Cerebral Autoregulation in Ischemic Stroke: From Pathophysiology to Clinical Concepts.

cerebral hemodynamics dynamic cerebral autoregulation ischemic stroke

Journal

Brain sciences
ISSN: 2076-3425
Titre abrégé: Brain Sci
Pays: Switzerland
ID NLM: 101598646

Informations de publication

Date de publication:
16 Apr 2021
Historique:
received: 22 01 2021
revised: 02 04 2021
accepted: 09 04 2021
entrez: 30 4 2021
pubmed: 1 5 2021
medline: 1 5 2021
Statut: epublish

Résumé

Ischemic stroke (IS) is one of the most impacting diseases in the world. In the last decades, new therapies have been introduced to improve outcomes after IS, most of them aiming for recanalization of the occluded vessel. However, despite this advance, there are still a large number of patients that remain disabled. One interesting possible therapeutic approach would be interventions guided by cerebral hemodynamic parameters such as dynamic cerebral autoregulation (dCA). Supportive hemodynamic therapies aiming to optimize perfusion in the ischemic area could protect the brain and may even extend the therapeutic window for reperfusion therapies. However, the knowledge of how to implement these therapies in the complex pathophysiology of brain ischemia is challenging and still not fully understood. This comprehensive review will focus on the state of the art in this promising area with emphasis on the following aspects: (1) pathophysiology of CA in the ischemic process; (2) methodology used to evaluate CA in IS; (3) CA studies in IS patients; (4) potential non-reperfusion therapies for IS patients based on the CA concept; and (5) the impact of common IS-associated comorbidities and phenotype on CA status. The review also points to the gaps existing in the current research to be further explored in future trials.

Identifiants

pubmed: 33923721
pii: brainsci11040511
doi: 10.3390/brainsci11040511
pmc: PMC8073938
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

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Auteurs

Ricardo C Nogueira (RC)

Neurology Department, School of Medicine, Hospital das Clinicas, University of São Paulo, São Paulo 01246-904, Brazil.
Department of Neurology, Hospital Nove de Julho, São Paulo 01409-002, Brazil.

Lucy Beishon (L)

Cerebral Haemodynamics in Ageing and Stroke Medicine Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester LE2 7LX, UK.

Edson Bor-Seng-Shu (E)

Neurology Department, School of Medicine, Hospital das Clinicas, University of São Paulo, São Paulo 01246-904, Brazil.

Ronney B Panerai (RB)

Cerebral Haemodynamics in Ageing and Stroke Medicine Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester LE2 7LX, UK.
National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University of Leicester, Leicester LE5 4PW, UK.

Thompson G Robinson (TG)

Cerebral Haemodynamics in Ageing and Stroke Medicine Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester LE2 7LX, UK.
National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University of Leicester, Leicester LE5 4PW, UK.

Classifications MeSH