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EFFECTS OF SYMPATHECTOMY ON THE CEREBRAL CIRCULATION OF HYPERTENSIVE PATIENTS

EFFECTS OF SYMPATHECTOMY ON THE CEREBRAL CIRCULATION OF HYPERTENSIVE PATIENTS Abstract WE HAVE previously shown that the cerebral circulation participates in the generalized increase in vascular resistance that characterizes human hypertension.1 The beneficial effects of surgical procedures on the sympathetic nervous system in the amelioration of the increased vascular resistance include evidence that perhaps the cerebrovascular resistance is also affected. Such evidence consists of relief from the cerebral symptoms of hypertension and the improvement in the hypertensive eyeground changes. In an effort to determine more precisely the effects of the surgical treatment of hypertension on the cerebral circulation, we have measured the cerebral blood flow, cerebrovascular resistance and cerebral oxygen consumption in a series of patients before and after standard operative procedure performed for the relief of hypertension. METHODS The cerebral blood flow of patients with essential hypertension judged suitable for sympathectomy was determined by the nitrous oxide method2 a few days before operation. Mean arterial pressure was obtained References 1. Kety, S. S.; Hafkenschiel, J. H.; Jeffers, W. A.; Leopold, I. H., and Shenkin, H. A.: The Blood Flow, Vascular Resistance, and Oxygen Consumption of the Brain in Essential Hypertension , J. Clin. Investigation 27:511, 1948.Crossref 2. Kety, S. S., and Schmidt, C. F.: The Nitrous Oxide Method for the Quantitative Determination of Cerebral Blood Flow in Man: Theory, Procedure, and Normal Values , J. Clin. Investigation 27:476, 1948.Crossref 3. Kety, S. S.; Hafkenschiel, J. H.; King, B. D.; Horvath, S. M., and Jeffers, W. A.: The Effect of Differential Thoracolumbar Spinal Sympathetic Block on the Cerebral Circulation of Hypertensive Patients, to be published. 4. Kety, S. S., and Schmidt, C. F.: The Effects of Active and Passive Hyperventilation on Cerebral Blood Flow, Cerebral Oxygen Consumption, Cardiac Output and Blood Pressure of Normal Young Men , J. Clin. Investigation 25:107, 1946.Crossref 5. Leopold, I. H.; Kety, S. S.; Jeffers, W. A.; Hafkenschiel, J. H., and Shenkin, H. A.: Correlation of the Cerebrovascular Resistance and the Grade of Hypertensive Retinal Findings , Am. J. Ophth. 32:365, 1949. 6. Smithwick, R. H.: Surgical Treatment of Hypertension: Effect of Radical (Lumbodorsal) Splanchnicectomy on the Hypertensive State of Patients Followed One to Five Years , Arch. Surg. 49:180 ( (Sept.) ) 1944.Crossref 7. Peet, M. M., and Isberg, E. M.: The Surgical Treatment of Arterial Hypertension , J. A. M. A. 130:467 ( (Feb. 23) ) 1946.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

EFFECTS OF SYMPATHECTOMY ON THE CEREBRAL CIRCULATION OF HYPERTENSIVE PATIENTS

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Publisher
American Medical Association
Copyright
Copyright © 1950 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1950.01250020323014
Publisher site
See Article on Publisher Site

Abstract

Abstract WE HAVE previously shown that the cerebral circulation participates in the generalized increase in vascular resistance that characterizes human hypertension.1 The beneficial effects of surgical procedures on the sympathetic nervous system in the amelioration of the increased vascular resistance include evidence that perhaps the cerebrovascular resistance is also affected. Such evidence consists of relief from the cerebral symptoms of hypertension and the improvement in the hypertensive eyeground changes. In an effort to determine more precisely the effects of the surgical treatment of hypertension on the cerebral circulation, we have measured the cerebral blood flow, cerebrovascular resistance and cerebral oxygen consumption in a series of patients before and after standard operative procedure performed for the relief of hypertension. METHODS The cerebral blood flow of patients with essential hypertension judged suitable for sympathectomy was determined by the nitrous oxide method2 a few days before operation. Mean arterial pressure was obtained References 1. Kety, S. S.; Hafkenschiel, J. H.; Jeffers, W. A.; Leopold, I. H., and Shenkin, H. A.: The Blood Flow, Vascular Resistance, and Oxygen Consumption of the Brain in Essential Hypertension , J. Clin. Investigation 27:511, 1948.Crossref 2. Kety, S. S., and Schmidt, C. F.: The Nitrous Oxide Method for the Quantitative Determination of Cerebral Blood Flow in Man: Theory, Procedure, and Normal Values , J. Clin. Investigation 27:476, 1948.Crossref 3. Kety, S. S.; Hafkenschiel, J. H.; King, B. D.; Horvath, S. M., and Jeffers, W. A.: The Effect of Differential Thoracolumbar Spinal Sympathetic Block on the Cerebral Circulation of Hypertensive Patients, to be published. 4. Kety, S. S., and Schmidt, C. F.: The Effects of Active and Passive Hyperventilation on Cerebral Blood Flow, Cerebral Oxygen Consumption, Cardiac Output and Blood Pressure of Normal Young Men , J. Clin. Investigation 25:107, 1946.Crossref 5. Leopold, I. H.; Kety, S. S.; Jeffers, W. A.; Hafkenschiel, J. H., and Shenkin, H. A.: Correlation of the Cerebrovascular Resistance and the Grade of Hypertensive Retinal Findings , Am. J. Ophth. 32:365, 1949. 6. Smithwick, R. H.: Surgical Treatment of Hypertension: Effect of Radical (Lumbodorsal) Splanchnicectomy on the Hypertensive State of Patients Followed One to Five Years , Arch. Surg. 49:180 ( (Sept.) ) 1944.Crossref 7. Peet, M. M., and Isberg, E. M.: The Surgical Treatment of Arterial Hypertension , J. A. M. A. 130:467 ( (Feb. 23) ) 1946.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Aug 1, 1950

References