Cerebral Circulation

• Normal Rate of Cerebral Blood Flow

Normal blood flow through the brain of the
adult person averages 50 to 65 milliliters
per 100 grams of brain tissue per minute.
For the entire brain, this amounts to 750 to
900 ml/min, or 15 per cent of the resting
cardiac output.
 Determination of Cerebral
Circulation
• Radioactive method
• Ketty and Schmidt’s Nitrous oxide method
• Computerized Axial Tomography
• Positron Emission Tomography
• Functional MRI
Radioactive method
 Ketty and Schmidt’s Nitrous oxide method

• Cerebral blood = Amt of Nitrous oxide

taken by Brain / Arteriovenous diff. of N2O
 Monroe-Kellie Doctrine

• The ICP within the skull is directly related

to the volume of the contents.
– Defined as the Monroe-Kellie Doctrine

– This doctrine states that any increase in

volume of the contents within the brain must
be met with a decrease in the other cranial
contents
 Monroe-Kellie Doctrine
Vintracranial vault = Vbrain + Vblood + Vcsf
Increased Intracranial Pressure
 Monroe – Kellie Principle
• Brain tissue is not compressible
• Though the cerebral arteries are
compressed by inc. intracranial or CSF
pressure, vol. of brain tissue is not
affected.
• CSF & Blood vol. varies inversely
(Black-out & Red-out)
Monroe – Kellie Principle
 Cushing’s reflex
• Inc. in Intracranial or CSF P
• Compression of cerebral Blood vessels
• Dec. in cerebral blood flow
• Activation of vasomotor center
• Peripheral vasoconstriction
• Inc. in arterial BP
• Restoration of cerebral Blood flow
When Intra Cranial Pressure becomes very high,
this does not come into operation
Cushing’s reflex