Experimental cerebral hemodynamics

TLDR

Cerebral perfusion pressure equals mean arterial pressure minus critical closing pressure, which is largely determined by vasomotor tone and intracranial pressure and ranges from 10 to 95 mm Hg in anesthetized monkeys, with resistance vessel diameter remaining relatively constant across normal flow ranges. Using these limits and average MAP and CCP values from 11 awake monkeys, the authors derived theoretical flow curves in response to changes in intracranial pressure and mean arterial pressure that closely match human data. The study shows that cerebral blood flow is governed mainly by perfusion pressure rather than vascular bed resistance, as flow varies with pressure while resistance remains largely unchanged.

Abstract

✓ Application of Burton's concept of the critical closing pressure to experimental data on brain-blood flow in the monkey suggests that perfusion pressure, not vascular bed resistance, is the primary variable affecting cerebral blood flow. Perfusion pressure for the cerebral circulation is the mean arterial pressure minus the critical closing pressure (MAP — CCP). Vasomotor tone and intracranial pressure are the major determinants of the critical closing pressure. Changes in either of these variables, therefore, affect perfusion pressure and flow. Data on brain-blood flow at fixed vasomotor tone obtained over wide pressure ranges show little change in vascular bed resistance despite significant changes in flow. The diameter of resistance vessels probably does not change significantly throughout the normal physiological range of cerebral blood flow. The limits of the critical closing pressure in the anesthetized monkey are from 10 to 95 mm Hg. Using these limits, and beginning with the average values for MAP and CCP in 11 awake monkeys breathing room air, the authors present theoretical flow curves in response to changes in intracranial pressure and mean arterial pressure that closely approximate the data reported in man.