Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Cerebral autoregulatory performance and the cerebrovascular response to head-of-bed positioning in acute ischemic stroke

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. More precise phenotyping of cluster headache using prospective attack reports

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Randomized trial of facilitated subcutaneous immunoglobulin in multifocal motor neuropathy

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Acute endovascular reperfusion treatment in patients with ischaemic stroke and large-vessel occlusion (Denmark 2011–2017)

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Disturbed sleep in cluster headache is not the result of transient processes associated with the cluster period

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Disturbances of consciousness and sleep-wake functions in patients following brainstem lesions

    Research output: Contribution to journalConference abstract in journalResearchpeer-review

  1. Cervical Spine Clearance in Trauma Patients with an Unreliable Physical Examination

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Red blood cell transfusion in surgery: an observational study of the trends in the USA from 2011 to 2016

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Abnormal routine blood tests as predictors of mortality in acutely admitted patients

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Neuroinflammatory markers associate with cognitive decline after major surgery: findings of an explorative study

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND AND PURPOSE: Cerebrovascular responses to head-of-bed positioning in patients with acute ischemic stroke are heterogeneous, questioning applicability of general recommendations on head positioning. Cerebral autoregulation is impaired to various extents after acute stroke, while it is unknown whether this affects cerebral perfusion during posture change. We aimed to elucidate whether the cerebrovascular response to head position manipulation depends on autoregulatory performance in ischemic stroke patients.

METHODS: In 39 patients with acute ischemic stroke and in 17 reference subjects from 2 centers the responses of bilateral transcranial Doppler ultrasound determined cerebral blood flow velocity (CBFV) and local cerebral blood volume (CBV) assessed by near-infrared spectroscopy total hemoglobin tissue concentration ([total Hb]) to head-of-bed lowering from 30° to 0° were determined. Cerebrovascular autoregulatory performance was expressed as the phase difference of the arterial pressure-to-CBFV transfer function.

RESULTS: Following head-of-bed lowering, CBV increased in the reference subjects only ([total Hb] +2.1±2.0 vs. +0.4±2.6 μM; p<0.05), whereas CBFV did not change in both groups. In patients' hemispheres with autoregulatory performance <50th percentile CBV increased upon head-of-bed lowering vs. a decrease in hemispheres with better autoregulatory performance ([total Hb]: +1.0±1.3 μM vs. -0.5±1.0 μM; p<0.05). The CBV response was inversely related to autoregulatory performance (r= -0.68; p<0.001) in the patients, while no such relation was observed for CBFV.

CONCLUSIONS: This study is the first to provide evidence that in patients with acute ischemic stroke cerebral autoregulatory performance affects the cerebrovascular response to changes in the position of the head. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalEuropean Journal of Neurology
Volume25
Issue number11
Pages (from-to)1365-e117
ISSN1351-5101
DOIs
Publication statusPublished - 2018

ID: 54727248