Cerebral Autoregulation in Stroke
| العنوان: | Cerebral Autoregulation in Stroke |
|---|---|
| المؤلفون: | Patrick C.A.J. Vroomen, Jacques De Keyser, Berry Kremer, Jan Willem J. Elting, Marcel J.H. Aries |
| المصدر: | Stroke, 41(11), 2697-2704. LIPPINCOTT WILLIAMS & WILKINS |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2010. |
| سنة النشر: | 2010 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Ultrasonography, Doppler, Transcranial, INTRACRANIAL-PRESSURE, Blood Pressure, LACUNAR INFARCTION, AUTO-REGULATION, HEAD-UP TILT, BLOOD-FLOW-VELOCITY, Cerebral autoregulation, LARGE HEMISPHERIC STROKE, Internal medicine, ischemic stroke, medicine, Homeostasis, Humans, Autoregulation, ACUTE ISCHEMIC-STROKE, Stroke, Aged, Intracranial pressure, Aged, 80 and over, Advanced and Specialized Nursing, HYPERTENSION, business.industry, Brain, CEREBROVASCULAR REACTIVITY, DIABETES-MELLITUS, Middle Aged, medicine.disease, Transcranial Doppler, chemical vasomotor autoregulation, Blood pressure, dynamic cerebral autoregulation, Anesthesia, Ischemic stroke, cardiovascular system, transcranial Doppler ultrasonography, Cardiology, static cerebral autoregulation, High temporal resolution, Neurology (clinical), Cardiology and Cardiovascular Medicine, business |
| الوصف: | Background and Purpose— Cerebral autoregulation may become impaired after stroke. To provide a review of the nature and extent of any autoregulation impairment after stroke and its course over time, a technique allowing repeated bedside measurements with good temporal resolution is required. Transcranial Doppler (TCD) in combination with continuous blood pressure measurements allows noninvasive continuous bedside investigation with high temporal resolution of the dynamic and the steady-state components of cerebral autoregulation. Therefore, this review focuses on all TCD studies on cerebral autoregulation in the setting of documented ischemic stroke. Methods— PubMed and EMBASE were searched for studies of stroke, autoregulation, and TCD. Studies were either acute phase (96 hours after index stroke) autoregulation studies. Quality of studies was studied in a standardized fashion. Results— Twenty-three studies met the inclusion criteria. General agreement existed on cerebral autoregulation being impaired, even after minor stroke. Bilateral impairment of autoregulation was documented, particularly after lacunar stroke. Studies showed progressive deterioration of cerebral autoregulation in the first 5 days after stroke and recovery over the next 3 months. Impaired cerebral autoregulation as assessed by TCD was related to neurological deterioration, the necessity for decompressive surgery, and poor outcome. Synthesis of the data of various studies was, however, limited by studies not meeting key methodological criteria for observational studies. Conclusions— TCD in combination with continuous blood pressure measurement offers a method with a high temporal resolution feasible for bedside evaluation of cerebral autoregulation in the stroke unit. TCD studies have shown impairment of cerebral autoregulation in various subtypes of ischemic stroke. To improve the synthesis of data from various research groups, there is urgent need for standardization of methodology of TCD studies in cerebral autoregulation. |
| تدمد: | 1524-4628 0039-2499 |
| DOI: | 10.1161/strokeaha.110.594168 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::497a77aa2e64d0f63944d590d4d7dd99 https://doi.org/10.1161/strokeaha.110.594168 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....497a77aa2e64d0f63944d590d4d7dd99 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15244628 00392499 |
|---|---|
| DOI: | 10.1161/strokeaha.110.594168 |