Cerebral Autoregulation during Postural Change in Patients with Cervical Spinal Cord Injury—A Carotid Duplex Ultrasonography Study

Patients with spinal cord injuries (SCI) often experience sudden drops in blood pressure when they change posture. This study used carotid duplex ultrasonography (CDU) to examine how cerebral blood flow (CBF) changes during these postural changes in patients with cervical SCI. The study aimed to determine if changes in CBF correlate with presyncopal symptoms (like dizziness or light-headedness) and to identify factors that affect cerebral autoregulation (CA), the brain's ability to maintain stable blood flow. The researchers found that presyncopal symptoms were more likely to occur when blood flow in the internal carotid artery decreased significantly (≥21%) after tilting. They also observed that patients with more severe SCI and lower functional scores were more prone to cerebral autoregulation failure.

• 1
  Presyncopal symptoms occurred when the blood flow volume of the internal carotid artery decreased by ≥21% after tilt.
• 2
  In the group that had orthostatic hypotension and severe CBF decrease during tilt, the body mass index and physical and functional scores were lower than in other groups, and the proportion of patients with a severe SCI was high.
• 3
  The higher the SCI severity and the lower the functional score, the higher the possibility of cerebral autoregulation failure.