The goal of this study was to determine whether increases in cerebral venous pressure contribute to, and may account for, disruption of the blood-brain barrier during acute hypertension and hyperosmolar stimuli. We studied the relation between pial venous pressure and disruption of the blood-brain barrier during acute arterial hypertension, superior venae cavae occlusion, and superfusion with hyperosmolar arabinose. Sprague-Dawley rats were studied using intravital fluorescent microscopy and fluorescein-labelled dextran (mol. wt. = 70,000). Disruption of the blood-brain barrier was characterized by the appearance of microvascular leaky sites and quantitated by the clearance of fluorescein dextran. We measured pressure (servo null) in pial arterioles and venules 40-60 /xm in diameter. Acute hypertension, occlusion of the superior venae cavae, and hyperosmolar arabinose produced leaky sites primarily in venules. Acute hypertension increased arteriolar pressure and also venular pressure, from 7 ± 1 (mean ± SE) to 28 ± 2 mm Hg. Clearance of fluorescein dextran increased from 0.03 ±0.01 to 2.90 ± 0.40 ml/sec x 10"'. Occlusion of the superior venae cavae increased pial venous pressure from 7 ± 1 to 30 ± 3 mm Hg, and clearance of fluorescein dextran, from 0.02 ± 0.01 to 3.10 ± 0.59 ml/sec x 10*. In contrast to acute hypertension, there was a decrease in arterial and pial arteriolar pressure during occlusion of the superior venae cavae. Thus, similar Increases in venous pressure during acute hypertension and superior venae cavae occlusion, despite directlonally opposite changes in arterial and arteriolar pressure, produced similar disruption of the blood-brain barrier. Disruption of the blood-brain barrier during hyperosmolar arabinose was not associated with an increase in pial venous pressure. The findings suggest that 1) increases in pial venous pressure during acute hypertension are of sufficient magnitude to account for disruption of the blood-brain barrier, and 2) disruption of the blood-brain barrier during hyperosmolar arabinose is not associated with increases in pial venous pressure. (Circulation Research 1986;59:216-220)A CUTE severe increases in arterial blood pressure /\ produce an increase in cerebral blood flow, A. A. passive dilation of cerebral blood vessels, and disruption of the blood-brain barrier (BBB).13 Because pressure in cerebral arterioles increases during acute hypertension, 4 one might predict that arterioles and capillaries are the site of disruption of the BBB. We have reported, however, that venules are the primary site of disruption of the BBB during acute hypertension.
3In light of the rinding that venules are the site of disruption of the BBB during acute hypertension, we postulated that disruption of the BBB may be closely This manuscript from the University of Iowa was sent to John T. Shepherd, Consulting Editor, for review by expert referees, for editorial decision, and for final disposition. Received August 22, 1985; accepted June 5, 1986. related to increases in venular pressure...