Biomechanical Regulation of Cerebral Blood Flow

It is generally accepted that myogenic, metabolic and neurogenic regulation mechanisms exist for the cerebral blood flow (CBF). Recently, a hydraulic control acting at the predural level has been suggested by Chopp et al. [2] These mechanisms, however, do not take into consideration the problem represented by the peculiar feature of the brain (an incompressible organ) within the skull and dura mater (a rigid box and a stiff envelope), perfused by a pulsatile blood flow through a vascular tree with elastic walls. On the basis of this consideration we think that the progressive CBF reduction up to cerebral circulatory arrest following severe intracranial hypertension is probably due to an unbalance between cerebral blood volume variations during each cardiac cycle and the compensatory systems, primarily the venous vascular bed.