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INVITED REVIEW

HIGHLIGHTED TOPICS
Regulation of the Cerebral Circulation

Chronic hypoxia and the cerebral circulation

Department of Anatomy, Case Western Reserve University School of Medicine, Cleveland, Ohio

Exposure to mild hypoxia elicits a characteristic cerebrovascular response in mammals, including humans. Initially, cerebral blood flow (CBF) increases as much as twofold. The blood flow increase is blunted somewhat by a decreasing arterial PCO₂ as a result of the hypoxia-induced hyperventilatory response. After a few days, CBF begins to fall back toward baseline levels as the blood oxygen-carrying capacity is increasing due to increasing hemoglobin concentration and packed red cell volume as a result of erythropoietin upregulation. By the end of 2 wk of hypoxic exposure, brain capillary density has increased with resultant decreased intercapillary distances. The relative time courses of these changes suggest that they are adjusted by different control signals and mechanisms. The CBF response appears linked to the blood oxygen-carrying capacity, whereas the hypoxia-induced brain angiogenesis appears to be in response to tissue hypoxia.

altitude adaptation; angiogenesis; cerebral blood flow; cerebral blood volume

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