Cerebral Vasomotor Control and CSF pH in Metabolic and Respiratory Coma

  • C. Fieschi
  • A. Agnoli
  • N. Battistini
  • M. Nardini
  • M. Prencipe

Abstract

Regional CBF was measured in the resting state and during vasomotor tests, along with CSF acid-base status, in 15 patients comatose due to diffuse brain lesions (Table 1). Fig. 1 illustrates 1 patient, showing the data obtained in a typical study. Flow was measured in 5 regions with 85Kr analyzing the entire clearance curves; the arterial blood was repeatedly sampled, and CSF was sampled at the end and/or at the beginning of the study, for pCO2, pH and pO2 determinations. Clearance curves were obtained in the resting state, and during different stimuli. In this case (hepatic coma with a slight metabolic acidosis and marked respiratory alkalosis; flow slightly reduced) the stimuli were mannitol infusion followed by an induced increase in arterial pressure. Both stimuli revealed a diffuse loss of autoregulation. In some other cases CO2 inhalation or hyperventilation have been tested.

Keywords

Angiotensin Neurol Mannitol 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Betz, E., and D. Heuser: Cerebral cortical blood flow during changes of acid-base equilibrium of the brain. J. appl. Physiol. 23, 726 (1967).PubMedGoogle Scholar
  2. 2.
    Kety, S. S., B. D. Polis, C. S. Nadler, and C. F. Schmidt: The blood flow and oxygen consumption of the human brain in diabetic acidosis and coma. J. clin. Lab. Invest. 27, 500 (1948).CrossRefGoogle Scholar
  3. 3.
    Kety, S. S., B. D. Polis, C. S. Nadler, and C. F. Schmidt: The cerebral circulation. In: Handbook of physiology. Neurophysiology III, 1751 (1960).Google Scholar
  4. 4.
    Lassen, N.: Brain extracellular pH: the main factor controlling cerebral blood flow. Scand. J. clin. Lab. Invest. 22, 247 (1968).PubMedCrossRefGoogle Scholar
  5. 5.
    Posner, J. B., A. G. Swanson, and F. Plum: Acid base balance in cerebrospinal fluid. Arch. Neurol. 12, 479 (1965).PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1969

Authors and Affiliations

  • C. Fieschi
    • 1
  • A. Agnoli
    • 1
  • N. Battistini
    • 1
  • M. Nardini
    • 1
  • M. Prencipe
    • 1
  1. 1.Department of Neurology and PsychiatryUniversity of GenoaItaly

Personalised recommendations