Clinical Investigations on Interrelations Between Intracranial Pressure and Intracranial Hemodynamics

Changes in intracranial pressure and arterial blood pressure following electric stimulation to restricted regions in the cat brainstem.

“…sites as well as the arterial pressor and depressor responses and that the ICP responses cannot be explained merely by the secondary, transmural action of the BP change evoked by the activation of brainstem sites. Though the net volume changes in any of the intracranial contents within the rigid skull, which are induced by vascular autoregulation of cerebral blood vessels due to metabolic changes (LANGFITT et al, 1965), chemical substances like angiotensin (BARBELLA et al, 1983), and any other causes (LUNDGERG et al, 1968), produce a change in ICP, the rapid changes and reversibility of ICP and the enhancement of the stimulus-induced increase in ICP at the lowered BP level indicate that the ICP responses are primarily caused by alteration in blood volume due to neurogenic dilation and constriction of intracranial vessels, thereby permitting some of the systemic blood pressure to affect the geometry of the vascular bed, as is the case with a possible origin of the plateau waves of ICP (LUNDBERG et al, 1968). The primary neurogenic response of intracranial blood vessels was also proposed in case of electrical stimulation of fastigial nucleus (NAKAI et al, 1983) parasympathetic nerve stimulation (D'ALECY and ROSE, 1977) and sympathetic nerve stimulation (WEI et al, 1975;AUER et al, 1983;BAUMBACH and HEISTAD, 1983).…”

“…MATSUURA, M. KUNO, T. YASUNAMI, and M. MAEDA et al, 1978;BAUMBACH and HEISTAD, 1983). However, as vascular changes occur within a rigid skull, it is reasonable to assume that the ICP is influenced by a change in blood volume in intracranial vascular beds and alteration in compliance of intracranial content (LANGFITT et al, 1965;LUNDBERG et al, 1968). Changes in pulsatile fluctuation of ICP due to respiratory and cardiac rhythms and other origins related to slow arterial pressure fluctuations (PETTOROSSI et al, 1978) also have to be considered.…”

“…On the contrary, moderate and large increases in ICP influence arterial blood pressure as well as cardiac and respiratory rhythms due to changes in sympathetic and parasympathetic outflows (MATSUURA et al, 1984). Furthermore, ROSNER and BECKER (1984) suggested that changes in ICP prior to and during plateau waves, which are characterized by spontaneous and rapid elevations in ICP rising above moderately elevated baseline levels, are dependent on systemic circulatory events, as has been evident under certain circumstances in humans and laboratory animals (LUNDBERG et al, 1968). Electric stimulation applied to restricted areas in the brainstem also induces arterial pressor and depressor responses via neural activates associated with or without influences on cerebral circulation (LANGFITT and KASSELL,1968;DOBA and REIS, 1972;DAMPNEY et al, 1979;GOADSBY et al, 1983).…”

The prognostic and therapeutic importance of changes in the CSF during the acute stage of brain injury

“…According to the present knowledge of the pathophysiological mechanisms in brain damage, the changes in the cerebral blood-flow can only be caused by two haemodynamically effective factors, the perfusion pressure and the vascular resistance (Lundberg 1968, Langfitt 1972. Between these two factors there exists the following direct relationship:…”

Introduction: Traumatic Brain Injury

“…1,3 Despite the hard-fought efforts of numerous researchers around the world, however, not one Phase III clinical trial of a pharmacological compound for TBI has been successful. But a renaissance is in the making as modern tools are brought to bear on the understanding of and therapeutic interventions for TBI.…”