Abstract
The brain can withstand only very short periods of ischemia because neurons produce ATP almost entirely by oxidative metabolism. Without oxygen, energy-dependent processes stop causing irreversible cellular injury. Therefore, cerebral blood flow must be maintained to ensure oxygen delivery and removal of the products of metabolism. The regulation of the cerebral circulation is an intricate and critical process that relies on the complex and interacting influences of the cardiovascular, respiratory, neural, and local metabolic systems. These physiologic systems act in complex and interacting ways to maintain an adequate cerebral blood flow by altering arterial, intracranial, and venous pressures. This is achieved by multiple mechanisms. For example, cerebral autoregulation is the response of the cerebral vessels to changes in arterial blood pressure. It is well documented that a decrease in systemic arterial blood pressure causes dilatation of the cerebral vessels and that, conversely, an increase in systemic arterial blood pressure causes vasoconstriction of the cerebral circulation. Changes in cerebral vascular tone are also mediated by putative constricting and dilating substances, and cerebral blood flow is tightly coupled with regional brain metabolism. These vasoactive substances may be supplied to the vessels via the bloodstream [e.g., arterial partial pressure of carbon dioxide (PaCO2), produced locally (adenosine, nitric oxide, potassium), or reach the vascular smooth muscle through direct autonomic innervation (acetylcholine, norepinephrine)]. Unique anatomical features, including the rigid skull, are also important considerations in the control of cerebral blood flow. In this chapter, we briefly discuss the major factors regulating cerebral blood flow including important anatomical features for a functional understanding of the regulation of the cerebral circulation.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Wiggers C. On the action of adrenaline on cerebral vessels. Am J Phys. 1905;14:452–65.
Bevan J. Sites of transition between functional systemic and cerebral arteries or rabbits occur at embryological junctional sites. Science. 1979;204:635–7.
Dunning H, Wolff H. The relative vascularity of various parts of the central and peripheral nervous system in the cat and its relation to function. J Comp Neurol. 1937;67:280–6.
Sokoloff L, Reivich M, Kennedy C, Des Rosiers MH, Patlak CS, Pettigrew KD, et al. The [14C]deoxyglucose method for the measurement of local cerebral glucose utilization: theory, procedure, and normal values in the conscious and anesthetized albino rat. J Neurochem. 1977;28(5):897–916.
Nakagawa Y, Tsuru M, Yada K. Site and mechanism for compression of the venous system during experimental intracranial hypertension. J Neurosurg. 1974;41(4):427–34.
Piechnik SK, Czosnyka M, Richards HK, Whitfield PC, Pickard JD. Cerebral venous blood outflow: a theoretical model based on laboratory simulation. Neurosurgery. 2001;49(5):1214–22.
Ursino M, Lodi CA. A simple mathematical model of the interaction between intracranial pressure and cerebral hemodynamics. J Appl Physiol. 1997;82(4):1256–69.
Czosnyka M, Piechnik S, Richards HK, Kirkpatrick P, Smielewski P, Pickard JD. Contribution of mathematical modelling to the interpretation of bedside tests of cerebrovascular autoregulation. J Neurol Neurosurg Psychiatry. 1997;63(6):721–31.
Attwell D, Buchan AM, Charpak S, Lauritzen M, Macvicar BA, Newman EA. Glial and neuronal control of brain blood flow. Nature. 2010;468(7321):232–43.
Hall CN, Reynell C, Gesslein B, Hamilton NB, Mishra A, Sutherland BA, et al. Capillary pericytes regulate cerebral blood flow in health and disease. Nature. 2014;508(7494):55–60.
Willie CK, Tzeng YC, Fisher JA, Ainslie PN. Integrative regulation of human brain blood flow. J Physiol. 2014;592(5):841–59.
Schaller B. Physiology of cerebral venous blood flow: from experimental data in animals to normal function in humans. Brain Res Brain Res Rev. 2004;46(3):243–60.
Lee SP, Duong TQ, Yang G, Iadecola C, Kim SG. Relative changes of cerebral arterial and venous blood volumes during increased cerebral blood flow: implications for BOLD fMRI. Magn Reson Med. 2001;45(5):791–800.
Rosenblum WI. Endothelium-derived relaxing factor in brain blood vessels is not nitric oxide. Stroke. 1992;23(10):1527–32.
Menon D. Cerebral circulation. In: Priebe H-J, Sharvans K, editors. Cardiovascular physiology. London: BMJ Publishing Group; 1995. p. 198–223.
Berntman L, Carlsson C, Siesjo BK. Influence of propranolol on cerebral metabolism and blood flow in the rat brain. Brain Res. 1978;151(1):220–4.
Berntman L, Carlsson C, Siesjo BK. Cerebral oxygen consumption and blood flow in hypoxia: influence of sympathoadrenal activation. Stroke. 1979;10(1):20–5.
Edvinsson L, Sercombe R. Influence of pH and pCO2 on alpha-receptor mediated contraction in brain vessels. Acta Physiol Scand. 1976;97(3):325–31.
Pickard J, Simeone F, Vinall P. In: Betsz E, editor. H+, CO2, prostaglndins and cerebrovascular smooth muscle. Berlin: Springer-Verlag; 1976.
Busija DW, Heistad DD. Effects of cholinergic nerves on cerebral blood flow in cats. Circ Res. 1981;48(1):62–9.
Heistad DD, Marcus ML, Ehrhardt JC, Abboud FM. Effect of stimulation of carotid chemoreceptors on total and regional cerebral blood flow. Circ Res. 1976;38(1):20–5.
Ainslie PN, Duffin J. Integration of cerebrovascular CO2 reactivity and chemoreflex control of breathing: mechanisms of regulation, measurement, and interpretation. Am J Physiol Regul Integr Comp Physiol. 2009;296(5):R1473–95.
Lassen N. In: Sutton J, Jones N, Houston C, editors. The brain: cerebral blood flow. New York: Thieme-Stratton; 1982.
Strandgaard S, Sigurdsson ST. Point: counterpoint: sympathetic activity does/does not influence cerebral blood flow. Counterpoint: sympathetic nerve activity does not influence cerebral blood flow. J Appl Physiol (1985). 2008;105(4):1366–7.
van Lieshout JJ, Secher NH. Point: counterpoint: sympathetic activity does/does not influence cerebral blood flow. Point: sympathetic activity does influence cerebral blood flow. J Appl Physiol (1985). 2008;105(4):1364–6.
Visocchi M, Chiappini F, Cioni B, Meglio M. Cerebral blood flow velocities and trigeminal ganglion stimulation. A transcranial Doppler study. Stereotact Funct Neurosurg. 1996;66(4):184–92.
Umeyama T, Kugimiya T, Ogawa T, Kandori Y, Ishizuka A, Hanaoka K. Changes in cerebral blood flow estimated after stellate ganglion block by single photon emission computed tomography. J Auton Nerv Syst. 1995;50(3):339–46.
Iwayama T, Furness JB, Burnstock G. Dual adrenergic and cholinergic innervation of the cerebral arteries of the rat. An ultrastructural study. Circ Res. 1970;26(5):635–46.
Nielsen KC, Owman C. Adrenergic innervation of pial arteries related to the circle of Willis in the cat. Brain Res. 1967;6(4):773–6.
Heistad DD, Marcus ML. Evidence that neural mechanisms do not have important effects on cerebral blood flow. Circ Res. 1978;42(3):295–302.
Purves MJ. Do vasomotor nerves significantly regulate cerebral blood flow? Circ Res. 1978;43(4):485–93.
Owman C, Edvinsson L, Nielsen KC. Autonomic neuroreceptor mechanisms in brain vessels. Blood Vessels. 1974;11(1-2):2–31.
Duckles SP, Bevan JA. Pharmacological characterization of adrenergic receptors of a rabbit cerebral artery in vitro. J Pharmacol Exp Ther. 1976;197(2):371–8.
Edvinsson L, MacKenzie ET. Amine mechanisms in the cerebral circulation. Pharmacol Rev. 1976;28(4):275–348.
Toda N, Fujita Y. Responsiveness of isolated cerebral and peripheral arteries to serotonin, norepinephrine, and transmural electrical stimulation. Circ Res. 1973;33(1):98–104.
Lee TJ, Su C, Bevan JA. Neurogenic sympathetic vasoconstriction of the rabbit basilar artery. Circ Res. 1976;39(1):120–6.
Navari RM, Wei EP, Kontos HA, Patterson JL Jr. Comparison of the open skull and cranial window preparations in the study of the cerebral microcirculation. Microvasc Res. 1978;16(3):304–15.
Oldendorf WH. Brain uptake of radiolabeled amino acids, amines, and hexoses after arterial injection. Am J Phys. 1971;221(6):1629–39.
Tindall GT, Greenfield JC Jr. The effects of intra-arterial histamine on blood flow in the internal and external carotid artery of man. Stroke. 1973;4(1):46–9.
MacKenzie ET, McCulloch J, O’Kean M, Pickard JD, Harper AM. Cerebral circulation and norepinephrine: relevance of the blood-brain barrier. Am J Phys. 1976;231(2):483–8.
Bill A, Linder J. Sympathetic control of cerebral blood flow in acute arterial hypertension. Acta Physiol Scand. 1976;96(1):114–21.
Edvinsson L, Owman C, Siesjo B. Physiological role of cerebrovascular sympathetic nerves in the autoregulation of cerebral blood flow. Brain Res. 1976;117(3):519–23.
Heistad DD, Marcus ML. Effect of sympathetic stimulation on permeability of the blood-brain barrier to albumin during acute hypertension in cats. Circ Res. 1979;45(3):331–8.
Heistad DD, Marcus ML, Gross PM. Effects of sympathetic nerves on cerebral vessels in dog, cat, and monkey. Am J Phys. 1978;235(5):H544–52.
MacKenzie ET, McGeorge AP, Graham DI, Fitch W, Edvinsson L, Harper AM. Effects of increasing arterial pressure on cerebral blood flow in the baboon: influence of the sympathetic nervous system. Pflugers Arch. 1979;378(3):189–95.
Lindvall M, Edvinsson L, Owman C. Sympathetic nervous control of cerebrospinal fluid production from the choroid plexus. Science. 1978;201(4351):176–8.
Johansson B, Li CL, Olsson Y, Klatzo I. The effect of acute arterial hypertension on the blood-brain barrier to protein tracers. Acta Neuropathol. 1970;16(2):117–24.
Hart MN, Heistad DD, Brody MJ. Effect of chronic hypertension and sympathetic denervation on wall/lumen ratio of cerebral vessels. Hypertension. 1980;2(4):419–23.
Larsson LI, Edvinsson L, Fahrenkrug J, Hakanson R, Owman C, Schaffalitzky de Muckadell O, et al. Immunohistochemical localization of a vasodilatory polypeptide (VIP) in cerebrovascular nerves. Brain Res. 1976;113(2):400–4.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 The Author(s)
About this chapter
Cite this chapter
Lujan, H.L., Augustyniak, R.A., DiCarlo, S.E. (2018). Physiology of the Cerebrovascular System. In: Hans, S. (eds) Extracranial Carotid and Vertebral Artery Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-91533-3_2
Download citation
DOI: https://doi.org/10.1007/978-3-319-91533-3_2
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-91532-6
Online ISBN: 978-3-319-91533-3
eBook Packages: MedicineMedicine (R0)