Regional dynamic cerebral autoregulation across anterior and posterior circulatory territories: A detailed exploration and its clinical implications

Core Tip

Core Tip: Cerebral autoregulation (CA) maintains stable cerebral blood flow (CBF) despite systemic blood pressure changes. Recent evidence highlights regional CA variations between anterior and posterior circulations. Non-invasive neuromonitoring techniques like transcranial Doppler, transfer function analysis, and near-infrared spectroscopy facilitate dynamic CBF assessment. Studies show robust autoregulation in the anterior circulation but lower capacity in the posterior circulation. Impaired CA in the posterior circulation, especially during acute brain injuries, may result from decreased sympathetic innervation, endothelial dysfunction, increased metabolic demands, and impaired blood-brain barrier integrity. Understanding these mechanisms is vital for improving cerebrovascular disorder management.