Measuring Cerebrovascular Reactivity: Sixteen Avoidable Pitfalls

An increase in arterial PCO 2 is the most common stressor used to cerebral blood flow for assessing vascular reactivity (CVR). That CO readily obtained, inexpensive, easy administer, and safe inhale belies difficulties extracting scientifically clinically relevant information from resulting responses. Over past two decades, we have studied more than 2,000 individuals, with cervical pathology using as vasoactive agent oxygen-level-dependent magnetic resonance imaging signal surrogate. The ability deliver different forms of precise hypercapnic stimuli enabled systematic exploration flow-related changes. We learned effect on CVR particular aspects stimulus such partial pressure oxygen, baseline , magnitude, rate, pattern its change. Similarly, interpret response speed direction Finally, were able test whether falls into a normal range. Here, present review our accumulated insight 16 “lessons learned.” hope many these insights are sufficiently general apply range types -based perfusion metrics CVR.