Cerebral blood flow and brain function during hypotension and shock

Annu Rev Physiol. 1976:38:571-96. doi: 10.1146/annurev.ph.38.030176.003035.

Abstract

In conclusion, the reviewed results clearly suggest that vital functions of the brain -in spite of the well-developed autoregulatory mechanisms-are impaired during long-lasting hypovolemic and other shock conditions. The insufficiency of the cerebrocortical and hypothalamic regulatory mechanisms can contribute to the development of the irreversible shock. In other words, failure of the body suffering from shock to restore the homeostatic equilibrium can be attributed to the inadequacy of the central nervous servocontrol system. According to the available results, the regional cerebral microcirculatory defect develops through sludge formation. The unevenly distributed local brain damage could be the background of the functional impairment. The focal appearance suggest that, in addition to generalized (bloody borne) changes, local factors play an important role in the production of patchy ischemic areas in the brain.

Publication types

  • Review

MeSH terms

  • Acetylcholine / pharmacology
  • Angiotensin II / pharmacology
  • Animals
  • Brain / pathology
  • Brain / physiopathology*
  • Brain Stem / blood supply
  • Cardiac Output
  • Cerebellum / blood supply
  • Cerebral Cortex / blood supply
  • Cerebrovascular Circulation* / drug effects
  • Diencephalon / blood supply
  • Electroencephalography
  • Epinephrine / pharmacology
  • Evoked Potentials
  • Humans
  • Hypotension / physiopathology*
  • Hypothalamus / metabolism
  • Hypothalamus / physiopathology
  • Hypoxia / physiopathology
  • Norepinephrine / pharmacology
  • Reflex
  • Regional Blood Flow
  • Serotonin / pharmacology
  • Shock / physiopathology*
  • Shock, Hemorrhagic / physiopathology
  • Sympathetic Nervous System / physiopathology
  • Synapses / physiology
  • Vasomotor System / physiopathology

Substances

  • Angiotensin II
  • Serotonin
  • Acetylcholine
  • Norepinephrine
  • Epinephrine