Transcranial Doppler assessment of cerebral autoregulation

Ultrasound in Medicine & Biology
Judith Bellapart, John F Fraser

Abstract

Cerebral autoregulation describes the process by which cerebral blood flow is maintained despite fluctuations in cerebral perfusion pressure. The assessment of cerebral autoregulation is a key to the optimisation of cerebral perfusion pressure in patients with brain injury. This review evaluates the current evidence for transcranial Doppler in the assessment of cerebral autoregulation. The study of cerebral autoregulation classically assesses changes in cerebral perfusion pressure secondary to changes in systemic blood pressure. It is defined static autoregulation if blood pressure changes are progressive, thereby allowing a steady-state autoregulatory response to be completed. For sudden changes in blood pressure, the autoregulatory response is defined as dynamic. The static and dynamic components of cerebral autoregulation have been approached using linear mathematical models (models based in direct correlations). Over the past decade, demonstration of the nonstationary (the property of changing over time or space) behaviour of cerebral autoregulation has emphasised the benefit obtained in using nonlinear statistical models (models based on changeable functions), suggesting that these methods may improve the mathematical repr...Continue Reading

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Related Concepts

Blood Flow Velocity
Cerebrovascular Circulation
Pulmonary Vascular Resistance
Ultrasonography, Doppler, Transcranial
Chaos Theory
Blood Pressure
Evaluation
Anatomical Space Structure
Blood Flow
Brain Injuries

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