SUMMARY Cerebrorascular responses to a 20% toJume hemorrhage were studied In chloraloseanesthetized dogs with tbe Doppler cerebral venous outflow method. Arterial Pco,, Po t , and pH were held constant by servocontrol of ventilation. Tbe experimental results were divided into 2 groups as determined by the spontaneous responses of mean arterial pressure (MAP) to hemorrhage. In Group 1 (n ** 11), steady state MAP decreased 25%, cerebral blood flow (CBF) decreased 15%, and cerebrovascular resistance (CVR) decreased 13% (autoregulatory vasodilatation). In group 2 (n = 23), MAP changed less than 10 mm Hg, CBF decreased 13%, and CVR increased 15%. Tbe hemorrhage-Induced cerebral vasoconstriction In Group 2 was characterized by the following: pbenoxybenzamine (2 mg/kg i.r., n •» 3) reduced post-bemorrfaage CVR from 116% to 95% of prebemorrhage CVR (cCVR); phentolamine (2 mg/kg i.v., n = 5) reduced post-hemorrhage CVR from 114% to 91% of cCVR; and verified local anesthetization of both superior cervical ganglia (n = 5) reduced post-hemorrhage CVR from 116% to 94% of cCVR. Thus in Group 2, sympatbetic vasoconstriction contributed approximately 5% of cCVR; following normotensive hemorrhage, it accounted for up to 20% of post-hemorrhage CVR. In combination witb previous studies, these data suggest that cerebrovascular responses to hemorrhage balance between autoregulatory vasodilatatloa and sympatbetic vasoconstriction.
Stroke, Vol 11, No 2, 1980DESPITE the widely accepted existence of a sympathetic cerebrovascular innervation, 1 the functional significance of this innervation remains unclear. Methodological controversy complicates interpretation of the results of electrical stimulation of this innervation. Reflex stimulation, however, as produced during studies of cerebral blood flow (CBF) autoregulation, has suggested a physiological role for these nerves. When arterial hypotension was produced by graded hemorrhage, the lower limit of CBF autoregulation was approximately 70 mm Hg.2 "* When arterial hypotension was produced by pharmacological ganglionic blockade, however, the lower limit of CBF autoregulation was approximately 40 mm Hg.3 ' *•" In other words, the maximal cerebral vasodilatation observed during hypotension resulting from ganglionic blockade was greater than that observed during hemorrhagic hypotension. Since sympathetic outflow is interrupted by ganglionic blockade and is augmented by hemorrhage, these results may be interpreted to suggest reflex sympathetic cerebral vasoconstriction during hemorrhage. Consistent with this interpretation are the findings that pretreatment with alpha-receptor blockade (ARB) or acute cervical sympathectomy (CSx) extends the lower limit of CBF autoregulation.7 ' $ A common problem complicating demonstrations of reflex sympathetic cerebral vasoconstriction has been the simultaneous vasoconstriction or vasodilatation attributable to metabolic or autoregulatory mechanisms. For example, the sympathetic cerebral vasoconstriction suggested to occur during hemorrhagic hypotension ha...