Point/counterpoint: Cerebrovascular resistance is a flawed concept

J Cereb Blood Flow Metab. 2023 Jul;43(7):1216-1218. doi: 10.1177/0271678X231172854. Epub 2023 Apr 27.

Abstract

The relationship between cerebral blood flow and blood pressure is a critical part of investigation of cerebral autoregulation. Conventionally, cerebrovascular resistance (CVR) has been used to describe this relationship, but the underlying principles used for this method is flawed in real-world application for several reasons. Despite this, the use of CVR remains entrenched within current literature. This 'Point/Counterpoint' review provides a summary of the flaws in using CVR and explains the benefits of calculating the more accurate critical closing pressure (CrCP) and resistance-area product (RAP) parameters, with support of real-world data.

Keywords: Cerebrovascular resistance; cerebral autoregulation; cerebral vascular conductance; critical closing pressure; resistance-area product.

MeSH terms

  • Blood Flow Velocity / physiology
  • Blood Pressure / physiology
  • Cerebrovascular Circulation* / physiology
  • Homeostasis
  • Ultrasonography, Doppler, Transcranial* / methods
  • Vascular Resistance / physiology