response consisted of restlessness and attempted flight. These results suggest the existence of cholinergic vasodilator and adrenergic vasoconstrictor pathways to cerebral blood vessels that may be stimulated electrically.


1985 ◽  
Vol 1 (3) ◽  
pp. 245-248
Author(s):  
N. Bircher ◽  
P. Safar

Since standard cardiopulmonary resuscitation (SCPR) cannot reliably preserve the brain during resuscitation, a “New” CPR has been proposed, which seeks to augment blood flow by increasing peak intrathoracic pressure (ITP) during chest compression. This “New” CPR (NCPR) consists of a) high pressure ventilation (70-110 cmH2O) simultaneous with chest compression, b) compression rate of 40/min, c) compression duration of 60% of the compression relaxation cycle, and d) abdominal binding. Although laboratory evidence suggests that NCPR may be capable of augmenting cerebral blood flow (1), the effect on cerebral outcome remains to be demonstrated.Although the hemodynamic superiority of open-chest CPR has long been recognized, its advantages with respect to the brain have only recently been recognized. It can reliably sustain EEC activity and pupillary light reflexes during CPR (2) as well as providing better cerebral blood flow (3,4). The objective of this two phase study was to establish the relative efficacy of standard, “new,” and open-chest CPR with respect to preserving the brain during CPR.The objective of phase I of this study was to compare standard and “New” CPR with respect to maintenance of hemodynamic, respiratory, and cerebral variables during prolonged resuscitation. Methods: Ten 10-15 kg dogs were anesthetized with halothane and 50% N2O/O2. Catheters were placed in the carotid artery, aortic arch, right atrium, external jugular vein and the sagittal sinus. An electromagnetic flowprobe was placed on the common carotid artery. Intracranial pressure was monitored with a subdural catheter. EEG electrodes were secured to the skull.


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