Regulation of cerebral blood flow in response to changes in blood viscosity.

Cerebral blood flow (CBF) was measured by the non-invasive xenon-133 technique in patients with increased blood viscosity as a result of paraproteinaemia or leukaemia. A highly significant inverse relation was found between CBF and arterial oxygen content in 59 paraproteinaemic patients. There was no significant correlation between CBF and whole blood viscosity, and no significant difference between CBF in paraproteinaemic patients and a matched group of anaemic patients. 7 leukaemic patients with up to threefold increases in whole blood viscosity were also found to have CBF appropriate to their degree of anaemia. The effects of treatment to reduce blood viscosity were studied in 7 paraproteinaemic and 5 leukaemic patients; changes in CBF were significantly related to changes in arterial oxygen content but not to changes in blood viscosity. These studies confirm the importance of arterial oxygen content in the determination of CBF, and demonstrate that regulatory mechanisms can maintain normal cerebral oxygen transport despite increased plasma and whole blood viscosity.