Cerebrovascular reactivity to CO2 and hypotension after mild cortical impact injury

Departments of 1 Neurosurgery and 2 Anesthesiology, Baylor College of Medicine, Houston, Texas 77030 Cerebrovascular reactivity to CO 2 or hypotension was studied in vivo and in vitro [pressurized arteries (~82 µm) and arterioles (~30 µm)] at 1 h after mild controlled cortical impact (CCI) injury in rats. The cortical perfusion response [assessed using laser-Doppler flowmetry (LDF)] to altered CO 2 was diminished (up to 81%) after mild CCI injury. The responses to CO 2 alterations in arteries and arterioles isolated from the injured cortex were similar to responses in vessels isolated from sham-injured animals. After mild CCI injury, the autoregulatory response to hypotension (measured using LDF) was maintained or even enhanced, depending on the method used to measure the response. Vessels isolated from the injury site showed a response to changes in pressure similar to that in vessels isolated from sham-injured rats. We conclude that mild CCI injury produces complicated alterations in cerebrovascular control. Whereas the autoregulatory response to hypotension was maintained or even enhanced, the in vivo vascular response to CO 2 was severely compromised. The altered response to CO 2 was not caused by an intrinsic vascular perturbation but rather an altered milieu after mild CCI injury. autoregulation; carbon dioxide reactivity; rat; secondary injury; traumatic brain injury