Baroreflex: a new therapeutic target in human stroke?
OBJECTIVE
Autonomic dysfunction, including increased sympathetic drive and blunted baroreflex, has repeatedly been observed in acute stroke. Of clinical importance is that the stroke-related autonomic imbalance seems to be linked to worse outcome after stroke. Here, we discuss the role of baroreflex impairment in acute stroke and its possible pathophysiological and therapeutic relevance. Summary of Review- Possible mechanisms linking baroreflex impairment with unfavorable outcome in stroke may include increased cardiovascular morbidity and mortality, promotion of secondary brain injury due to local inflammation, hyperglycemia, or altered cerebral perfusion.


CONCLUSIONS
We suggest therefore that the modifying of autonomic functions may have important therapeutic implications in acute ischemic as well as in hemorrhagic stroke.
Sykora
Marek
M
Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. marek.sykora@med.uni-heidelberg.de
Diedler
Jennifer
J
Turcani
Peter
P
Hacke
Werner
W
Steiner
Thorsten
T
D001341:Autonomic Nervous System / Q000033:anatomy & histology / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D017704:Baroreflex / Q000187:drug effects / Q000502:physiology*; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D002536:Cerebral Arteries / Q000294:innervation / Q000503:physiopathology; D002540:Cerebral Cortex / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D006801:Humans; D012021:Reflex, Abnormal / Q000187:drug effects / Q000502:physiology*; D020521:Stroke / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*