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dc.contributor.authorMinhas, Jatinder S
dc.contributor.authorGhaly, George
dc.contributor.authorDivall, Pip
dc.contributor.authorRobinson, Thompson
dc.date.accessioned2021-10-04T15:39:11Z
dc.date.available2021-10-04T15:39:11Z
dc.date.issued2019-01
dc.identifier.citationMinhas, J. S., Panerai, R. B., Ghaly, G., Divall, P., & Robinson, T. G. (2019). Cerebral autoregulation in hemorrhagic stroke: A systematic review and meta-analysis of transcranial Doppler ultrasonography studies. Journal of clinical ultrasound : JCU, 47(1), 14–21. https://doi.org/10.1002/jcu.22645en_US
dc.identifier.other10.1002/jcu.22645
dc.identifier.urihttp://hdl.handle.net/20.500.12904/14894
dc.description.abstractPurpose: International guidelines advocate intensive blood pressure (BP) lowering within 6 hours of acute intracerebral hemorrhage (ICH) to a target systolic BP of 130-140 mm Hg, though more intensive lowering may be associated with adverse outcome. Observational studies suggest impaired cerebral autoregulation (CA) following ICH. Transcranial Doppler ultrasonography (TCD), alongside continuous BP monitoring, provides a noninvasive bedside investigation that offers detailed perspectives on physiological perturbations post-acute ICH. This systematic review and meta-analysis focuses on all TCD studies of CA in ICH. Methods: MEDLINE, EMBASE, and CENTRAL were searched for studies of hemorrhagic stroke and blood flow measurement. Results: Eight studies met inclusion criteria (293 ICH patients); CA was impaired up to 12-days post-acute ICH. Impaired CA was evidenced by reduced transfer function analysis phase and higher mean flow correlation values: these were associated with worsened clinical parameters including ICH-volume and Glasgow Coma Scale. Meta-analysis of CBV demonstrated that, compared to controls, mean CBV was significantly lower in the ipsilateral (49.7 vs 64.8 cm s-1 , Z = 4.26, P < .0001) and contralateral hemispheres following ICH (51.5 vs 64.8 cm s-1 , Z = 3.44, P = .0006). Conclusion: Lower mean CBV in combination with impaired CA may have implications for more intensive BP lowering and warrants further studies examining such strategies on cerebral blood flow and its regulatory mechanisms.
dc.description.urihttps://onlinelibrary.wiley.com/doi/10.1002/jcu.22645en_US
dc.subjectCerebral haemodynamicsen_US
dc.subjectTranscranial Doppler ultrasonographyen_US
dc.subjectHaemorrhagic strokeen_US
dc.subjectSystematic reviewen_US
dc.titleCerebral autoregulation in hemorrhagic stroke: A systematic review and meta-analysis of transcranial Doppler ultrasonography studiesen_US
dc.typeArticleen_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.versionNAen_US
rioxxterms.typeJournal Article/Reviewen_US
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2018-09
html.description.abstractPurpose: International guidelines advocate intensive blood pressure (BP) lowering within 6 hours of acute intracerebral hemorrhage (ICH) to a target systolic BP of 130-140 mm Hg, though more intensive lowering may be associated with adverse outcome. Observational studies suggest impaired cerebral autoregulation (CA) following ICH. Transcranial Doppler ultrasonography (TCD), alongside continuous BP monitoring, provides a noninvasive bedside investigation that offers detailed perspectives on physiological perturbations post-acute ICH. This systematic review and meta-analysis focuses on all TCD studies of CA in ICH. Methods: MEDLINE, EMBASE, and CENTRAL were searched for studies of hemorrhagic stroke and blood flow measurement. Results: Eight studies met inclusion criteria (293 ICH patients); CA was impaired up to 12-days post-acute ICH. Impaired CA was evidenced by reduced transfer function analysis phase and higher mean flow correlation values: these were associated with worsened clinical parameters including ICH-volume and Glasgow Coma Scale. Meta-analysis of CBV demonstrated that, compared to controls, mean CBV was significantly lower in the ipsilateral (49.7 vs 64.8 cm s-1 , Z = 4.26, P < .0001) and contralateral hemispheres following ICH (51.5 vs 64.8 cm s-1 , Z = 3.44, P = .0006). Conclusion: Lower mean CBV in combination with impaired CA may have implications for more intensive BP lowering and warrants further studies examining such strategies on cerebral blood flow and its regulatory mechanisms.en_US
rioxxterms.funder.project94a427429a5bcfef7dd04c33360d80cden_US


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