Cerebral Blood Flow: Clinical and Experimental Results

ISBN-13: 9783642858628 / Angielski / Miękka / 2012 / 292 str.

Mario Brock; C. Fieschi; D. H. Ingvar

Opis

This book is a survey of some aspects of current knowledge on regional Cerebral Blood Flow (rCBF), mainly as studied by the isotope clearance method. Although both theoretical and methodological problems are discussed, attention is mainly dedicated to data obtained from clinical studies. The papers which make up this book were presented at the International Symposium on the Clinical Applications of Isotope Clearance Measurement of Cerebral Blood Flow, held in Mainz, Western Germany, on April 10-12, 1969. The previous meetings on Cerebral Blood Flow, held in Lund in 1964* and in Lund and Copenhagen 1968**, had shown that the moment had come to concentrate on the possibilities of introducing rCBF measurements into clinical routine. This is why in the Mainz Symposium attention was initially focused on methodological aspects. This is also why theoretical problems of physiology of CBF were not emphasized. Finally, this explains why such topics as cerebrovascular disease, head trauma, coma, carotid surgery, brain tumors and intracranial pressure were given pride of place. However a survey of the clinical aspects of rCBF measurements would not be complete without an account of the application of such measurements to monitor cerebral circulatory changes during anesthesia and therapeutic procedures like, for instance, hyperventilation and hyperbaric treatment. Furthermore, it is now possible to obtain data from correlative rCBF studies per formed before, during and after surgical operations on the human brain."

Spis treści

I: Methodology.- Dependence of 85Kr(?)-Clearance rCBF Determination on the Input Function.- Comments on the Inert Gas Elimination Method for the Determination of Cerebral Blood Flow.- Further Studies on Exponential Models of Cerebral Clearance Curves.- Evaluation of the rCBF Method of Lassen and Ingvar.- Problems in Control Studies for the Evaluation of Drugs.- The Heterogeneity of Blood Flow throughout the Normal Cerebral Hemisphere.- The Two-Minutes-Flow-Index (TMFI).- Stochastic Analysis and Slope Determination of Linear and Semilogarithmic Clearance Curves Respectively. Practical Considerations.- Regional Cerebral Blood Flow Measured by Multiple Probes: An Oscilloscope and a Digital Computer System for Rapid Data Processing.- Gamma-Camera and Multichannel Analyser for Multilocular rCBF Measurement.- Measurements of the rCBF by Intravenous Injection of 133Xe. A Comparative Study with the Intra- Arterial Injection Method.- Comment on the Paper by Agnoli et al.- Application of the 133Xenon Clearance Method to the Measurement of Local Blood Flow in the Conscious Animal.- Problems Concerning the Hg Inhalation Technique to Determine the Cerebral Blood Flow by Means of Palladinized Pt-Electrodes.- Local H2-Clearance and PO2-Measurements in Microareas of the Brain Tissue in Rats.- Simultaneous Focal Intracerebral Blood Flow Measurements in Man Around 18 Chronically Implanted Electrodes.- Gas and Heat Clearance Comparison and Use of Heat Transport for Quantitative Local Blood Flow Measurements.- Regional Brain Blood Flow Estimated by Using Particle Distribution and Isotope Clearance Methods.- Absolute Measurement of Brain Blood Flow Using Non-Diffusible Isotopes.- A Method of Employing External Counting Techniques to Obtain the Mean Transit Time and Distribution of Transit Times of Isotope Passage through the Head.- Effects of Various Agents on Cerebral Circulation Studied by Ultrasonic Doppler Technique in Man.- The Use of a New Cyclotron Produced Isotope Krypton-85m, for the Measurement of Cerebral Blood Flow.- The Simultaneous Measure In Vivo of Regional Cerebral Blood Flow and Regional Cerebral Oxygen Utilization by Means of Oxyhemoglobin Labelled with Radioactive Oxygen15.- Comments to Chapter I.- II: Regulation of CBF.- Influence of Hypoxia on the Response of CBF to Hypocapnia.- The Influence of Oxygen Affinity of Blood and Cerebral Blood Flow on Cerebral Oxygen Supply.- Lack of Adaptation of CBF and CSF pH in Hypoxic Hypercapnia.- Cerebral Blood Flow in Patients with Chronic Respiratory Insufficiency, with Special Regard to Induced Acute Changes of the Blood Gas Situation.- Arterial pCO2 and Blood Flow in Different Parts of the Central Nervous System of the Anesthetized Cat.- Changes of the Transmural Pressure – the Probable Stimulus to Cerebral Blood Flow Autoregulation.- CBF in Non-Pulsatile Perfusion.- On the Location of the Vascular Resistance in the Cerebral Circulation.- The Spasm of the Internal Carotid Arteries.- Regional Cerebral Blood Volume during Paradoxical Sleep.- The Effect of Hemodilution Caused by Low Molecular Weight Dextran on Human Cerebral Blood Flow and Metabolism.- Cerebral Vascular Responses to Changes in the Ionic Osmolar Composition of Blood.- Comments to Chapter II.- III: Cerebrovascular Disease.- Regional Cerebral Blood Flow at Rest and during Functional Tests in Occlusive and Non-Occlusive Cerebrovascular Disease.- rCBF at Rest and during Functional Tests in Transient Ischemic Attacks.- Partial Cerebral Vasoparalysis in Patients with Apoplexy: Dissociation between Carbon Dioxide Responsiveness and Autoregulation.- Discrepancies between Autoregulation and CO2 Reactivity of Cerebral Vessels.- Microflow Patterns after Experimental Occlusion of Middle Cerebral Artery Demonstrated by Fluorescein Angiography and 133 Xenon Clearance.- Cerebral Circulation Speed and EEG Frequency.- Correlation between Brain Gas Exchange and CSF Acid-Base Status in Patients with Cerebral Haemorrhage.- The Acid-Base-Equilibrium of the CSF and the Respiration in Cerebral Vascular Diseases.- Clinical Applications of the Gamma Camera in the Evaluation of Patients with Cerebrovascular Disease.- Iconoscopic Evaluation of Cerebral Vacsular Disease.- Correlations between CBF and Clinical Results in Cerebrovascular Patients. A Statistical Analysis.- rCBF Studies in Patients with Arteriovenous Malformations of the Brain.- ATP Influences on Cerebral Hemodynamics and Metabolism in Patients with Ischaemic Cerebral Disturbances.- A New Therapeutical Method for Cerebral Circulatory Disturbances.- Comments to Chapter III.- IV: Carotid Surgery.- Cerebral Blood Flow Studies during Carotid Surgery.- The Effect of Hyperbaric Oxygen during Carotid Surgery.- Pre- and Postoperative Cerebral Blood Flow in Patients with Carotid Artery Stenoses.- Cerebral Blood Flow Measurements in the Evaluation of Carotid Surgery.- The Influence of Carotid Stenosis on Cortex Perfusion..- Comments to Chapter IV.- V: Tumors, Intracranial Pressure.- Regional Cerebral Blood Flow in Cases of Brain Tumor.- rCBF Studies in Intracranial Tumors.- Paradoxical rCBF Reactions in Intracranial Tumors.- Cerebrovascular Dilatation and Compression in Intracranial Hypertension.- Studies on the CBF and Problems of the Determination of the Cerebral Metabolism in Patients with Localized Cerebral Lesions.- Total COg in Brain Biopsies Taken from Patients with Intracranial Tumors and Cerebrovascular Disease after Freezing of the Tissue in Situ.- The Effect of Intracranial Pressure on Perifocal Hyperemia.- Transit Time and Microflow Measured by Fluorescein Angiography and Radioisotopes in Brain Tumor with Red Veins.- Correlation between rCBF, Angiography, EEG and Scanning in Brain Tumors.- Iconoscope Assessment of Meningiomas, Gliomas and Metastatic Brain Tumors.- Comments to Chapter V.- VI: Trauma, Coma, Alcoholism and Dementia.- Cerebral Hemodynamics and Metabolism Following Brain Trauma. Demonstration of Luxury Perfusion Following Brain-Stem Laceration.- Disturbance ofAutoregulation Following Head Injury-Acute and Chronic Observations.- LOSS of Autoregulation Produced by Cerebral Trauma.- Cessation of Cerebral Blood Flow in Total Irreversible Loss of Brain Function.- Hemodynamic and Metabolic Studies in “Coma Dépassé”. A Search for a Biological Test of Death of the Brain.- Cerebral Blood Flow in Cases of Fallowing Coma after Severe Head Injury.- Effect of High Concentration of CO2 on Cerebral Energy Metabolism and EEG Activity.- Cerebral Vasomotor Control and CSF pH in Metabolic and Respiratory Coma.- CBF and Metabolism in Uremic and Hepatic Precomatose States.- Energy Metabolism, Lactate/Pyruvate Ratio and Extracellular Space in Cortex and White Matter Adjacent to and Distant from a Local Freezing Lesion.- Regional Cerebral Blood Flow in Chronic Alcoholism.- Cerebral Blood Flow and Metabolism in Senile Dementia.- Comments to Chapter VI.- VII: Anesthesia and Therapy.- Effect of Blood Pressure Alterations on CBF during General Anesthesia in Man.- Effects of General Anesthetics in Man on the Ratio of Cerebral Blood Flow to Cerebral Oxygen Consumption.- Effect of Hyper- and Hypoventilation on CBF during Anesthesia.- Cerebral Blood Flow and Oxygen Consumption in Man during Electroencephalographic Seizure Patterns Associated with Ethrane Anesthesia.- Effects of Hyperventilation on Focal Brain Damage Following Middle Cerebral Artery Occlusion.- Possible Adverse Effects of Hyperventilation on rCBF during the Acute Phase of Total Proximal Occlusion of a Main Cerebral Artery.- Artificial Hyperventilation in the Treatment of Patients with Severe Brain Lesions.- Clinical Results of Respirator Treatment in Unconscious Patients with Brain Lesions.- Cerebrospinal Fluid and Cerebral Venous pOg in Unconscious Patients with Brain Lesions.- Extremely Severe Brain Injuries Treated with Hyperventilation and Ventricular Drainage.- The Effect of Hyperbaric Oxygen on Intracranial Pressure and Cerebral Blood Flow in Experimental Cerebral Edema.- rCBF during Hyperbaric Oxygenation.- Comments to Chapter VII.- I Closing Remarks.- Theories and Methods for CBF Measurement.- II Closing Remarks.- Clinical Implications of Cerebral Blood Flow Studies.