Compartmental abnormalities of regional cerebral blood flow in children with head trauma

1972 ◽  
Vol 36 (4) ◽  
pp. 463-470 ◽  
Author(s):  
Samuel S. Kasoff ◽  
Lawrence H. Zingesser ◽  
Kenneth Shulman
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Gray Matter ◽  
Regional Cerebral Blood Flow ◽  
Head Injuries ◽  
Relative Weight ◽  
Compartmental Analysis ◽  
Regional Cerebral Blood ◽  
Content Type ◽  
Pediatric Age Group

✓ Regional cerebral blood flow (CBFr) and compartmental analysis in a series of children with closed head injuries have demonstrated abnormalities of both rate and distribution of blood flow. The most frequent derangement was a triphasic flow pattern overlying one or more regions of traumatized brain. The rate of flow in this third compartment is two to five times the rate of normal gray matter flow; while the relative weight of the compartment varies between 3.5% and 15%. The pathophysiology of this third, rapid compartment of flow is discussed, and the argument put forth that such flow does not represent hyperperfusion but rather an ischemia of the gray matter because such blood flow is not available to the tissue for nutrition. If this is so, it may well be a cause of permanent sequelae in the pediatric age group.

scholarly journals Noninvasive Method of Estimating Human Newborn Regional Cerebral Blood Flow

1982 ◽  
Vol 2 (4) ◽  
pp. 415-420 ◽  
Author(s):  
D. P. Younkin ◽  
M. Reivich ◽  
J. Jaggi ◽  
W. Obrist ◽  
M. Delivoria-Papadopoulos
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Gray Matter ◽  
Regional Cerebral Blood Flow ◽  
Relative Weight ◽  
Initial Slope ◽  
Noninvasive Method ◽  
Regional Cerebral Blood ◽  
Fractional Flow ◽  
Xenon 133

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 xenon-133 inhalation rCBF technique, this method uses eight extracranial NaI scintillation detectors and an i. v. bolus injection of xenon-133 (∼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.

Reproducibility of regional cerebral blood flow measurements in acute severe head injury

1978 ◽  
Vol 49 (3) ◽  
pp. 366-377 ◽  
Author(s):  
Erna M. Enevoldsen ◽  
Finn T. Jensen
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Head Injuries ◽  
Initial Slope ◽  
Regional Cerebral Blood ◽  
Flow Measurements ◽  
Content Type ◽  
Flow Parameters ◽  
The Brain

✓ In order to evaluate the reproducibility of regional cerebral blood flow (rCBF) measurements in pathological brain tissue, serial measurements were carried out in 13 determinations performed in patients who were comatose after severe head injuries within the first 2 weeks after the head trauma. The xenon-133 intra-arterial method was used for the flow measurements, and the flow was studied separately in 16 areas of the brain, producing 197 regional double determinations. The patients were maintained in a steady state during and between the measurements, and only differences of less than 2 mm Hg in the arterial CO2 pressure and less than 5 mm Hg in the perfusion pressure were tolerated. The reproducibility was found to be reasonably good as regards initial slope-flow indices and height/area flow values, whereas that of the compartmentally calculated flow parameters was poorer. On dividing the series into severely and moderately pathological areas, it could be shown that the reproducibility of the flow values in the moderately pathological brain areas was acceptable and similar to the results reported by others, whereas the reproducibility in the most severely pathological areas of the brain was rather poor, as regards the flow in the fast compartments. The correlation between the various flow parameters was found to be fairly good.

Accuracy of methods for calculating cerebral blood flow from intracarotid xenon-133 injection

1980 ◽  
Vol 238 (5) ◽  
pp. H750-H758
Author(s):  
J. P. Marc-Vergnes ◽  
P. Celsis ◽  
J. P. Charlet ◽  
G. Setien
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Gray Matter ◽  
Relative Weight ◽  
Compartmental Analysis ◽  
Optimization Method ◽  
Initial Slope ◽  
Method Of Calculation ◽  
Blood Flows ◽  
Xenon 133

The accuracy of the three commonly used methods, the initial slope analysis, the stochastic analysis, and the compartmental analysis, for calculating mean cerebral blood flow from xenon-133 clearance curves was studied with the use of computer-generated and real curves. The accuracy of calculation was affected by the cutoff time of the curve, by the level of the compartmental blood flows to white and gray matter and by the ratio of these flow levels, by the relative weight of gray matter, and by the choice of the method of calculation. None of the methods was clearly superior to the others. Each had its own defects that render it more or less suitable for different situations. All three methods generally overestimated mean cerebral blood flow. This overestimation was greater the lower the flow. A curve-fitting index was devised which can be used to check the validity of the bicompartmental model when using compartmental analysis. This same index can provide, though not always, an estimate of the error in the calculation of mean cerebral blood flow when an optimization method is used.

scholarly journals Quantifying the Link between Anatomical Connectivity, Gray Matter Volume and Regional Cerebral Blood Flow: An Integrative MRI Study

PLoS ONE ◽  
2011 ◽  
Vol 6 (4) ◽  
pp. e14801 ◽  
Author(s):  
Bálint Várkuti ◽  
Mustafa Cavusoglu ◽  
Alexander Kullik ◽  
Björn Schiffler ◽  
Ralf Veit ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Gray Matter ◽  
Regional Cerebral Blood Flow ◽  
Gray Matter Volume ◽  
Regional Cerebral Blood ◽  
Anatomical Connectivity ◽  
Matter Volume ◽  
Mri Study

Regional cerebral blood flow and metabolism in reversible ischemia due to vasospasm

1985 ◽  
Vol 62 (4) ◽  
pp. 539-546 ◽  
Author(s):  
William J. Powers ◽  
Robert L. Grubb ◽  
Roy P. Baker ◽  
Mark A. Mintun ◽  
Marcus E. Raichle
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Emission Tomography ◽  
Neurological Deficits ◽  
Regional Cerebral Blood ◽  
Content Type ◽  
Cerebral Metabolic Rate ◽  
Positron Emission ◽  
Reversible Ischemia

✓ Regional cerebral blood flow (rCBF) and regional cerebral metabolic rate of oxygen (rCMRO2) were measured by positron emission tomography (PET) in four patients with subarachnoid hemorrhage and hemiparesis due to cerebral vasospasm. With resolution of the vasospasm, two patients recovered and two remained hemiparetic. Contralateral to the hemiparesis, rCBF was slightly higher in the two patients who eventually recovered (15.0 and 16.2 ml/100 gm/min) than in the two who remained hemiparetic (12.0 and 11.7 ml/100 gm/min). The rCMRO2 measurements showed similar differences, with values of 1.34 and 2.60 ml/100 gm/min in the patients who recovered, and 0.72 and 1.66 ml/100 gm/min in those who did not. These preliminary findings indicate that with PET studies it may be possible to prospectively differentiate patients with neurological deficits due to reversible ischemia from patients with irreversible infarction.

Regional cerebral blood flow studies in subarachnoid hemorrhage

1972 ◽  
Vol 37 (1) ◽  
pp. 36-44 ◽  
Author(s):  
M. Peter Heilbrun ◽  
Jes Olesen ◽  
Niels A. Lassen
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Subarachnoid Hemorrhage ◽  
Regional Cerebral Blood Flow ◽  
Surgical Intervention ◽  
Focal Ischemia ◽  
Regional Cerebral Blood ◽  
Content Type ◽  
Clinical Grading ◽  
Fine Print

✓ Regional cerebral blood flow (rCBF) studies using the intra-arterial 133xenon method were performed on 10 patients with subarachnoid hemorrhage. Both preoperative and postoperative studies showed evidence of decreased flow in the entire hemisphere studied, and, in addition, evidence of focal ischemia, focal hyperemia, focal vasoparalysis, and often global impairment of autoregulation. The degree of flow abnormalities correlated well with the clinical grading of the neurological deficit. It is suggested that analysis of the state of autoregulation might be useful in determining the time for surgical intervention and that rCBF studies are important in defining the effects of drugs used to counteract the ischemic effects of spasm.

Regional cerebral blood flow in the acute stage of experimentally induced subarachnoid hemorrhage

1983 ◽  
Vol 58 (2) ◽  
pp. 210-216 ◽  
Author(s):  
Felix Umansky ◽  
Thalia Kaspi ◽  
Mordechai N. Shalit
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Subarachnoid Hemorrhage ◽  
Regional Cerebral Blood Flow ◽  
Internal Capsule ◽  
Acute Stage ◽  
Regional Cerebral Blood ◽  
Content Type ◽  
Steep Decline ◽  
Triphasic Pattern

✓ Subarachnoid hemorrhage (SAH) was induced in 13 adult mongrel cats by a slow injection of fresh autogenous blood into the cisterna magna. Serial determinations of regional cerebral blood flow (rCBF) in the cortex and deep-seated areas (internal capsule, thalamus, and caudate nucleus) were made during the following 2 hours, while intracranial pressure (ICP) was maintained at normal values. A decrease in rCBF was observed in all the areas examined. This reduction followed a characteristic triphasic pattern with an initial steep decline immediately after the SAH. The clinical implications of these findings are discussed.

Beagle pup model of brain injury: regional cerebral blood flow and cerebral prostaglandins

1987 ◽  
Vol 67 (2) ◽  
pp. 278-283 ◽  
Author(s):  
Laura R. Ment ◽  
William B. Stewart ◽  
Charles C. Duncan ◽  
Bruce R. Pitt ◽  
Judith Cole
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Brain Injury ◽  
White Matter ◽  
Regional Cerebral Blood Flow ◽  
Ventilatory Support ◽  
Periventricular White Matter ◽  
Regional Cerebral Blood ◽  
Content Type ◽  
Carbon 14

✓ Asphyxia is the most common cause of severe brain injury in very young children, and frequently results in lesions of the periventricular white matter in addition to other neuropathological changes. This study examines the effects of asphyxia on regional cerebral blood flow (rCBF) and the role of prostaglandins (PG's) in its control in the newborn beagle pup. Pups were anesthetized, tracheotomized, paralyzed, artificially ventilated, and randomly assigned to two groups: asphyxial insult produced by discontinuing ventilatory support, and no insult. Experiments for carbon-14-iodoantipyrine autoradiographic determination of rCBF and regional cerebral PG determination were performed on separate groups of pups. These studies demonstrated a significant increase in cortical gray PGE2 levels at a time when rCBF was significantly impaired in response to severe asphyxial insult. No such increase was noted in the periventricular white matter zones.

Experimental augmentation of cerebral blood flow by intermittent aortic occlusion

1972 ◽  
Vol 36 (6) ◽  
pp. 700-713 ◽  
Author(s):  
Frederick A. Simeone ◽  
John P. Laurent ◽  
Peter J. Trepper ◽  
Daniel J. Brown ◽  
John Cotter
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Cardiovascular Response ◽  
Good Health ◽  
Aortic Occlusion ◽  
Regional Cerebral Blood ◽  
Descending Aorta ◽  
Content Type ◽  
The Common

✓ Intermittent occlusion of the descending aorta just below the origin of the brachiocephalic vessels by a preformed balloon passed via the femoral artery is capable of significantly increasing the pressure and flow in the common carotid artery. Regional cerebral blood flow determination by the krypton-85 washout technique measured maximum increases of over 40% of the controls, which could easily be achieved and maintained. This technique apparently takes advantage of the finite delay in autoregulatory response to the increased arterial pressure before the onset of maximal autoregulation. Dogs were “pumped” in this way for up to 18 hours and survived in good health. Principal problems with this technique were the development of cerebral edema in the presence of diffuse established cerebral anoxia, and a shock-like cardiovascular response if the intermittent aortic occlusion was discontinued too abruptly. The clinical application of this technique to cerebral ischemia secondary to postoperative vasospasm may not require the extremes of hyperperfusion used in these experiments.

Regional cerebral blood flow, sensory evoked potentials, and intracranial pressure in dogs with MCA occlusion by embolization or trapping

1983 ◽  
Vol 58 (4) ◽  
pp. 500-507 ◽  
Author(s):  
Yoshikazu Okada ◽  
Takeshi Shima ◽  
Mitsuo Yamamoto ◽  
Tohru Uozumi
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Intracranial Pressure ◽  
Evoked Potentials ◽  
Regional Cerebral Blood Flow ◽  
Regional Cerebral Blood ◽  
Content Type ◽  
Sensory Evoked Potentials ◽  
Sensory Evoked ◽  
Fine Print

✓ Regional cerebral blood flow (rCBF), sensory evoked potentials (SEP), and intracranial pressure (ICP) were investigated in dogs with focal cerebral ischemia produced by a silicone cylinder embolus in the middle cerebral artery (MCA) trunk as compared to that produced by trapping the same vessel. These variables were measured at intervals of 1 hour for a period of 6 hours after MCA occlusion. In the embolized animals, rCBF decreased most extensively at the basal ganglia, from a control level of 53.9 ± 3.9 (mean ± SE) to 21.5 ± 2.7 ml/100 gm/min at the 6th hour. Sensory evoked potentials decreased progressively from the resting level of 100% to 53.0% ± 7.2% at the 3rd hour. Intracranial pressure, measured by epidural pressure on the occluded side, increased rapidly during the first 3 hours, from 10.6 ± 0.3 to about 30 cm H2O. In the animals with trapping, the decreases in rCBF and declines of SEP were significantly less than those in the embolized animals, and no evident brain swelling was observed. This study demonstrates that MCA trunk occlusion by silicone cylinder embolization produces a more marked decrease in deep CBF, with diminution of SEP and increase in ICP, than that produced by trapping.

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