Dynamic cerebral autoregulation associates with infarct size and outcome after ischemic stroke
- 6 April 2011
- journal article
- research article
- Published by Hindawi Limited in Acta Neurologica Scandinavica
- Vol. 125 (3), 156-162
- https://doi.org/10.1111/j.1600-0404.2011.01515.x
Abstract
Objectives - Cerebral autoregulation is particularly challenged in acute ischemic stroke. We investigated (1) clinical and radiological factors related to dynamic cerebral autoregulation (DCA) in acute stroke and (2) the relationship between DCA and clinical outcome of stroke. Methods - A total of 45 patients with middle cerebral artery (MCA) stroke were analyzed pooling two previous studies. DCA was measured by transcranial Doppler in both MCAs early (within 48 h from onset) and late (day 5-7) using low-frequency phase and correlation analysis (index Mx). Outcome was assessed by modified Rankin scale after a mean period of 4 months. Results - Mx increased (i. e. autoregulation worsened) between the early and late measurement, more so on affected (P = 0.005) than on unaffected sides (P = 0.014). Poorer autoregulation as indicated by lower ipsilateral phase (early and late) and higher Mx (late measurement) were significantly related to larger infarction. More severe stroke was significantly related to poorer ipsilateral Mx and phase. Ipsilateral phase in the early (P = 0.019) and Mx in the late measurement (P = 0.016) were related to poor clinical outcome according to univariate analysis. Conclusions - Impairment of DCA ipsilateral to acute ischemic stroke is associated with larger infarction. Dysautoregulation tends to worsen and spread to the contralateral side over the first days post- stroke and is associated with poor clinical outcome.Keywords
This publication has 19 references indexed in Scilit:
- Cerebral Autoregulation in StrokeStroke, 2010
- Transcranial Doppler for evaluation of cerebral autoregulationClinical Autonomic Research, 2009
- Cerebral Autoregulation Dynamics in Acute Ischemic Stroke after rtPA ThrombolysisCerebrovascular Diseases, 2008
- Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008Cerebrovascular Diseases, 2008
- Guidelines for the Early Management of Adults With Ischemic StrokeStroke, 2007
- Dynamic Cerebral Autoregulation in Acute Ischemic Stroke Assessed From Spontaneous Blood Pressure FluctuationsStroke, 2005
- European Stroke Initiative Recommendations for Stroke Management – Update 2003Cerebrovascular Diseases, 2003
- Transfer function analysis of dynamic cerebral autoregulation in humansAmerican Journal of Physiology-Heart and Circulatory Physiology, 1998
- Monitoring of Cerebral Autoregulation in Head-Injured PatientsStroke, 1996
- Quantification of Atheromatous Stenosis in the Extracranial Internal Carotid ArteryCerebrovascular Diseases, 1995