Cerebral Blood Circulation Research Articles

EFFECT OF BRAIN DISTENSION ON CEREBRAL CIRCULATION

Abstract It is contended that distension of the brain secondary to regressive changes—e.g., brain atrophy— is common in the higher age-groups. The distension may be, and often is, the cause of diminished blood-flow in the ageing brain. This hypothesis is supported by recent investigations, initiated by the discovery of a pathological condition termed normal-pressure hydrocephalus. With this type of hydrocephalus the cerebrospinal-fluid (C.S.F.) pressure is normal or not pathologically increased, but the cerebral blood-flow is reduced. This reduction in flow is correlated with the degree of ventricular dilatation. The condition of those affected improves after drainage of the C.S.F. by shunt procedures which cause a concomitant increase in cerebral blood-flow. The brain can be said to form an elastic container around the ventricular system, and the tensile strength of this container is diminished by atrophic processes due to ageing. These processes allow the ventricular system to expand even without an increase in the intraventricular pressure. Pneumoencephalographic investigations confirm that such distension is the rule rather than the exception at higher ages. This distension reduces the cerebral blood-flow by compressing the cerebral vessels. Probably there is a complex interaction between, on the one hand, morphological changes due to ageing in the brain tissue, in the C.S.F. valves, and in the cerebral blood-vessels, and, on the other hand, physiological disturbances in the cerebral blood circulation and in the C.S.F. circulation.

The regulation of cerebral blood circulation in subclavian steal syndrome.

Blood flow to the brain was studied in 11 patients suffering from subclavian steal syndrome. The venous isotope-dilution method was used to measure total blood flow to the brain and the dye-dilution method with intravenous administration of 50 mg of Evans blue was used to determine cardiac output. Cerebral blood flow was significantly lower in the 11 patients with subclavian steal syndrome than in the control group, and the O 2 consumption of the brain was low, cerebral resistance was elevated, and the cerebral fraction of the cardiac output was decreased in comparison with the controls. The effect of occlusion of the ipsilateral brachial artery was studied in 10 of the patients with subclavian steal syndrome. The cerebral blood flow and the cerebral fraction of the cardiac output increased significantly as a result of the occlusion in these patients. Studies on three patients after surgical correction of the lesion in the subclavian artery showed significant improvement in the cerebral circulation.

EFFECT OF BRAIN DISTENSION ON CEREBRAL CIRCULATION

It is contended that distension of the brain secondary to regressive changes—e.g., brain atrophy— is common in the higher age-groups. The distension may be, and often is, the cause of diminished blood-flow in the ageing brain. This hypothesis is supported by recent investigations, initiated by the discovery of a pathological condition termed normal-pressure hydrocephalus. With this type of hydrocephalus the cerebrospinal-fluid (C.S.F.) pressure is normal or not pathologically increased, but the cerebral blood-flow is reduced. This reduction in flow is correlated with the degree of ventricular dilatation. The condition of those affected improves after drainage of the C.S.F. by shunt procedures which cause a concomitant increase in cerebral blood-flow. The brain can be said to form an elastic container around the ventricular system, and the tensile strength of this container is diminished by atrophic processes due to ageing. These processes allow the ventricular system to expand even without an increase in the intraventricular pressure. Pneumoencephalographic investigations confirm that such distension is the rule rather than the exception at higher ages. This distension reduces the cerebral blood-flow by compressing the cerebral vessels. Probably there is a complex interaction between, on the one hand, morphological changes due to ageing in the brain tissue, in the C.S.F. valves, and in the cerebral blood-vessels, and, on the other hand, physiological disturbances in the cerebral blood circulation and in the C.S.F. circulation.

Diagnosis and Therapy of Arteriovenous Malformations shown by Vertebral Angiography

Cerebrovascular malformations of the vertebral circulation system are much rarer than those of the carotid circulation system. This becomes even more evident considering aneurysms and arteriovenous malformations (AVM) of the posterior fossa which only can be demonstrated by the vertebral angiography. The vertebral angiography also shows in cases of supratentorial cerebrovascular malformations, that branches of the posterior cerebral artery (p.c.a.) can take part in supplying AVM mainly belonging to the carotid circulation system. In some cases these branches of the posterior cerebral artery even are the only nutrient vessels of the supratentorial AVM. In such situations therapy offers especial problems and possibilities. The results of the operated AVM indicate the following: the ligation of the posterior cerebral artery and of the anterior chorioid artery is of use in the paramedical AVM, for their expansion is reduced and the cerebral blood circulation is improved. The ligation of the posterior cerebral artery leads to a complete recovery in combined cortical and subcortical AVM of the occipital region if the AVM is only supplied by the posterior cerebral artery. An improvement can only be expected by ligating the supplying branches of the subtentorial AVM, if their blood is supplied by accessible arteries (like the arteria cerebelli superior or inferior posterior).

CEREBRAL BLOOD CIRCULATION IN DEMENTIA.

Acta Psychiatrica ScandinavicaVolume 40, Issue 1 p. 77-106 CEREBRAL BLOOD CIRCULATION IN DEMENTIA S. Hedlund M. D., S. Hedlund M. D. Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden. Sven Hedlund, M. D., Södersjukhuset, Stockholm, Sweden.Search for more papers by this authorV. Köhler, V. Köhler Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this authorG. Nylin†, G. Nylin† Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this authorR. Olsson, R. Olsson Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this authorO. Regnström†, O. Regnström† Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this authorE. Rothström, E. Rothström Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this authorK. E. ÅStröm, K. E. ÅStröm Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this author S. Hedlund M. D., S. Hedlund M. D. Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden. Sven Hedlund, M. D., Södersjukhuset, Stockholm, Sweden.Search for more papers by this authorV. Köhler, V. Köhler Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this authorG. Nylin†, G. Nylin† Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this authorR. Olsson, R. Olsson Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this authorO. Regnström†, O. Regnström† Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this authorE. Rothström, E. Rothström Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this authorK. E. ÅStröm, K. E. ÅStröm Radioisotope Laboratory and the Department of Cardiovascular Diseases, Södersjukhuset, Stockholm, the Department of Psychiatry, S:t Eriks Sjukhus, Stockholm, and the Department of Pathology II, Karolinska Institutet, Stockholm, Sweden.Search for more papers by this author First published: March 1964 https://doi.org/10.1111/j.1600-0447.1964.tb05736.xCitations: 29AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume40, Issue1March 1964Pages 77-106 RelatedInformation

Studies on the disturbances of the cerebral blood circulation.

Studies on the disturbances of the cerebral blood circulation.

Transcarotid coronary arteriography in man with emphasis on intercoronary arterial anastomosis.

At the annual meeting of the Radiological Society of North America in 1957 we demonstrated the technic and the results of transcarotid aortic valvulography based on a series of 51 injections in 49 patients (1). On that occasion, and in subsequent publications, attention was called to the incidental satisfactory, although inconstant, visualization of the normal coronary arteries in these cases (2, 3). It became evident that, after certain modifications, the method (4) could be utilized for the direct visualization of the coronary arteries in those patients in whom clinical findings and electrocardiography failed to establish a diagnosis. Experimental studies, including approximately 300 injections in 50 mongrel dogs, helped us to introduce the changes in the method necessary for constant detailed visualization of both coronary arteries without increasing the risk associated with thoracic aortography. The results of these experimental studies in animals and the associated electrocardiographic and physiologic changes during and following the injection of contrast material have been discussed separately (5, 6). It is the purpose of this paper to describe the technic of coronary arteriography as used clinically in our institution since 1958, and to demonstrate the radiographic detail obtained in visualization of normal and diseased coronary arteries in 50 patients. Selection Of Patients For Transcarotid Coronary Arteriography Selection and preparation of patients for coronary arteriography is important. The disappointing results obtained by other investigators who performed coronary arteriography in old, cachectic individuals (7) and our own previous experiences indicate that the patients should be carefully chosen for the procedure. Inasmuch as most of the candidates for coronary arteriography are between forty and sixty years of age, the cerebral blood circulation should be tested by separate compression of the right and left common carotid arteries for at least ten minutes in the recumbent position. If there is any evidence of carotid or cerebral vascular insufficiency, the transcarotid approach should not be employed. In the presence of a dilated or tortuous innominate artery, the left common carotid artery, rather than the right, should be used for the introduction of the catheter. The presence of a thoracic aortic aneurysm probably increases the risk of cerebral complications. In an earlier series of 26 injections performed to demonstrate aneurysms of the thoracic aorta or of the innominate artery we encountered carotid thrombosis at the site of arteriotomy in 2 cases and temporary hemiparesis in 1, due to cerebral embolus. Although we believe that at least one of these complications can be explained on the basis of our initial technical difficulties, it seems likely that the transcarotid approach is prone to produce cerebral complications in patients with aneurysms.

X-ray visualization of the entire cerebrovascular system by means of contrast medium injection into one single artery; cerebral pan-angiography

Êste trabalho visa a demonstrar que é possível, mediante redução da pressão arterial, contrastar todos os vasos encefálicos pela substância radiopaca injetada em uma das carótidas. Para promover a baixa da pressão arterial, lançamos mão, em primeiro lugar, das drogas ganglioplégicas; entretanto, não tendo fornecido resultados satisfatórios, êsse método foi abandonado. O bloqueio da corrente sangüínea por hiperpressão intrapulmonar, método sistematizado por Boerema e Blickman como recurso para melhorar as qualidades técnicas das angiocar-diografias, pareceu-nos ideal para o objetivo a que visávamos. Quando a pressão intrapulmonar atinge valores próximos de 60 cm de água, a pulsação das artérias torna-se imperceptível à palpação e a pressão arterial cai a níveis muito baixos; em tais condições, se uma substância radiopaca é injetada em uma das carótidas, por ser a pressão arterial muito baixa, a pressão exercida na seringa fará com que o contraste penetre em todos os vasos encefálicos. A injeção de 15 ml de Nosylan a 35% na vigência de hipotensão arterial mostrou-se plenamente satisfatória; em 38 dos 40 pacientes que constituem a casuística dêste trabalho tôdas ou quase tôdas as artérias encefálicas foram visibilizadas mediante injeção de contraste por via carotídea. Tratando-se de método simples e seguro, julgamos que êle poderá vir a ser usado em tôdas as eventualidades clínicas que exijam o exame angiográfico de ambos os territórios carotídeos e do sistema vértebro-basilar.

Disorders of cerebral blood circulation in the cat following a short series of electroshock treatments

Disorders of cerebral blood circulation in the cat following a short series of electroshock treatments