Skip to main content
SpringerLink
Log in

Blood Pressure and Cerebral Ischemic Reperfusion Injury

  • Chapter
  • First Online:
Cerebral Ischemic Reperfusion Injuries (CIRI)

Part of the book series: Springer Series in Translational Stroke Research ((SSTSR))

  • 476 Accesses

Abstract

Recanalization and reperfusion injury in ischemic stroke patients casts shadows on current stroke management. The potential mechanisms of reperfusion injury remain obscure and need further investigation. This article summarized several clinically important mechanisms and especially discussed a potential role of blood pressure control in reperfusion injury.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. van Mook WN, Rennenberg RJ, Schurink GW, et al. Cerebral hyperperfusion syndrome. Lancet Neurol. 2005;4:877–88.

    Article  PubMed  Google Scholar 

  2. Farooq MU, Goshgarian C, Min J, Gorelick PB. Pathophysiology and management of reperfusion injury and hyperperfusion syndrome after carotid endarterectomy and carotid artery stenting. Exp Transl Stroke Med. 2016;8:7.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ogasawara K, Yukawa H, Kobayashi M, et al. Prediction and monitoring of cerebral hyperperfusion after carotid endarterectomy by using single-photon emission computerized tomography scanning. J Neurosurg. 2003;99:504–10.

    Article  PubMed  Google Scholar 

  4. Rose JC, Mayer SA. Optimizing blood pressure in neurological emergencies. Neurocrit Care. 2006;4:98.

    Article  PubMed  CAS  Google Scholar 

  5. Waltz AG. Effect of blood pressure on blood flow in ischemic and in nonischemic cerebral cortex. The phenomena of autoregulation and luxury perfusion. Neurology. 1968;18:613–21.

    Article  PubMed  CAS  Google Scholar 

  6. Markus HS. Cerebral perfusion and stroke. J Neurol Neurosurg Psychiatry. 2004;75:353–61.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Strandgaard S, Olesen J, Skinhoj E, Lassen NA. Autoregulation of brain circulation in severe arterial hypertension. Br Med J. 1973;1:507–10.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Dawson SL, Panerai RB, Potter JF. Serial changes in static and dynamic cerebral autoregulation after acute ischaemic stroke. Cerebrovasc Dis. 2003;16:69–75.

    Article  PubMed  Google Scholar 

  9. Pryds O, Edwards AD. Cerebral blood flow in the newborn infant. Arch Dis Child Fetal Neonatal Ed. 1996;74:F63–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Tyszczuk L, Meek J, Elwell C, Wyatt JS. Cerebral blood flow is independent of mean arterial blood pressure in preterm infants undergoing intensive care. Pediatrics. 1998;102:337–41.

    Article  PubMed  CAS  Google Scholar 

  11. Pan J, Konstas AA, Bateman B, Ortolano GA, Pile-Spellman J. Reperfusion injury following cerebral ischemia: pathophysiology, MR imaging, and potential therapies. Neuroradiology. 2007;49:93–102.

    Article  PubMed  Google Scholar 

  12. Symon L, Branston NM, Strong AJ. Autoregulation in acute focal ischemia. An experimental study. Stroke. 1976;7:547–54.

    Article  PubMed  CAS  Google Scholar 

  13. Jiang WJ. Cerebral perfusion imaging. The carotid and supra-aortic trunks: diagnosis, angioplasty and stenting. 2nd ed. Chichester: John Wiley & Sons, Ltd; 2011. p. 76–85.

    Book  Google Scholar 

  14. Jorgensen LG, Schroeder TV. Defective cerebrovascular autoregulation after carotid endarterectomy. Eur J Vasc Surg. 1993;7:370–9.

    Article  PubMed  CAS  Google Scholar 

  15. Vaughan CJ, Delanty N. Hypertensive emergencies. Lancet. 2000;356:411–7.

    Article  PubMed  CAS  Google Scholar 

  16. Bernstein M, Fleming JF, Deck JH. Cerebral hyperperfusion after carotid endarterectomy: a cause of cerebral hemorrhage. Neurosurgery. 1984;15:50-6.

    PubMed  Google Scholar 

  17. Janigro D, West GA, Nguyen TS, Winn HR. Regulation of blood-brain barrier endothelial cells by nitric oxide. Circ Res. 1994;75:528–38.

    Article  CAS  PubMed  Google Scholar 

  18. Ogasawara K, Inoue T, Kobayashi M, Endo H, Fukuda T, Ogawa A. Pretreatment with the free radical scavenger edaravone prevents cerebral hyperperfusion after carotid endarterectomy. Neurosurgery. 2004;55:1060–7.

    Article  PubMed  Google Scholar 

  19. Timmers HJ, Wieling W, Karemaker JM, Lenders JW. Baroreflex failure: a neglected type of secondary hypertension. Neth J Med. 2004;62:151–5.

    PubMed  CAS  Google Scholar 

  20. Macfarlane R, Moskowitz MA, Sakas DE, Tasdemiroglu E, Wei EP, Kontos HA. The role of neuroeffector mechanisms in cerebral hyperperfusion syndromes. J Neurosurg. 1991;75:845–55.

    Article  PubMed  CAS  Google Scholar 

  21. Edvinsson L, McCulloch J, Kingman T, Uddman R. On the functional role of the trigemino-cerebrovascular system in the regulation of cerebral circulation. In: Neural regulation of the brain cerebral circulation. New York, NY: Elsevier; 1986. p. 407–18.

    Google Scholar 

  22. Sundt TM Jr, Sharbrough FW, Piepgras DG, Kearns TP, Messick JM Jr, O’Fallon WM. Correlation of cerebral blood flow and electroencephalographic changes during carotid endarterectomy: with results of surgery and hemodynamics of cerebral ischemia. Mayo Clin Proc. 1981;56:533–43.

    PubMed  Google Scholar 

  23. Sbarigia E, Speziale F, Giannoni MF, Colonna M, Panico MA, Fiorani P. Post-carotid endarterectomy hyperperfusion syndrome: preliminary observations for identifying at risk patients by transcranial Doppler sonography and the acetazolamide test. Eur J Vasc Surg. 1993;7:252–6.

    Article  PubMed  CAS  Google Scholar 

  24. Hosoda K, Kawaguchi T, Shibata Y, et al. Cerebral vasoreactivity and internal carotid artery flow help to identify patients at risk for hyperperfusion after carotid endarterectomy. Stroke. 2001;32:1567–73.

    Article  CAS  PubMed  Google Scholar 

  25. Nielsen MY, Sillesen HH, Jorgensen LG, Schroeder TV. The haemodynamic effect of carotid endarterectomy. Eur J Vasc Endovasc Surg. 2002;24:53–8.

    Article  PubMed  Google Scholar 

  26. Ascher E, Markevich N, Schutzer RW, Kallakuri S, Jacob T, Hingorani AP. Cerebral hyperperfusion syndrome after carotid endarterectomy: predictive factors and hemodynamic changes. J Vasc Surg. 2003;37:769–77.

    Article  PubMed  Google Scholar 

  27. Yoshimoto T, Houkin K, Kuroda S, Abe H, Kashiwaba T. Low cerebral blood flow and perfusion reserve induce hyperperfusion after surgical revascularization: case reports and analysis of cerebral hemodynamics. Surg Neurol. 1997;48:132–8. discussion 8–9.

    Article  PubMed  CAS  Google Scholar 

  28. Byrom FB. The pathogenesis of hypertensive encephalopathy and its relation to the malignant phase of hypertension; experimental evidence from the hypertensive rat. Lancet. 1954;267:201–11.

    Article  PubMed  CAS  Google Scholar 

  29. Schwartz RB. Hyperperfusion encephalopathies: hypertensive encephalopathy and related conditions. Neurologist. 2002;8:22–34.

    Article  PubMed  Google Scholar 

  30. Okazaki H. Fundamentals of neuropathology. Morphologic basics of neurologic disorders. New York, NY: Igaku-Shoin; 1989.

    Google Scholar 

  31. Moncada S, Higgs A. The L-arginine-nitric oxide pathway. N Engl J Med. 1993;329:2002–12.

    Article  PubMed  CAS  Google Scholar 

  32. Busija DW, Heistad DD. Factors involved in the physiological regulation of the cerebral circulation. Rev Physiol Biochem Pharmacol. 1984;101:161–211.

    Article  PubMed  CAS  Google Scholar 

  33. Beausang-Linder M, Bill A. Cerebral circulation in acute arterial hypertension--protective effects of sympathetic nervous activity. Acta Physiol Scand. 1981;111:193–9.

    Article  PubMed  CAS  Google Scholar 

  34. Dacey RG Jr, Duling BR. A study of rat intracerebral arterioles: methods, morphology, and reactivity. Am J Phys. 1982;243:H598–606.

    Google Scholar 

  35. Ngai AC, Winn HR. Modulation of cerebral arteriolar diameter by intraluminal flow and pressure. Circ Res. 1995;77:832–40.

    Article  PubMed  CAS  Google Scholar 

  36. Edvinsson L, Owman C, Sjoberg NO. Autonomic nerves, mast cells, and amine receptors in human brain vessels. A histochemical and pharmacological study. Brain Res. 1976;115:377–93.

    Article  PubMed  CAS  Google Scholar 

  37. Neal CR, Michel CC. Openings in frog microvascular endothelium induced by high intravascular pressures. J Physiol. 1996;492(Pt 1):39–52.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  38. Johansson BB. Hypertension mechanisms causing stroke. Clin Exp Pharmacol Physiol. 1999;26:563–5.

    Article  PubMed  CAS  Google Scholar 

  39. Wardlaw JM, Doubal F, Armitage P, et al. Lacunar stroke is associated with diffuse blood-brain barrier dysfunction. Ann Neurol. 2009;65:194–202.

    Article  PubMed  Google Scholar 

  40. Yoshimoto T, Shirasaka T, Yoshizumi T, Fujimoto S, Kaneko S, Kashiwaba T. Evaluation of carotid distal pressure for prevention of hyperperfusion after carotid endarterectomy. Surg Neurol. 2005;63:554–7. discussion 7–8.

    Article  PubMed  Google Scholar 

  41. Coutts SB, Hill MD, Hu WY. Hyperperfusion syndrome: toward a stricter definition. Neurosurgery. 2003;53:1053–8. discussion 8–60.

    Article  PubMed  Google Scholar 

  42. Dalman JE, Beenakkers IC, Moll FL, Leusink JA, Ackerstaff RG. Transcranial Doppler monitoring during carotid endarterectomy helps to identify patients at risk of postoperative hyperperfusion. Eur J Vasc Endovasc Surg. 1999;18:222–7.

    Article  PubMed  CAS  Google Scholar 

  43. Sacco RL, Adams R, Albers G, et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Circulation. 2006;113:e409–49.

    PubMed  Google Scholar 

  44. Tietjen CS, Hurn PD, Ulatowski JA, Kirsch JR. Treatment modalities for hypertensive patients with intracranial pathology: options and risks. Crit Care Med. 1996;24:311–22.

    Article  PubMed  CAS  Google Scholar 

  45. Muzzi DA, Black S, Losasso TJ, Cucchiara RF. Labetalol and esmolol in the control of hypertension after intracranial surgery. Anesth Analg. 1990;70:68-71.

    PubMed  Google Scholar 

  46. Ahn SS, Marcus DR, Moore WS. Post-carotid endarterectomy hypertension: association with elevated cranial norepinephrine. J Vasc Surg. 1989;9:351–60.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Vascular Neurosurgery Department of New Era Stroke Care and Research Institute, The PLA Rocket Force General Hospital, Beijing, China

    Weijian Jiang & Chen Li

  2. MUSC Stroke Center, Department of Neurology, Medical University of South Carolina, Charleston, SC, USA

    Mohamad Orabi & Wuwei Feng

Authors
  1. Weijian Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chen Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohamad Orabi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wuwei Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Weijian Jiang .

Editor information

Editors and Affiliations

  1. Department of Vascular Neurosurgery, PLA Rocket Force General Hospital, Beijing, China

    Weijian Jiang

  2. Department of Neurology, University of California Irvine, Irvine, California, USA

    Wengui Yu

  3. Department of Neurosurgery, Tangdu Hospital of Air Force Medical University, Xi’an, China

    Yan Qu

  4. Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

    Zhongsong Shi

  5. Department of Neurology, The First Affiliated Hospital School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China

    Benyan Luo

  6. Department of Anesthesiology, Loma Linda University, Loma Linda, California, USA

    John H. Zhang

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Jiang, W., Li, C., Orabi, M., Feng, W. (2018). Blood Pressure and Cerebral Ischemic Reperfusion Injury. In: Jiang, W., Yu, W., Qu, Y., Shi, Z., Luo, B., Zhang, J. (eds) Cerebral Ischemic Reperfusion Injuries (CIRI). Springer Series in Translational Stroke Research. Springer, Cham. https://doi.org/10.1007/978-3-319-90194-7_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-90194-7_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90193-0

  • Online ISBN: 978-3-319-90194-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation