The effect of carbon dioxide on Doppler flow velocity waveforms in the human fetus.

Twelve healthy pregnant women were studied between 35 to 40 weeks gestation to determine the effect of carbon dioxide on the Doppler flow velocity waveform in the cerebral and umbilical arteries of the human fetus near term. The Resistance index (RI), as an index of vascular resistance, was calculated for the internal carotid and umbilical arteries during a control period while patients breathed room air followed by three randomized 15-30 min study periods with patients breathing either room air, a prepared gas mixture with 2% carbon dioxide, or undergoing controlled hyperventilation as determined by monitoring end-tidal PCO2. The RI of the internal carotid and umbilical arteries both showed a significant inverse relationship to maternal end-tidal PCO2 with a greater negative slope for RI plotted against end-tidal PCO2 in the internal carotid artery (0.0153) than in the umbilical artery (0.0047). The change in the RI as an index of changing vascular resistance, suggests that carbon dioxide is also an important determinant of cerebral blood flow in the human fetus, as previously described for fetal sheep, with a lesser although significant effect on umbilical blood flow.     

Structure and sympathetic innervation of the intracranial arteries in the giraffe (Giraffa camelopardalis)

Fluorescence histochemistry discloses that the carotid rete mirabile in the giraffe has a poor sympathetic innervation. In contrast, the efferent artery of the rete (internal carotid artery) and the cerebral arteries show moderate sympathetic innervation. A certain degree of regional variability was noted in which the rostral arteries (anterior and middle cerebral) receive more sympathetic nerves than the caudal (posterior communicating and basilar) arteries. The sympathetic nerves on the giraffe cerebral vessels may constitute part of a host of mechanisms by which regional blood flow to the brain is regulated. Conversely, the paucity of sympathetic innervation of the carotid rete mirabile may indicate that this structure does not play an active role in vasoconstrictor responses during postural changes of the head.     

Ultrasonographic study of blood flow in the renal arteries of patients with arterial hypertension

Vascular duplex ultrasound duplex with simultaneous ECG registration was made to estimate the quantitative and time parameters of blood flow in the renal arteries with grade 1-2 arterial hypertension. There were increases in vascular resistance indices and acceleration phase index and a reduction in systolic phase index. There were correlations of the time parameters of blood flow in the renal arteries with age and lipidogram values.     

Age and sex dependence of hemodynamic parameters of human internal carotid arteries

The study of the ultrasound diameter, linear velocity, and resistance of the internal carotid arteries in 647 subjects of both sexes aged from 1 to 74 years has been performed. Additionally, shear stress and the Reynolds number have been calculated. During the period from early childhood to adolescence and from the first mature to younger elderly ages, there is an increase in the diameter of the internal carotid arteries. Phases of an increase in the vascular resistance by the first period of childhood, adolescence, and younger elderly age are observed. The space flow velocity has relatively stable parameters till youth, and then it declines by younger elderly age. The average linear velocity, shear stress, and the Reynolds number progressively diminish twice by younger elderly age. Laminar blood flow with local twists in the early stages of postnatal ontogenesis is characteristic of the internal carotid arteries. The diameter of the internal carotid arteries, vascular resistance index, and blood flow velocity are higher in men than in women during most age periods. Shear stress in both internal carotid arteries during all the age periods studied is symmetrical and has no sex differences.     

Modeling Stroke in Mice - Middle Cerebral Artery Occlusion with the Filament Model

Stroke is among the most frequent causes of death and adult disability, especially in highly developed countries. However, treatment options to date are very limited. To meet the need for novel therapeutic approaches, experimental stroke research frequently employs rodent models of focal cerebral ischaemia. Most researchers use permanent or transient occlusion of the middle cerebral artery (MCA) in mice or rats.Proximal occlusion of the middle cerebral artery (MCA) via the intraluminal suture technique (so called filament or suture model) is probably the most frequently used model in experimental stroke research. The intraluminal MCAO model offers the advantage of inducing reproducible transient or permanent ischaemia of the MCA territory in a relatively non-invasive manner. Intraluminal approaches interrupt the blood flow of the entire territory of this artery. Filament occlusion thus arrests flow proximal to the lenticulo-striate arteries, which supply the basal ganglia. Filament occlusion of the MCA results in reproducible lesions in the cortex and striatum and can be either permanent or transient. In contrast, models inducing distal (to the branching of the lenticulo-striate arteries) MCA occlusion typically spare the striatum and primarily involve the neocortex. In addition these models do require craniectomy. In the model demonstrated in this article, a silicon coated filament is introduced into the common carotid artery and advanced along the internal carotid artery into the Circle of Willis, where it blocks the origin of the middle cerebral artery. In patients, occlusions of the middle cerebral artery are among the most common causes of ischaemic stroke. Since varying ischemic intervals can be chosen freely in this model depending on the time point of reperfusion, ischaemic lesions with varying degrees of severity can be produced. Reperfusion by removal of the occluding filament at least partially models the restoration of blood flow after spontaneous or therapeutic (tPA) lysis of a thromboembolic clot in humans.In this video we will present the basic technique as well as the major pitfalls and confounders which may limit the predictive value of this model.     

Cerebral perfusion changes in patients with internal carotid artery stenoses after surgical revascularization

Changes of cerebral perfusion and the condition of collateral blood supply in patients with internal carotid artery stenoses may have a prognostic value for effective blood flow restoration after revascularization of the internal carotid arteries (ICAs). To determine the patterns of cerebral perfusion changes in patients with ICA stenoses before and after surgical treatment, a clinical CT perfusion study of 41 patients with moderate to severe ICA stenoses was performed. Perfusion CT (PCT) had been conducted in 17 patients with moderate ICA stenoses (50–69%) and in 24 patients with severe ICA stenoses (70–99%) 3 times: before intervention (balloon angioplasty with stenting or carotid endarterectomy), on the 3rd to 7th day, and within 1 to 3 months after surgery. Scanning was performed at the level of the basal ganglia and semioval centers. In patients without ICA stenosis (control group of 39 individuals), PCT was conducted once. We found that surgical recanalization of the ICA leads to normalization of the cerebral blood flow parameters in the perfusion area of the middle cranial artery, as evidenced by a decrease of MTT and CBV and an increase of CBF to values comparable to those in the control group. However, blood flow restoration in the anterior and posterior watershed areas, which are known to be mostly affected under chronic hypoperfusion conditions, was observed only in patients with a complete circle of Willis (CW) and moderate ICA stenosis. Therefore, severe stenosis (>70%) and the incomplete CW are the prognostic factors for inadequate blood flow restoration after revascularization in patients with ICA stenoses.     

Basic laws of blood screw motion in human common carotid arteries

The basic laws of blood screw motion in common carotid arteries in people were determined by means of modern ultrasound techniques for the first time. 92 healthy adults, aged 18-30, were examined. The blood flow in the middle one-third of common carotid arteries was registered by means of Color Doppler Imaging and impulse Doppler with the help of ultrasound Medison 8000EX scanner by linear transducer of 5-9 MHz. The steady registration of blood screw motion in both common carotid arteries in Color Doppler Imaging regimen was observed in 54.3 % of cases. The direction of screw stream rotation in most cases (54%) was multi-directed: in the right common carotid artery it was right, in the left common carotid artery--left (48%), and in 6% of cases it was reverse. For 46% of cases blood rotation in both common carotid arteries was one-directed (26%--right, 20%--left). The velocity parameters of rotation component of blood motion were determined, maximum velocity being 19.68 +/- 5.84 cm/sec, minimum--4.57 +/- 2.89 cm/sec, average--7.48 +/- 2.49 cm/sec, angular--10.7 +/- 2.49 sec(-1). The rated velocity of blood cells motion in screw motion with regard of screw current lines to the vessel vertical axis makes up from 158.67 +/- 32.79 to 224.39 +/- 46.37 cm/sec.     

Blood supply of the rat amygdala.

The cerebral vessels of the rat were filled with inks of different colours. The topography of the vessels of the amygdala were reconstructed from serial sections. The circulation of the individual amygdaloid nuclei was studied in detail. The arteries of the amygdala arise from the deep and cortical branches of the internal carotid and middle cerebral arteries. Eight major arteries were found to supply blood to the amygdala. All amygdaloid nuclei receive branches from both arterial trunks. The vast majority of the veins are collected by the middle cerebral and basal veins. Only a small fraction drains into the hippocampal vein. Of particular importance are the veins ending in the basal vein and those cortical ones that run in the rhinal sulcus. All amygdaloid nuclei have a multidirectional drainage.     

Adrenergic and cholinergic components of the innervation of the arteries of the base of the bird brain

By means of Falck's and Koelle's methods adrenergic and cholinergic structures were studied in the arteries in the cerebral basis of blue rock pigeons and of hens, white leghorn stock. The number of nerve transmitters was estimated per 1 mm2 of the vessel surface. The arteries of the basis in pigeon brain are surrounded with developed adrenergic and cholinergic nerve plexuses, their density decreasing in the following order: nasal branch of the internal carotid artery, middle, nasal cerebral and basilar arteries. A little more cholinergic transmitters occur on the middle cerebral artery, while on the other vessels, concentration of cholinergic and adrenergic fibers is equal. In hens, the density in the arrangement of adrenergic nerve transmitters is higher in the nasal branch of the internal carotid and in the nasal cerebral arteries than in the basilar artery. At the same time, chromaffin cells forming numerous conglomerations in some places are found on the latter. In pigeons, the density of adrenergic fibers arrangement on the arteries of the cerebral basis is higher than in hens.     

Effects of hypoxia on contractility of isolated fetal lamb cerebral arteries

We studied the contractile properties of isolated cerebral arteries in near term fetal lambs, as well as the magnitudes and rates of relaxation during moderate hypoxia. Paired 5-mm segments of basilar, middle cerebral, posterior communicating, and common carotid arteries were suspended in a temperature controlled bath and isometric tension measured during 122 mM K(+)-induced contractions. In one vessel of each pair hypoxia was imposed by switching the bubbling gas from 95% O2 + 5% CO2 to 95% N2 + 5% CO2 4 minutes into a K+ contraction, thus lowering the bath PO2 to approximately 15 Torr. After 15 min exposure to hypoxia the middle cerebral artery had relaxed 61%, the posterior communicating 46%, the basilar 44%, and the common carotid only 18% compared to normoxic controls. All cerebral arteries relaxed relatively rapidly (relaxation rates of 42-45 x 10(-4) s-1), whereas the common carotid relaxed slowly (20 x 10(-4) sec-1). The data indicate that these cerebral arteries play an important role in regulating blood flow responses during hypoxemia in intact fetuses.     

Trifurcations of the middle cerebral arteries

The furcation types of 100 human middle cerebral arteries (MCA) were investigated. Considering the physiological flow characteristics in furcations, a distinct definition for a bifurcation and a trifurcation was found. The common ramification type of the human MCA is the bifurcation. Trifurcations are very rare and we found them only in the proximal parts of the MCA. In 7 of the 100 cases, a trifurcation was found at the main division of the MCA, in 3 cases a secondary trunk trifurcated. Quadro- and pentafurcations according to the hydrodynamic definitions were not observed at all. Only in 1 case did the internal carotid artery trifurcate into the anterior cerebral artery, a superior trunk and an inferior trunk of the MCA.     

树鼩(Tupaia belangeri chinensis)的脑底动脉环

用25只树鼩,从升主动脉灌注带色的橡胶乳液,在解剖显微镜下进行解剖观察,用目测微尺进行测量。大多数树鼩(22只)有完整的脑底动脉环。由左、右大脑前动脉向内侧各发一前交通动脉组成大脑前总动脉。前交通动脉口径为大脑前动脉的75～85％。后交通动脉口径与大脑后动脉相近,连于颈内动脉与大脑后动脉(基底动脉的分支)之间。测量了组成脑底动脉环有关动脉的口径。由于后交通动脉足够粗大,只有中断左、右颈总动脉和左、右椎动脉,才能造成全脑缺血。     

川金丝猴脑的动脉供应

为了探讨川金丝猴脑动脉供应的形态学特征,为脑生物学研究提供结构基础,用血管铸型和组织透明方法追踪观察了川金丝猴幼体脑动脉的来源和分支分布。结果表明川金丝猴与人脑的动脉供应基本相同,也由颈内动脉和椎动脉供应。上述动脉的分支于垂体周围形成大脑动脉环。颈内动脉通过大脑前动脉和大脑中动脉主要供应大脑半球前部的血液,椎动脉参与形成基底动脉、小脑动脉系和大脑后动脉,供应脑干、小脑和大脑后部的血液。另外,川金丝猴幼体左、右大脑前动脉间缺少前交通动脉。     

The microcirculation of cerebral arteries: a morphologic and morphometric examination of the major canine cerebral arteries

A morphologic and morphometric examination of the major cerebral blood vessels in the dog was carried out to determine whether there were vasa vasorum in these arteries and what features might be associated with them. True vasa vasorum confined to the media were not seen in any of the vessels examined. Microvessels confined to the adventitia, however, were found in the internal carotid and vertebral arteries but not in the basilar, middle cerebral, or anterior spinal arteries. Animal size, vessel size as determined by adventitial and medial area, and the number of smooth muscle cell lamellae were not associated with the presence of these adventitial vessels; they occurred only in arteries with both an intra- and extradural portion. It therefore appears that most canine cerebral arteries do not have vasa vasorum.     

Hemodynamic role of the circle of Willis in stenoses of internal carotid arteries. An analytical solution of a linear model

A mathematical model of blood flow through the circle of Willis was developed, within a linear framework. Comprehensive analytical solutions, including a remarkably small number of parameters, were derived in the cases of obstructive lesions of extracranial carotid arteries. The influence of these lesions and the role of anterior and posterior communicating arteries on the blood pressure at the entry of the cerebral territories were quantified and analyzed emphasizing that the responses of the system of Willis to obstructive carotid lesions are extremely varied, depending on the communicating artery anatomy. Comparison with numerical results obtained by using a non-linear model showed no physiologically significant differences. Such a model might be an essential tool for an accurate assessment of the cerebral hemodynamics in carotid diseases.     

Ischemic Postconditioning Fails to Protect against Neonatal Cerebral Stroke

The lack of efficient neuroprotective strategies for neonatal stroke could be ascribed to pathogenic ischemic processes differentiating adults and neonates. We explored this hypothesis using a rat model of neonatal ischemia induced by permanent occlusion of the left distal middle cerebral artery combined with 50 min of occlusion of both common carotid arteries (CCA). Postconditioning was performed by repetitive brief release and occlusion (30 s, 1 and/or 5 min) of CCA after 50 min of CCA occlusion. Alternative reperfusion was generated by controlled release of the bilateral CCA occlusion. Blood-flow velocities in the left internal carotid artery were measured using color-coded pulsed Doppler ultrasound imaging. Cortical perfusion was measured using laser Doppler. Cerebrovascular vasoreactivity was evaluated after inhalation with the hypercapnic gas or inhaled nitric oxide (NO). Whatever the type of serial mechanical interruptions of blood flow at reperfusion, postconditioning did not reduce infarct volume after 72 hours. A gradual perfusion was found during early re-flow both in the left internal carotid artery and in the cortical penumbra. The absence of acute hyperemia during early CCA re-flow, and the lack of NO-dependent vasoreactivity in P7 rat brain could in part explain the inefficiency of ischemic postconditioning after ischemia-reperfusion.     

Computational modelling of emboli travel trajectories in cerebral arteries: influence of microembolic particle size and density

Ischaemic stroke is responsible for up to 80 % of stroke cases. Prevention of the reoccurrence of ischaemic attack or stroke for patients who survived the first symptoms is the major treatment target. Accurate diagnosis of the emboli source for a specific infarction lesion is very important for a better treatment for the patient. However, due to the complex blood flow patterns in the cerebral arterial network, little is known so far of the embolic particle flow trajectory and its behaviour in such a complex flow field. The present study aims to study the trajectories of embolic particles released from carotid arteries and basilar artery in a cerebral arterial network and the influence of particle size, mass and release location to the particle distributions, by computational modelling. The cerebral arterial network model, which includes major arteries in the circle of Willis and several generations of branches from them, was generated from MRI images. Particles with diameters of 200, 500 and 800  $\upmu \hbox {m}$ and densities of 800, 1,030 and 1,300 $\hbox {kg/m}^{3}$ were released in the vessel’s central and near-wall regions. A fully coupled scheme of particle and blood flow in a computational fluid dynamics software ANASYS CFX 13 was used in the simulations. The results show that heavy particles (density large than blood or a diameter larger than 500  $\upmu \hbox {m}$ ) normally have small travel speeds in arteries; larger or lighter embolic particles are more likely to travel to large branches in cerebral arteries. In certain cases, all large particles go to the middle cerebral arteries; large particles with higher travel speeds in large arteries are likely to travel at more complex and tortuous trajectories; emboli raised from the basilar artery will only exit the model from branches of basilar artery and posterior cerebral arteries. A modified Circle of Willis configuration can have significant influence on particle distributions. The local branch patterns of internal carotid artery to middle cerebral artery and anterior communicating artery can have large impact on such distributions.     

Continuous monitoring of absolute cerebral blood flow by near-infrared spectroscopy during global and focal temporary vessel occlusion

Treatment of intracranial aneurysms by surgical clipping carries a risk of intraoperative ischemia, caused mainly by prolonged temporary occlusion of cerebral arteries. The objective of this study was to develop a near-infrared spectroscopy (NIRS) technique for continuous monitoring of cerebral blood flow (CBF) during surgery. With this approach, cerebral hemodynamics prior to clipping are measured by a bolus-tracking method that uses indocyanine green as an intravascular contrast agent. The baseline hemodynamic measurements are then used to convert the continuous Hb difference (HbD) signal (HbD = oxyhemoglobin - deoxyhemoglobin) acquired during vessel occlusion to units of CBF. To validate the approach, HbD signal changes, along with the corresponding CBF changes, were measured in pigs following occlusion of the common carotid arteries or a middle cerebral artery. For both occlusion models, the predicted CBF change derived from the HbD signal strongly correlated with the measured change in CBF. Linear regression of the predicted and measured CBF changes resulted in a slope of 0.962 (R(2) = 0.909) following carotid occlusion and 0.939 (R(2) = 0.907) following middle cerebral artery occlusion. These results suggest that calibrating the HbD signal by baseline hemodynamic measurements provides a clinically feasible method of monitoring CBF changes during neurosurgery.     

A numerical and experimental analysis of the flow field in a two-dimensional model of the human carotid artery bifurcation

Axial velocities were measured in an enlarged, two-dimensional, rigid model of the carotid artery bifurcation by means of a laser-Doppler anemometer, under both steady and unsteady flow conditions. Also a numerical model was developed, based on the finite element approximation of the Navier-Stokes and continuity equations. From this study it appeared that the numerically predicted velocities agree well with the experimentally obtained values. Besides, the bifurcation hardly influenced the upstream flow in the main branch (common carotid artery), high velocity gradients were observed at the divider walls of the daughter branches (internal and external carotid arteries) and large zones with reversed flow were present near the nondivider walls of these branches. For steady flow the maximal diameter of this zone at the entrance of the internal carotid artery (carotid sinus) was about 25% of the local diameter of this branch. For unsteady flow this zone was absent during the initial phase of flow acceleration and maximal at the end of flow deceleration with a maximal diameter of about 50% of the local diameter of the carotid sinus.     

Contribution of the vertebral artery to cerebral circulation in the rat snake Elaphe obsoleta

Blood supplying the brain in vertebrates is carried primarily by the carotid vasculature. In most mammals, cerebral blood flow is supplemented by the vertebral arteries, which anastomose with the carotids at the base of the brain. In other tetrapods, cerebral blood is generally believed to be supplied exclusively by the carotid vasculature, and the vertebral arteries are usually described as disappearing into the dorsal musculature between the heart and head. There have been several reports of a vertebral artery connection with the cephalic vasculature in snakes. We measured regional blood flows using fluorescently labeled microspheres and demonstrated that the vertebral artery contributes a small but significant fraction of cerebral blood flow (∼13% of total) in the rat snake Elaphe obsoleta. Vascular casts of the anterior vessels revealed that the vertebral artery connection is indirect, through multiple anastomoses with the inferior spinal artery, which connects with the carotid vasculature near the base of the skull. Using digital subtraction angiography, fluoroscopy, and direct observations of flow in isolated vessels, we confirmed that blood in the inferior spinal artery flows craniad from a point anterior to the vertebral artery connections. Such collateral blood supply could potentially contribute to the maintenance of cerebral circulation during circumstances when craniad blood flow is compromised, e.g., during the gravitational stress of climbing. J. Morphol. 238:39–51, 1998. © 1998 Wiley-Liss, Inc.