ArticleStroke and vascular neurology2017
Blood pressure gradients in cerebral arteries: a clue to pathogenesis of cerebral small vessel disease.
Article in Stroke and vascular neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 3 of them syntheses that pooled it.
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Who cites it
84 citing papers in PubMed, 3 syntheses or guidelines pooled it, 202 citations in OpenAlex.
- The Clinical Significance of Ambulatory Blood Pressure on Cerebral Small Vessel disease. A Systematic Review and meta-analysis of the Literature.Current hypertension reports · 2025Pooled it
- Clinical features of neuronal intranuclear inclusion disease with seizures: a systematic literature review.Frontiers in neurology · 2024Pooled it
- Common Genetic Variation Indicates Separate Causes for Periventricular and Deep White Matter Hyperintensities.Stroke · 2020Pooled it
- Spatial Distribution of Intracranial Vessel Wall Enhancement in Hypertension and Primary Angiitis of the CNS.Scientific reports · 2019Trial
- Computational Fluid Dynamics Analysis of Cerebrovascular Hemodynamic Differences in Adults with Sickle Cell Disease: Comparing Stroke and Non-Stroke Cohorts.Annals of biomedical engineering · 2026Article
- First-principles multiscale modeling of cerebral hemodynamics enables personalized predictions of human brain temperature.Scientific reports · 2026Article
- Association of Metabolic Dysfunction-Associated Steatotic Liver Disease With Features of Cerebral Small-Vessel Disease on Magnetic Resonance Images: A Large Cross-Sectional Study.Journal of the American Heart Association · 2026Article
- Typical distribution of hypertensive cerebral microbleed: a matched case-control study using primary aldosteronism.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Distinct Hemodynamic and Morphological Characteristics of Arteries Adjacent to White Matter Hyperintensities.CNS neuroscience & therapeutics · 2025Observational
- Blood flow in the human cerebral cortex: Large-scale pial vascularization and 1D simulation.PLoS computational biology · 2025Article
- Endovascular structures of the basilar artery as forms of the basilar nonfusion spectrum.Scientific reports · 2025Article
- Differences in Cerebral Small Vessel Disease Magnetic Resonance Imaging Depending on Cardiovascular Risk Factors: A Retrospective Cross-Sectional Study.Brain sciences · 2025Article
- High-fat feeding has sex-dependent effects on the structure and biomechanical properties of cerebral parenchymal arterioles and cognitive function.American journal of physiology. Heart and circulatory physiology · 2025Article
- The pathogenesis of cerebral small vessel disease and vascular cognitive impairment.Physiological reviews · 2025Review
- Laser coagulation of blood vessels at 454 nm wavelength for neurosurgical interventions.Journal of biomedical optics · 2025Article
- Monro-Kellie 4.0: moving from intracranial pressure to intracranial dynamics.Critical care (London, England) · 2025Review
- A computational framework for quantifying blood flow dynamics across myogenically-active cerebral arterial networks.Biomechanics and modeling in mechanobiology · 2025Article
- Dementia from Small Vessel Disease Versus Alzheimer's Disease: Separate Diseases or Distinct Manifestations of Cerebral Capillopathy Due to Blood-Brain Barrier Dysfunction? A Pilot Study.International journal of molecular sciences · 2025Article
- White matter hyperintensity spatial patterns: Risk factors and clinical correlates.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Parameter selection and optimization of a computational network model of blood flow in single-ventricle patients.Journal of the Royal Society, Interface · 2025Article
24 more citing papers are in PubMed but not listed here.
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleThe role of hypertension in cerebral small vessel disease is poorly understood. At the base of the brain (the 'vascular centrencephalon'), short straight arteries transmit blood pressure directly to small resistance vessels; the cerebral convexity is supplied by long arteries with many branches, resulting in a drop in blood pressure. Hypertensive small vessel disease (lipohyalinosis) causes the classically described lacunar infarctions at the base of the brain; however, periventricular white matter intensities (WMIs) seen on MRI and WMI in subcortical areas over the convexity, which are often also called 'lacunes', probably have different aetiologies.
objectivesWe studied pressure gradients from proximal to distal regions of the cerebral vasculature by mathematical modelling. METHODS AND
resultsBlood flow/pressure equations were solved in an Anatomically Detailed Arterial Network (ADAN) model, considering a normotensive and a hypertensive case. Model parameters were suitably modified to account for structural changes in arterial vessels in the hypertensive scenario. Computations predict a marked drop in blood pressure from large and medium-sized cerebral vessels to cerebral peripheral beds. When blood pressure in the brachial artery is 192/113 mm Hg, the pressure in the small arterioles of the posterior parietal artery bed would be only 117/68 mm Hg. In the normotensive case, with blood pressure in the brachial artery of 117/75 mm Hg, the pressure in small parietal arterioles would be only 59/38 mm Hg.
conclusionThese findings have important implications for understanding small vessel disease. The marked pressure gradient across cerebral arteries should be taken into account when evaluating the pathogenesis of small WMIs on MRI. Hypertensive small vessel disease, affecting the arterioles at the base of the brain should be distinguished from small vessel disease in subcortical regions of the convexity and venous disease in the periventricular white matter.
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