Cerebral hemorrhagic insults are common in neonates. However, the consequences of intracranial blood on cerebral hemodynamics are poorly understood. We examined the effects of perivascular blood on cerebrovascular dilator responses in 29 piglets. Fresh, autologous blood (n=15) or cerebrospinal fluid (n = 14) was placed under the dura mater over the parietal cortex, and the piglets were allowed to recover from anesthesia. One to four days later, a closed cranial window was placed over the parietal cortex and pial arteriolar responses to arterial hypercapnia (Paco 2 >55 mm Hg), hemorrhagic hypotension (mean arterial blood pressure <35 mm Hg), or topical application of 10~6 and 10* M isoproterenol were determined. Pial arterioles in the cerebrospinal fluid group dilated 27±4% (mean±SEM) (n=ll) in response to hypercapnia, 26±5% (n=9) in response to hypotension, and 26±3% in response to 10~6 M and 40±4% in response to 10~4 M isoproterenol (n=ll). In the group in which blood was placed on the parietal cortex, pial arterioles did not dilate significantly in response to hypercapnia (8 ±3%, n = l l ) or hypotension (2±5%, t=13) but dilated normally in response to isoproterenol (25±5% in response to 10" 6 M and 36±7% in response to 10~4 M, n = 13). We conclude that prolonged contact of pial arterioles with extravascular blood selectively attenuates cerebrovascular dilation in piglets. (Stroke 1991 £2:484-488) I ntracranial hemorrhage (ICH) is a serious problem in preterm and full-term infants. The most common types are subdural, primary subarachnoid, intraparenchymal, and intraventricular hemorrhages.1 -4 Depending on the location and extent of bleeding, the neurologic sequelae can be quite serious. Several mechanisms contribute to immediate and later derangements of cerebral blood flow (CBF). First, rupture of arteries and capillaries leads to ischemia in areas served by those vessels. Second, increased intracranial pressure due to blood and edema causes extraluminal compression of vessels, which can reduce CBF. Third, the presence of blood and/or macrophages leads to production of substances that could damage vessels and, consequently, alter cerebral vascular responsiveness. For example, we have shown that fresh, Supported by grants HL-30260 and HL-34059 from the National Institutes of Health Heart, Lung, and Blood Institute.Address for reprints: David W. Busija, PhD, Department of Physiology and Pharmacology, Bowman Gray School of Medicine, 300 South Hawthorne Road, Winston-Salem, NC 27103.Received September 11, 1990; accepted December 18, 1990. autologous blood placed on the brain surface generates superoxide anion in piglets, 5 and free radicals have been implicated in the altered responsiveness of cerebral resistance vessels.
-7In adult animal models of ICH, the perivascular presence of blood alters cerebrovascular responsiveness. 8 -12 In particular, responses involving endothelium-derived relaxing factor (EDRF) and arterial hypercapnia 13 can be reduced. On the other hand, little is known concerning the effect...