Cardiovascular Center (medulla):
- regulates cardiac output (modified heart rate, stroke volume, vascular tone via sympathetic / parasympathetic stimulation).
- responds to baroreceptor signals (stretch) and chemoreceptors signals (PO2 / PCO2)
Rostral Ventrolateral Medulla and upper cervical spinal cord region:
- play a key role in central BP control
- High cervical SCI associated with very erratic BP
- Dysregulated neural net rows dynamics in caudal pressors regions implicated in development of HTN
Higher Brain Regions:
- I.e. cerebral cortex, hypothalamus, Lim nic system
- Modulates brainstem control centers
- Based on studies of patients undergoing intraoperative stimulation of insula before temporal lobe tiny for seizure control:
- Stimulation of L insular cortex – produces bradycardia and depressor responses
- Stimulation of R insular cortex – produces tachycardia and pressor effects (i.e. R dominance for sympathetic cardiovascular effects)
R MCA infarction May disinhibition insular function –> increased sympathetic cardiovascular tone
*NOTE TO SELF: short term rise in BP after stroke – compensatory, no need to treat. Chronic high blood pressure – likely renally mediated, requires treatment. (?)
Kelly, D., & Rothwell, P. (2019). Blood pressure and the brain: the neurology of hypertension. Practical Neurology, practneurol-2019-002269. doi: 10.1136/practneurol-2019-002269.