Skip to main content
Article thumbnail
Location of Repository

Cerebrovascular Haemodynamic Parameters: reproducibility and changes following acute stroke

By Fiona Gillian Brodie

Abstract

Introduction: This Thesis will discuss the importance of stroke disease, and review the existing literature regarding acute stroke blood pressure (BP) changes and management. It will also review methods of measuring cerebral autoregulation, and the effects of stroke, hypertension, and antihypertensive therapy on cerebral autoregulation.\ud Using an established method of measuring cerebral autoregulation this Thesis will examine the reproducibility of this method in a study of healthy volunteers. The same measurement technique will then be used to examine the effects of ageing on cerebral autoregulation in a cohort of healthy volunteers. The effects of acute stroke and early recovery on cerebral autoregulation will then be studied and compared to healthy controls. In addition it will consider the potential effects of stroke type, clinical features, and history of hypertension on cerebral autoregulation post-stroke

Publisher: University of Leicester
Year: 2010
OAI identifier: oai:lra.le.ac.uk:2381/8339

Suggested articles

Citations

  1. (1995). A prospective study of primary and secondary risk factor management in stroke patients. J.R.Coll.Physicians Lond
  2. (1996). Analysis of cerebral blood flow autoregulation in neonates.
  3. (1992). Anatomy and Freehand Examination Techniques.
  4. Angiotensin-converting enzyme inhibition and regional cerebral blood flow in acute stroke.
  5. Antihypertensive therapy increases cerebral blood flow and carotid distensibility in hypertensive elderly subjects.
  6. (1995). Assessment of autoregulation by means of periodic changes in blood pressure.
  7. Assessment of cerebral autoregulation using carotid artery compression.
  8. (1998). Assessment of cerebral pressure autoregulation in humans--a review of measurement methods. Physiol Meas.
  9. Assessment of the thigh cuff technique for measurement of dynamic cerebral autoregulation.
  10. Autoregulation of cerebral blood flow in hypertensive patients. The modifying influence of prolonged antihypertensive treatment on the tolerance to acute, drug-induced hypotension.
  11. Bendrofluazide fails to reduce elevated blood pressure levels in the immediate post-stroke period.
  12. Blood pressure and cardiovascular disease in the Asia Pacific region.
  13. Blood pressure and stroke: an overview of published reviews.
  14. Blood pressure course in patients with acute stroke and matched controls.
  15. Blood pressure reduction for vascular risk: is there a price to be paid?
  16. (1990). Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias.
  17. Blood velocity in the middle cerebral artery and regional cerebral blood flow during carotid endarterectomy.
  18. (1997). CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke.
  19. (1993). Cerebral arterial diameters during changes in blood pressure and carbon dioxide during craniotomy.
  20. Cerebral autoregulation and blood pressure lowering.
  21. Cerebral autoregulation dynamics in acute ischemic stroke after rtPA thrombolysis.
  22. Cerebral autoregulation dynamics in humans.
  23. Cerebral autoregulation following minor head injury.
  24. Cerebral autoregulation in carotid artery occlusive disease assessed from spontaneous blood pressure fluctuations by the correlation coefficient index.
  25. (2008). Cerebral autoregulation: an overview of current concepts and methodology with special focus on the elderly. J.Cereb.Blood Flow Metab
  26. Cerebral autoregulation: from models to clinical applications.
  27. Cerebral blood flow velocity during mental activation: interpretation with different models of the passive pressure-velocity relationship.
  28. (2001). Cerebral blood flow velocity response to induced and spontaneous sudden changes in arterial blood pressure. Am.J.Physiol Heart Circ.Physiol
  29. Cerebral hemodynamics after short- and long-term reduction in blood pressure in mild and moderate hypertension.
  30. Cerebral hemodynamics during orthostatic stress assessed by nonlinear modeling.
  31. (2007). Cerebrovascular function in pregnancy and eclampsia. Hypertension
  32. (2006). Cerebrovascular response to normal pregnancy: a longitudinal study. Am.J.Physiol Heart Circ.Physiol
  33. Characteristics of blood pressure profiles as predictors of long-term outcome after acute ischemic stroke.
  34. (1991). Classification and natural history of clinically identifiable subtypes of cerebral infarction.
  35. (1993). Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial.
  36. (1997). Comparable studies of the incidence of stroke and its pathological types: results from an international collaboration. International Stroke Incidence Collaboration. Stroke
  37. (1994). Comparison of flow and velocity during dynamic autoregulation testing in humans.
  38. (1991). Comparison of invasive and non-invasive measurements of continuous arterial pressure using the Finapres.
  39. (1995). Comparison of static and dynamic cerebral autoregulation measurements.
  40. Controlling hypertension and hypotension immediately post-stroke (CHHIPS): a randomised, placebocontrolled, double-blind pilot trial.
  41. (2008). Determination of Sample Size. An Introduction to Medical Statistics, p 331. Oxford:
  42. Dynamic but not static cerebral autoregulation is impaired in acute ischaemic stroke.
  43. Dynamic cerebral autoregulation and beat to beat blood pressure control are impaired in acute ischaemic stroke.
  44. Dynamic cerebral autoregulation in acute ischemic stroke assessed from spontaneous blood pressure fluctuations.
  45. Dynamic cerebral autoregulation in acute lacunar and middle cerebral artery territory ischemic stroke.
  46. Dynamic cerebral autoregulation is unaffected by aging.
  47. Dynamic pressure--flow velocity relationships in the human cerebral circulation.
  48. Dynamic regulation of middle cerebral artery blood flow velocity in aging and hypertension.
  49. Early morning impairment in cerebral autoregulation and cerebrovascular CO2 reactivity in healthy humans: relation to endothelial function.
  50. Effect of carotid endarterectomy or stenting on impairment of dynamic cerebral autoregulation.
  51. Effect of intravenous nimodipine on blood pressure and outcome after acute stroke.
  52. Effect of perindopril on cerebral and renal perfusion on normotensives in mild early ischaemic stroke: a randomized controlled trial.
  53. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialists' Collaboration.
  54. Effects of an angiotensinconverting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators.
  55. Essential hypertension.
  56. Failure of cerebral autoregulation as a cause of brain dysfunction in the elderly.
  57. (1998). Frequency-domain analysis of cerebral autoregulation from spontaneous fluctuations in arterial blood pressure. Med.Biol.Eng Comput.
  58. Glyceryl trinitrate vs. control, and continuing vs. stopping temporarily prior antihypertensive therapy, in acute stroke: rationale and design of the Efficacy of Nitric Oxide
  59. (1998). Grading of cerebral dynamic autoregulation from spontaneous fluctuations in arterial blood pressure.
  60. (2007). Guidelines for the management of spontaneous intracerebral hemorrhage in adults:
  61. Heart rate variability measures: a fresh look at reliability.
  62. Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage.
  63. High blood pressure in acute stroke and subsequent outcome: a systematic review.
  64. High blood pressure in early acute stroke: a sign of a poor outcome?
  65. (1998). Hypertension and its treatment in the NINDS rt-PA Stroke Trial. Stroke
  66. Impact of high-normal blood pressure on the risk of cardiovascular disease.
  67. (1997). Impaired dynamic cerebral autoregulation in carotid artery stenosis.
  68. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study.
  69. Influence of noninvasive peripheral arterial blood pressure measurements on assessment of dynamic cerebral autoregulation.
  70. Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial.
  71. (1993). Interobserver reliability of a clinical classification of acute cerebral infarction.
  72. Intraclass correlations: Uses in assessing rater reliability.
  73. intracranial pressure, autoregulation, and outcome after brain trauma.
  74. Is hypertension a more frequent risk factor for deep than for lobar supratentorial intracerebral haemorrhage?
  75. Long-term angiotensin-converting enzyme inhibitor perindopril therapy improves cerebral perfusion reserve in patients with previous minor stroke.
  76. Low dose beta blockade in acute stroke ("BEST" trial): an evaluation.
  77. Middle cerebral artery function after stroke: the threshold duration of reperfusion for myogenic activity.
  78. (1996). Monitoring of cerebral autoregulation in head-injured patients.
  79. MRI measures of middle cerebral artery diameter in conscious humans during simulated orthostasis.
  80. Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries.
  81. or Stop post-Stroke Antihypertensives Collaborative Study): rationale and design.
  82. Oxygen-dependent mechanisms in cerebral autoregulation.
  83. Phase relationship between cerebral blood flow velocity and blood pressure. A clinical test of autoregulation.
  84. Post-stroke antihypertensive treatment study. A preliminary result.
  85. Postischemic attenuation of cerebral artery reactivity is increased in the presence of tissue plasminogen activator.
  86. (2000). Pressure in Acute Stroke Collaboration. Interventions for deliberately altering blood pressure in acute stroke. Cochrane Database Systematic Reviews
  87. (1997). Prognostic value of admission blood pressure in patients with intracerebral hemorrhage. Keio Cooperative Stroke Study. Stroke
  88. Radiology of stroke.
  89. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack.
  90. (1995). Relation between blood pressure and outcome in intracerebral hemorrhage.
  91. Relation of low diastolic blood pressure to coronary heart disease death in presence of myocardial infarction: the Framingham Study.
  92. (2008). Reliability of dynamic cerebral autoregulation measurement using spontaneous fluctuations in blood pressure. Clin.Sci.(Lond)
  93. Reproducibility of orthostatic changes in cerebral oxygenation in healthy subjects aged 70 years or older.
  94. (1988). Resistance index, blood flow velocity, and resistance-area product in the cerebral arteries of very low birth weight infants during the first week of life. Ultrasound Med.Biol.
  95. Risk factor profile of cerebral small vessel disease and its subtypes.
  96. Role of cerebral amyloid angiopathy in intracerebral hemorrhage in hypertensive patients.
  97. (1998). Sample size and optimal designs for reliability studies.
  98. Serial changes in static and dynamic cerebral autoregulation after acute ischaemic stroke.
  99. Should hypertension be treated after acute stroke? A randomized controlled trial using single photon emission computed tomography.
  100. Sporadic cerebral amyloid angiopathy--an important cause of cerebral haemorrhage in older people.
  101. (1996). Streptokinase increases luxury perfusion after stroke.
  102. (1997). Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. International Stroke Trial Collaborative Group. Lancet
  103. System identification of human cerebral blood flow regulatory mechanisms.
  104. The ACCESS Study: evaluation of Acute Candesartan Cilexetil Therapy in Stroke Survivors.
  105. The bad news: stroke incidence is stable.
  106. The critical closing pressure of the cerebral circulation. Med.Eng Phys.
  107. (1990). The frequency-dependent behavior of cerebral autoregulation.
  108. The frequency, causes and timing of death within 30 days of a first stroke: the Oxfordshire Community Stroke Project.
  109. The influence of antihypertensive therapy on cerebral autoregulation in aged hypertensive rats.
  110. The J-curve phenomenon and the treatment of hypertension. Is there a point beyond which pressure reduction is dangerous?
  111. The lowering of blood pressure after stroke.
  112. The repeatability of cerebral autoregulation assessment using sinusoidal lower body negative pressure. Physiol Meas.
  113. Transcranial Doppler hemodynamic parameters and risk of stroke: the Rotterdam study.
  114. Transcranial Doppler measurement of middle cerebral artery blood flow velocity: a validation study.
  115. (1991). Transcranial Doppler. Lippincott Williams and Wilkins,
  116. Transdermal glyceryl trinitrate lowers blood pressure and maintains cerebral blood flow in recent stroke.
  117. (1999). Transfer function analysis of cerebral hemodynamics in patients with carotid stenosis. J.Cereb.Blood Flow Metab
  118. (1997). Ultrasound assessment of internal carotid artery stenosis.
  119. Use of ramipril in preventing stroke: double blind randomised trial.
  120. Variations in middle cerebral artery blood flow investigated with noninvasive transcranial blood velocity measurements.
  121. (1993). Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality.

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.