Local cerebral blood flow and the electrocorticogram during sodium nitroprusside hypotension

Changes in local cerebral blood flow during sodium nitroprusside hypotension were measured using the hydrogen electrode technique. At mean arterial pressures from 90% to 50% of control values, local cerebral blood flow showed a significant decrease by 20%. When blood pressure was reduced below 50%, the local cerebral blood flow increased significantly and approached control levels. It is suggested that the flow increase may be due to local hypoxia. Associated with this increase were electrocorticogram changes indicative of hypoxia. The significant decrease in mean local cerebral blood flow and the large range of flows seen during mild hypotension indicate that autoregulation is impaired. During hypotension, intracranial pressure increased by, at most, 3 mm Hg. Cardiac output was usually unaffected and was never decreased by more than 20%.

Cyanide intoxication in Macaca mulatta. Physiological and neuropathological aspects

Sodium cyanide was infused intravenously in 11 lightly anaesthetised and spontaneously breathing M. mulatta. In most, the EEG, ECG, respiratory rate, blood pressure, cerebral venous sinus pressure, end-tidal pCO2 and body temperature were recorded. Blood gases, pH, lactate and pyruvate were estimated in arterial and venous sinus blood samples. There was an initial hyperventilation with tetany in all animals. A rapid rate of cyanide infusion led to apnoea. An isoelectric or near-isoelectric EEG was usually precipitated by bradycardia often with additional hypotension. Neither epileptic seizures nor their EEG concomitants were seen at any stage. Three animals died of early heart failure. Brain damage was seen in 4 animals surviving up to 98 hr. White matter was involved in all. Ischaemic neuronal alterations, restricted to the striatum of one animal, were attributed to major circulatory complications. It was concluded that under these experimental conditions there is no evidence for hypoxic neuronal damage of purely histotoxic type.

[Anaesthesia and cerebral hypoxia (author's transl)]

The effects of intravenous and general anaesthesia on the cerebral circulation and metabolism are reviewed. The various anaesthetic agents differ both quantitatively and qualitatively in their action on the brain. The pathophysiology of raised intracranial pressure is discussed and the risks involved in the use of certain anaesthetic agents in cases of reduced intracranial compliance are emphasized. Details are given of the safe limits for induced changes in pCO2 and arterial pressure.

Ultrastructural changes in the capillary bed of the rat cerebral cortex in anoxic-ischemic brain lesions

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