The Effects of Increased Intracranial Pressure on Cerebral Circulatory Functions in Man 1

Kety, Seymour S.; Shenkin, Henry A.; Schmidt, Carl F.

doi:10.1172/jci101996

Cited by 222 publications

(51 citation statements)

References 5 publications

(5 reference statements)

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“…The classic studies of Cushing (19), recently confirmed by us in man (20), demonstrate that restriction of cerebral blood flow may result in a compensatory increase in blood pressure. Perhaps similar phenomena are the hypertensive states experimentally produced by Dixon and Heller (21) as the result of intracisternal injection of kaolin, or by Novak and Walker (22) with serial ligation of the arterial supply to the brain.…”

Section: Resultsmentioning

confidence: 80%

The Blood Flow, Vascular Resistance, and Oxygen Consumption of the Brain in Essential Hypertension 1

Kety

Hafkenschiel²,

Jeffers³

et al. 1948

J. Clin. Invest.

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142

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Section: Resultsmentioning

confidence: 80%

The Blood Flow, Vascular Resistance, and Oxygen Consumption of the Brain in Essential Hypertension 1

Kety

Hafkenschiel²,

Jeffers³

et al. 1948

J. Clin. Invest.

Self Cite

142

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“…Second, indicator dilution techniques enabled accurate measurements of cerebral perfusion in humans and demonstrated that elevated ICP leads to reduced CBF. 28 Finally, studies finding that markedly elevated ICP associates with poor outcome, 40 coupled with postmortem studies of patients with traumatic brain injury (TBI) showing extensive ischemic lesions, 17,18 showed that prolonged intracranial hypertension can reduce cerebral perfusion and cause global ischemia. Taken together, these findings suggested that aggressive ICP control could limit secondary brain injury by improving cerebral perfusion.…”

Section: Matching Metabolic Needs To Supply: a General Framework For mentioning

confidence: 99%

Unraveling the complexities of invasive multimodality neuromonitoring

Sinha¹,

Hudgins²,

Schuster³

et al. 2017

Neurosurgical Focus

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Acute brain injuries are a major cause of death and disability worldwide. Survivors of life-threatening brain injury often face a lifetime of dependent care, and novel approaches that improve outcome are sorely needed. A delayed cascade of brain damage, termed secondary injury, occurs hours to days and even weeks after the initial insult. This delayed phase of injury provides a crucial window for therapeutic interventions that could limit brain damage and improve outcome.A major barrier in the ability to prevent and treat secondary injury is that physicians are often unable to target therapies to patients’ unique cerebral physiological disruptions. Invasive neuromonitoring with multiple complementary physiological monitors can provide useful information to enable this tailored, precision approach to care. However, integrating the multiple streams of time-varying data is challenging and often not possible during routine bedside assessment.The authors review and discuss the principles and evidence underlying several widely used invasive neuromonitors. They also provide a framework for integrating data for clinical decision making and discuss future developments in informatics that may allow new treatment paradigms to be developed.

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“…16 Intracranial masses may cause CSF pressure to rise as high as 60 mm Hg. 17 Straining or coughing may produce transient increases in CSF pressure sufficient to produce venous congestion. Since the same CSF pressure is applied to parent and daughter vessels, the ratio of the transmural pressures (the difference between the intraluminal and CSF pressures) in the daughter and parent vessels will change with any change in CSF pressure unless the parent and daughter intraluminal pressures are equal.…”

Section: Formation Of Cerebral Aneurysmsmentioning

confidence: 99%

A mathematical model for the formation of cerebral aneurysms.

Brown

1991

Stroke

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Cerebral aneurysms are hypothesized to be acquired lesions resulting from a loss of static equilibrium in the apical region of the bifurcation, which causes the opening angle of the bifurcation to change during the cardiac cycle. Repeated dynamic cycling may disrupt wall elements in a manner analogous to a wire breaking with repeated bending and result in the formation of an aneurysm. A mathematical model that predicts the geometry of arterial bifurcations is proposed. The model predicts that the transmural pressure in the smaller branch is greater than or equal to that in the larger branch and that the larger branch makes a smaller angle with the direction of the parent artery. Bifurcations with smaller area ratios (the sum of the luminal areas of the branches divided by the luminal area of the parent artery) have smaller opening angles. When the area ratio is 1.0, the opening angle is about 90°. The model concludes that the opening angle is constant during the cardiac cycle if the fractional change in the radii of the daughter and parent arteries is the same for any increase in blood pressure and if the ratio of transmural pressures in the parent and daughter branches does not change during the cardiac cycle. Otherwise, the bifurcation is considered predisposed to the development of an aneurysm. (Stroke 1991^2:619-625)

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The Effects of Increased Intracranial Pressure on Cerebral Circulatory Functions in Man 1

Cited by 222 publications

References 5 publications

The Blood Flow, Vascular Resistance, and Oxygen Consumption of the Brain in Essential Hypertension 1

The Blood Flow, Vascular Resistance, and Oxygen Consumption of the Brain in Essential Hypertension 1

Unraveling the complexities of invasive multimodality neuromonitoring

A mathematical model for the formation of cerebral aneurysms.

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