Autoregulating cerebral tissue selfishly exploits collateral flow routes through the circle of willis
Journal
Acta Neurochirurgica, Supplementum
Journal Volume
126
Pages
275-279
Date Issued
2018
Author(s)
Abstract
Objective: Ischemic stroke is a leading cause of death and disability. Autoregulation and collateral blood flow through the circle of Willis both play a role in preventing tissue infarction. A steady-state model of the cerebral arterial network was used to investigate the interaction of these mechanisms when autoregulation is impaired ipsilateral to an occluded artery. Materials and methods: Twelve structural variants of the circle of Willis were modelled with left internal carotid artery occlusion and coupled with (1) a passive model of the cerebral vascular bed, (2) a steady-state model of an autoregulating cerebral vascular bed, and (3) a model in which the contralateral hemisphere autoregulates and the ipsilateral hemisphere does not. Results: Results showed that if the autoregulatory response is impaired ipsilaterally, then, in the autoregulating hemisphere, cerebral flows are preserved at the expense of those on the ipsilateral side. Conclusions: Thus, although autoregulation is an essential facilitator of collateral flow through the circle of Willis, contralateral autoregulation can exacerbate flow reductions if not balanced by the same response in the vascular beds on the ipsilateral side. The status of the autoregulatory response in both hemispheres can strongly influence cerebral blood flows and tissue survival and should, therefore, be monitored in stroke. ? Springer International Publishing AG 2018.
Subjects
autoregulation
brain blood flow
brain blood vessel
brain circulus arteriosus
brain ischemia
brain tissue
capillary resistance
collateral circulation
hemisphere
internal carotid artery
internal carotid artery occlusion
negative feedback
tissue survival
vascular resistance
anatomical variation
anatomy and histology
biological model
brain circulation
brain infarction
carotid artery disease
cerebrovascular accident
cerebrovascular disease
homeostasis
human
pathophysiology
physiology
Anatomic Variation
Brain Infarction
Carotid Artery Diseases
Carotid Artery, Internal
Cerebrovascular Circulation
Cerebrovascular Disorders
Circle of Willis
Collateral Circulation
Homeostasis
Humans
Models, Cardiovascular
Stroke
SDGs
Type
book part