Autonomic Disturbances in Acute Cerebrovascular Disease
1Department of Neurosurgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
2Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, USA
3Department of Neurosurgery, Loma Linda University, Loma Linda, USA
4Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
5Brain Research Institute, Zhejiang University, Hangzhou, China
6Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, China
7Department of Anesthesiology, Loma Linda University, Loma Linda, USA
Abstract
Autonomic disturbances often occur in patients with acute cerebrovascular disease due to damage of the central autonomic network. We summarize the structures of the central autonomic network and the clinical tests used to evaluate the functions of the autonomic nervous system. We review the clinical and experimental findings as well as management strategies of post-stroke autonomic disturbances including electrocardiographic changes, cardiac arrhythmias, myocardial damage, thermoregulatory dysfunction, gastrointestinal dysfunction, urinary incontinence, sexual disorders, and hyperglycemia. The occurrence of autonomic disturbances has been associated with poor outcomes in stroke patients. Autonomic nervous system modulation appears to be an emerging therapeutic strategy for stroke management in addition to treatments for sensorimotor dysfunction.
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