Even brief periods of hypoxia may cause endothelial dysfunction in intraparenchymal cerebral arterioles. This does not seem to be related to a deficiency of the nitric oxide substrate, L-arginine. Endothelial dysfunction and impaired endothelium-dependent dilation of microvessels may decrease oxygen delivery and increase neuronal injury during cerebral hypoxia-reoxygenation.

We present a case of brachial plexus injury in a living-related liver donor, most likely caused by compression of the plexus between the 1st rib and clavicle, the result of rib retraction for surgical exposure.

Hypoxia-induced changes in intracerebral arterioles, the major determinants of local cerebral oxygen delivery, are not well understood. Hippocampal arteriolar diameters were measured in rat brain slices using computerized videomicroscopy. In group 1 (control), artificial cerebrospinal fluid oxygen tension (PO2) was maintained at 500 mmHg. In groups 2 and 3, PO2 was gradually reduced to anoxia (95% N2/5% CO2). In group 3, prostaglandin F2a alpha was given to approximate physiological myogenic tone. PCO2 and pH were controlled. Graded hypoxia progressively dilated vessels (PO2 300 mmHg = 2.4 +/- 1.2%, 4.2 +/- 1.6%; PO2 90 mmHg = 15.4 +/- 3.0%, 14.5 +/- 1.8%; groups 2 and 3, respectively). The presence of preconstriction did not influence the extent of hypoxia-induced dilation. This vasorelaxation may be important in maintaining cerebral oxygen delivery during microvascular hypoxia.

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