Impaired Dynamic Cerebral Autoregulation in Cerebral Venous Thrombosis

Background: Cerebral autoregulation is crucial in traumatic brain injury, which might be used for determination the optimal intracranial pressure. Cerebral venous thrombosis is a cerebral vascular disease with the feature of high intracranial pressure, but the autoregulatory mechanism of which remains unknow. We aimed to investigate the capacity of cerebral autoregulation in patients with cerebral venous thrombosis. Methods: Twenty-three patients with cerebral venous thrombosis and 16 controls were enrolled. Cerebral autoregulation was assessed by transfer function analysis (rate of recovery / phase / gain) from spontaneous oscillations of cerebral blood flow velocity and arterial blood pressure. Results: A total of 76 middle cerebral arteries (MCAs) were investigated including 44 MCAs from CVT patients and 32 normal ones. Phase shift and rate of recovery estimated from CVT patients was significantly different from controls (37.63 ± 33.94 vs. 54.49 ± 26.44, p = 0.23; 29.74 ± 59.55 vs. 37.95 ± 22.55, p = 0.01, respectively). The bilateral impairment of cebral autoregulation was demonstrated, even in the hemispheres without severe sinus stenosis and brain parenchymal lesion. Conclusion: Our findings for the first time indicated that patients with cerebral venous thrombosis were more likely to have impaired cerebral autoregulation and suggest that cautious blood pressure control is required in such patients to prevent hyper or hypo-perfusion.