The relation of cerebral ischemia, hypoxia, and hypercarbia to the Cushing response

J Neurosurg. 1978 May;48(5):730-40. doi: 10.3171/jns.1978.48.5.0730.

Abstract

A marked increase in intracranial pressure (ICP) produces a concomitant increase in systemic blood pressure (the Cushing response). In this study a comparison is made between this response of systemic blood pressure to increased ICP and the blood pressure responses produced by ischemia, hypoxia, and hypercarbia of the primate brain. A carotid-to-carotid cross-perfusion system was used to produce a purely cerebral hypoxia and hypercarbia. Each stimulus, except hypercarbia, produced a hypertensive response that was qualitatively and quantitatively similar. These responses were characterized by a short latent period, a rapid development, and an increase in mean arterial pressure of 60% or more. The similarity of the responses suggests that these stimuli act through a final common pathway independent of the purely mechanical effects of increased ICP upon the brain.

MeSH terms

  • Animals
  • Blood Pressure*
  • Cross Circulation
  • Haplorhini
  • Hypercapnia / physiopathology*
  • Hypoxia, Brain / physiopathology*
  • Intracranial Pressure*
  • Ischemic Attack, Transient / physiopathology*
  • Macaca mulatta