Chen Jie, Liu Jia, Dong Kehui, Wang Yilong, Zhao Xingquan, Wang Yongjun, Gong Xiping
Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
Front Neurol. 2020 Nov 9;11:570306. doi: 10.3389/fneur.2020.570306. eCollection 2020.
Cerebral autoregulation is crucial in traumatic brain injury, which might be used for determining the optimal intracranial pressure. Cerebral venous thrombosis (CVT) is a cerebral vascular disease with features of high intracranial pressure. However, the autoregulatory mechanism of CVT remains unknown. We aimed to investigate the capacity of cerebral autoregulation in patients with CVT. This study consecutively enrolled 23 patients with CVT and 16 controls from December 2018 to May 2019. Cerebral autoregulation was assessed by transfer function analysis (rate of recovery/phase/gain) using the spontaneous oscillations of the cerebral blood flow velocity and arterial blood pressure. In total, 76 middle cerebral arteries (MCAs) were investigated, including 44 MCAs in patients with CVT and 32 normal ones. The phase shift estimated in patients with CVT was significantly different from that of the controls (37.37 ± 36.53 vs. 54.00 ± 26.78, p = 0.03). The rate of recovery and gain in patients with CVT were lower than those in controls but without statistical significance. To our knowledge, this is the first time that a study has indicated that patients with CVT were more likely to have impaired cerebral autoregulation. Hence, cautious blood pressure control is required in such patients to prevent hyper- or hypoperfusion.
脑自动调节在创伤性脑损伤中至关重要，其可用于确定最佳颅内压。脑静脉血栓形成（CVT）是一种具有高颅内压特征的脑血管疾病。然而，CVT的自动调节机制仍不清楚。我们旨在研究CVT患者的脑自动调节能力。本研究于2018年12月至2019年5月连续纳入了23例CVT患者和16例对照。使用脑血流速度和动脉血压的自发振荡，通过传递函数分析（恢复率/相位/增益）评估脑自动调节。总共研究了76条大脑中动脉（MCA），包括CVT患者的44条MCA和32条正常MCA。CVT患者估计的相移与对照组显著不同（37.37±36.53对54.00±26.78，p = 0.03）。CVT患者的恢复率和增益低于对照组，但无统计学意义。据我们所知，这是首次有研究表明CVT患者更有可能存在脑自动调节受损。因此，对此类患者需要谨慎控制血压，以防止灌注过多或过少。
