Cerebral perfusion pressure in giraffe: modelling the effects of head-raising and -lowering.

Loss of consciousness caused by positional changes of the head results from reduced cerebral blood flow (CBF). CBF is related to cerebral perfusion pressure (CPP). CPP is the difference between mean arterial pressure (MAP) at the head and intracranial pressure (ICP). The positional change of the giraffe head between ground level and standing upright is the largest of all animals yet loss of consciousness does not occur. We have investigated the possibility that an increase in CPP protects giraffe from fainting, using a mechanical model that functioned as an anatomical U-tube. It consisted of a rigid ascending "carotid" limb, a collapsible "brain" tube drained by a rigid, "vertebral venous plexus" (VVP) tube, and a collapsible "head" tube drained by a collapsible tube representing the "jugular vein". The descending tubes could be rotated relative to the "carotid" tube to be horizontal, or at 30 degrees , 45 degrees , and 60 degrees to the vertical to simulate changes in head position. Pressure at the top of the "carotid" tube was intracranial MAP, at the top of the "VVP" tube was ICP, and the difference CPP. In the simulated "head-up" position and a fluid flow rate of 4 L min(-1), CPP was approximately 170 mmHg. With the VVP tube horizontal, CPP fell from approximately 170 to 45 mmHg, but increased to approximately 67 mmHg at 30 degrees "down", to approximately 70 mmHg at 45 degrees "down" and to approximately 75 at 60 degrees "down". The fall in CPP in the head-down positions resulted from a decrease in viscous resistance in, and dissipation of pressure to, the "head" and "jugular" tubes. These data provide an estimate of cranial pressure changes in giraffe during positional changes of the head, and suggest that an increase in CPP plays a significant role in maintaining CBF during head-raising and that it may be an important mechanism for preventing fainting in giraffe.