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The authors examined the steal phenomenon using a new mathematical model of cerebral blood flow and the cerebrospinal fluid circulation. In this model, the two hemispheres are connected through the circle of Willis by an anterior communicating artery (ACoA) of varying size. The right hemisphere has no cerebrovascular reactivity and the left is normally reactive. The authors studied the asymmetry of hemispheric blood flow in response to simulated changes in arterial blood pressure and carbon dioxide concentration. The hemispheric blood flow was dependent on the local regulatory capacity but not on the size of the ACoA. Flow through the ACoA and carotid artery was strongly dependent on the size of the communicating artery. A global interhemispheric "steal effect" was demonstrated to be unlikely to occur in subjects with nonstenosed carotid arteries. Vasoreactive effects on intracranial pressure had a major influence on the circulation in both hemispheres, provoking additional changes in blood flow on the nonregulating side. A method for the quantification of the crosscirculatory capacity has been proposed.

Original publication

DOI

10.1097/00004647-200102000-00010

Type

Journal article

Journal

J Cereb Blood Flow Metab

Publication Date

02/2001

Volume

21

Pages

182 - 192

Keywords

Blood Pressure, Brain, Carbon Dioxide, Cerebral Arteries, Cerebrospinal Fluid, Cerebrovascular Circulation, Circle of Willis, Humans, Intracranial Pressure, Mathematics, Models, Biological, Vascular Resistance