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Cerebral Vasomotor Reactivity and Autoregulation

CVR and autoregulation define the physiological compensatory mechanisms when flow is impaired. Identification of exhausted CVR can be a good indication for high risk for stroke.

CVR can be assessed with TCD under two monitoring conditions: hypercapnia or CO2 reactivity, and with intravenous injections of Acetazolamide or the Diamox test.

Typically, an increase in peak velocities above 40% after the perturbation reflects intact CVR, whereas smaller increase reflect different degrees of impaired CVR. Absence of flow increase reflects a complete exhaustion of the autoregulatory capacity.

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