The dual role of cerebral autoregulation and collateral flow in the circle of Willis after major vessel occlusion
Objective: Ischaemic stroke is a leading cause of death and disability. Autoregulation and collateral blood flow through the circle of Willis both play a role in preventing tissue infarction. To investigate the interaction of these mechanisms a one-dimensional steady state model of the cerebral arte...
| Main Authors: | , |
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| Format: | Journal article |
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IEEE
2016
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| _version_ | 1797104864954679296 |
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| author | McConnell, F Payne, S |
| author_facet | McConnell, F Payne, S |
| author_sort | McConnell, F |
| collection | OXFORD |
| description | Objective: Ischaemic stroke is a leading cause of death and disability. Autoregulation and collateral blood flow through the circle of Willis both play a role in preventing tissue infarction. To investigate the interaction of these mechanisms a one-dimensional steady state model of the cerebral arterial network was created. Methods: Structural variants of the circle of Willis that present particular risk of stroke were recreated using a network model coupled with: (1) a steady state physiological model of cerebral autoregulation; (2) one wherein the cerebral vascular bed was modelled as a passive resistance. Simulations were performed in various conditions of internal carotid and vertebral artery occlusion. Results: Collateral flow alone is unable to ensure adequate blood flow (> 90% normal flow) to the cerebral arteries in several common variants during internal carotid artery occlusion. However, compared to a passive model, cerebral autoregulation is better able to exploit available collateral flow and to maintain flows within 10% of baseline. This is true for nearly all configurations. Conclusion: Hence, autoregulation is a crucial facilitator of collateral flow through the circle of Willis. Significance: Impairment of this response during ischemia will severely impact cerebral blood flows, and tissue survival, and hence autoregulation should be monitored in this situation. |
| first_indexed | 2024-03-07T06:39:33Z |
| format | Journal article |
| id | oxford-uuid:f8ca7072-a4c0-4290-b322-6282d1a27249 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T06:39:33Z |
| publishDate | 2016 |
| publisher | IEEE |
| record_format | dspace |
| spelling | oxford-uuid:f8ca7072-a4c0-4290-b322-6282d1a272492022-03-27T12:53:13ZThe dual role of cerebral autoregulation and collateral flow in the circle of Willis after major vessel occlusionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f8ca7072-a4c0-4290-b322-6282d1a27249Symplectic Elements at OxfordIEEE2016McConnell, FPayne, SObjective: Ischaemic stroke is a leading cause of death and disability. Autoregulation and collateral blood flow through the circle of Willis both play a role in preventing tissue infarction. To investigate the interaction of these mechanisms a one-dimensional steady state model of the cerebral arterial network was created. Methods: Structural variants of the circle of Willis that present particular risk of stroke were recreated using a network model coupled with: (1) a steady state physiological model of cerebral autoregulation; (2) one wherein the cerebral vascular bed was modelled as a passive resistance. Simulations were performed in various conditions of internal carotid and vertebral artery occlusion. Results: Collateral flow alone is unable to ensure adequate blood flow (> 90% normal flow) to the cerebral arteries in several common variants during internal carotid artery occlusion. However, compared to a passive model, cerebral autoregulation is better able to exploit available collateral flow and to maintain flows within 10% of baseline. This is true for nearly all configurations. Conclusion: Hence, autoregulation is a crucial facilitator of collateral flow through the circle of Willis. Significance: Impairment of this response during ischemia will severely impact cerebral blood flows, and tissue survival, and hence autoregulation should be monitored in this situation. |
| spellingShingle | McConnell, F Payne, S The dual role of cerebral autoregulation and collateral flow in the circle of Willis after major vessel occlusion |
| title | The dual role of cerebral autoregulation and collateral flow in the circle of Willis after major vessel occlusion |
| title_full | The dual role of cerebral autoregulation and collateral flow in the circle of Willis after major vessel occlusion |
| title_fullStr | The dual role of cerebral autoregulation and collateral flow in the circle of Willis after major vessel occlusion |
| title_full_unstemmed | The dual role of cerebral autoregulation and collateral flow in the circle of Willis after major vessel occlusion |
| title_short | The dual role of cerebral autoregulation and collateral flow in the circle of Willis after major vessel occlusion |
| title_sort | dual role of cerebral autoregulation and collateral flow in the circle of willis after major vessel occlusion |
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