Review of studies on dynamic cerebral autoregulation in the acute phase of stroke and the relationship with clinical outcome

R.C. Nogueira*, M. Aries, J.S. Minhas, N.H. Petersen, L. Xiong, J.M. Kainerstorfer, P. Castro

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

6 Citations (Web of Science)
21 Downloads (Pure)

Abstract

Acute stroke is associated with high morbidity and mortality. In the last decades, new therapies have been investigated with the aim of improving clinical outcomes in the acute phase post stroke onset. However, despite such advances, a large number of patients do not demonstrate improvement, furthermore, some unfortunately deteriorate. Thus, there is a need for additional treatments targeted to the individual patient. A potential therapeutic target is interventions to optimize cerebral perfusion guided by cerebral hemodynamic parameters such as dynamic cerebral autoregulation (dCA). This narrative led to the development of the INFOMATAS (Identifying New targets FOr Management And Therapy in Acute Stroke) project, designed to foster interventions directed towards understanding and improving hemodynamic aspects of the cerebral circulation in acute cerebrovascular disease states. This comprehensive review aims to summarize relevant studies on assessing dCA in patients suffering acute ischemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage. The review will provide to the reader the most consistent findings, the inconsistent findings which still need to be explored further and discuss the main limitations of these studies. This will allow for the creation of a research agenda for the use of bedside dCA information for prognostication and targeted perfusion interventions.
Original languageEnglish
Pages (from-to)430-453
Number of pages24
JournalJournal of Cerebral Blood Flow and Metabolism
Volume42
Issue number3
Early online date13 Sep 2021
DOIs
Publication statusPublished - Mar 2022

Keywords

  • Ischemic stroke
  • dynamic cerebral autoregulation
  • cerebral perfusion
  • clinical outcome
  • INFOMATAS
  • ANEURYSMAL SUBARACHNOID HEMORRHAGE
  • ACUTE ISCHEMIC-STROKE
  • EARLY NEUROLOGICAL DETERIORATION
  • CEREBROVASCULAR PRESSURE REACTIVITY
  • INDIVIDUAL PATIENT DATA
  • BLOOD-PRESSURE
  • PERFUSION-PRESSURE
  • ENDOVASCULAR THROMBECTOMY
  • SAH PATIENTS
  • FLOW

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