The cerebral circulation during pregnancy: adapting to preserve normalcy.

@article{Johnson2015TheCC,
  title={The cerebral circulation during pregnancy: adapting to preserve normalcy.},
  author={Abbie C Johnson and Marilyn J. Cipolla},
  journal={Physiology},
  year={2015},
  volume={30 2},
  pages={
          139-47
        }
}
The adaptation of the brain and cerebral circulation to pregnancy are unique compared with other organs and circulatory systems, ultimately functioning to maintain brain homeostasis. In this review, the effect of pregnancy on critical functions of the cerebral circulation is discussed, including changes occurring at the endothelium and blood-brain barrier, and changes in the structure and function of cerebral arteries and arterioles, hemodynamics, and cerebral blood flow autoregulation. 
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TLDR
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TLDR
It is suggested that infusion of IL17 independent of other placental ischemia-associated factors is insufficient to recapitulate the features of impaired cerebrovascular function during placental Ischemia. Expand
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TLDR
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References

SHOWING 1-10 OF 96 REFERENCES
Cerebral vascular adaptation to pregnancy and its role in the neurological complications of eclampsia.
TLDR
It is shown that pregnancy causes outward remodeling of penetrating arterioles and increased capillary density in the brain due to activation of peroxisome proliferator-activated receptor-γ (PPARγ), a transcription factor involved in cerebrovascular remodeling and highly activated in pregnancy. Expand
Changes in flow velocity, resistance indices, and cerebral perfusion pressure in the maternal middle cerebral artery distribution during normal pregnancy
TLDR
The objective was to define the hemodynamic changes, specifically velocity, resistance indices, and cerebral perfusion pressure, in the middle cerebral artery (MCA) distribution of the brain during normal pregnancy. Expand
Effect of Pregnancy and Nitric Oxide on the Myogenic Vasodilation of Posterior Cerebral Arteries and the Lower Limit of Cerebral Blood Flow Autoregulation
TLDR
Pregnancy enhanced myogenic vasodilation in PCA and shifted the lower limit of CBF autoregulation to lower pressures, likely protective of ischemic injury during hemorrhage and appears to be independent of NOS. Expand
Dynamic Cerebral Autoregulation in Pregnancy and the Risk of Preeclampsia
TLDR
DCA is well preserved during late midterm pregnancy, even in women with disturbed uterine blood flow, although limited in statistical power, this study does not support DCA as a strong early risk marker of preeclampsia. Expand
Resistance Artery Adaptation to Pregnancy Counteracts the Vasoconstricting Influence of Plasma From Normal Pregnant Women
TLDR
The increased reactivity and tone noted in NP vessels was abolished when pregnant plasma was perfused through LP arteries, suggesting these vessels adapt during pregnancy to the vasoconstricting influence of pregnant plasma. Expand
Effect of Pregnancy on Autoregulation of Cerebral Blood Flow in Anterior Versus Posterior Cerebrum
TLDR
It is suggested that, although pregnancy shifted the cerebral blood flow autoregulatory curve to higher pressures in both the anterior and posterior cortices, it did not protect from edema during acute hypertension. Expand
Cerebral artery reactivity changes during pregnancy and the postpartum period: a role in eclampsia?
TLDR
It is suggested that both pregnancy and the postpartum period predispose the cerebral circulation to FD at lower pressures, a response that may lower cerebrovascular resistance and promote hyperperfusion when blood pressure is elevated, as occurs during eclampsia. Expand
Cerebral autoregulation.
TLDR
Autoregulation is lost in severe head injury or acute ischemic stroke, leaving surviving brain tissue unprotected against the potentially harmful effect of blood pressure changes, and may be lost in the surroundings of a space-occupying brain lesion, be it a tumor or a hematoma. Expand
Cerebral Blood Flow Autoregulation and Edema Formation During Pregnancy in Anesthetized Rats
TLDR
There was no difference in blood–brain barrier permeability between nonpregnant and late-preg pregnant animals in response to acute hypertension, suggesting that pregnancy may predispose the brain to eclampsia by increasing cerebral edema through increased hydraulic conductivity. Expand
Autoregulation of cerebral blood flow: influence of the arterial blood pressure on the blood flow through the cerebral cortex.
  • A. Harper
  • Medicine
  • Journal of neurology, neurosurgery, and psychiatry
  • 1966
TLDR
The experiments reported in this paper were undertaken to measure the effect of gradual reduction of the mean arterial blood pressure on the blood flow through the cerebral cortex under 'normal' respiratory conditions and under conditions of hypercapnia (CO2 being added to the respiratory mixture). Expand
...
1
2
3
4
5
...