369:, or homeostatic mechanism for the maintenance of blood pressure, in the cranial region. Specifically, the reflex mechanism can maintain normal cerebral blood flow and pressure under stressful situations such as ischemia or subarachnoid hemorrhages. A case report of a patient who underwent a spontaneous subarachnoid hemorrhage demonstrated that the Cushing reflex played a part in maintaining cerebral perfusion pressure (CPP) and cerebral blood flow. Eventually, the ICP drops to a level range where a state of induced hypertension in the form of the Cushing reflex is no longer required. The Cushing reflex was then aborted, and CPP was maintained. It has also been shown that an increase in mean arterial pressure due to hypertension, characteristic of the reflex, can cause the normalization of CPP. This effect is protective, especially during increased intracranial pressure, which creates a drop in CPP.
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632:. The anesthesia used in experiments have led to respiratory depression, which might have had effect on the results. Early experiments also put animal subjects under artificial ventilation, only allowing for limited conclusions about respiration in the Cushing reflex. The use of anesthetics proposes ideas for future research, since the creation of the Cushing response has been difficult to create under basal conditions or without anesthesia.
322:. The blood pressure can be expected to remain higher than the pressure of the raised cerebral spinal fluid to continue to allow blood to flow to the brain. The pressure rises to the point where it overcomes the resisting pressure of the compressed artery, and blood is allowed through, providing oxygen to the hypoxic area of the brain. If the increase in blood pressure is not sufficient to compensate for the compression on the artery,
226:. In one study, it was confirmed that raised ICP due to subarachnoid hemorrhaging causes mechanical distortion of the brainstem, specifically the medulla. Due to the mechanism of the Cushing reflex, brainstem distortion is then swiftly followed by sympathetic nervous system over activity. In addition, during typical neurosurgical procedures on patients, especially those involving neuroendoscopic techniques, frequent washing of the
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473:. In June 1901 Cushing published his first paper through Johns Hopkins Hospital Bulletin entitled "Concerning a definite regulatory mechanism of the vasomotor centre which controls blood pressure during cerebral compression". Between 1901 and 1903, Cushing published five papers pertaining to his research on the vasopressor response. These papers were published in
550:, and others experimented with intracranial pressure similarly to Cushing. Some of these researchers published similar findings concerning the relationship of intracranial pressure to arterial blood pressure before Cushing had begun experimenting. Cushing studied this relationship more carefully and offered an improved explanation of the relationship.
314:. This induces bradycardia, or slowed heart rate, and signifies the second stage of the reflex. Bradycardia may also be caused by increased ICP due to direct mechanical distortion of the vagus nerve and subsequent parasympathetic response. Furthermore, this reflexive increase in parasympathetic activity is thought to contribute to the formation of
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neurosurgery being performed on the brain, there is always a likelihood that raised intracranial pressure may occur. Early recognition of this is crucial to the well being of the patient. Although direct measurement of ICP is possible, it is not always accurate. In the past, physicians and nurses have relied on
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This research clearly displayed the cause and effect relationship between intracranial pressure and cerebral compression. Cushing noted this relationship in his subsequent publications. He also noted that there must exist a specific regulatory mechanism that increased blood pressure to a high enough
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or bradycardia, the late phase of the reflex, to identify the ICP increase. Once the initial stage of the
Cushing reflex (bradycardia combined with hypertension) was discovered, it offered a much more reliable and swift warning sign of high ICP. It was found that hypertension and bradycardia occurred
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and venous blood pressure. Like Hill, Cushing used dogs for his experiments. To begin, Cushing monitored the caliber and color of cortical vessels by fitting a glass window into the skull of the dog. Intracranial pressure was raised by filling an intracranial, soft, rubber bag with mercury. Cushing
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in the
Cushing reflex is unclear. In most normal pressure responses the chemoreceptors and baroreceptors work together to increase or decrease blood pressure. In the Cushing reflex, the central chemoreceptors are likely involved in the detection of ischemia, contributing to the sympathetic surge and
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As first postulated by Harvey
Cushing, raised intracranial pressure is the primary cause of the Cushing reflex. Furthermore, continued moderate increases in cranial pressure allows for the Cushing reflex to occur. In contrast, rapid and dramatic pressure rises do not allow for the mechanism of the
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Brain plateau wave changes are also associated with the
Cushing reflex. These waves are characterized by acute rises of the ICP, and are accompanied by a decrease of the cerebral perfusion pressure. It has been found that if a Cushing reflex occurs, brain plateau wave changes can be erased due to
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is exhibited as an increase in rate rather than depth of ventilation, so the
Cushing reflex is often associated with slow, irregular breathing. As a result of the now defective regulation of heart rate and blood pressure, the physiologic response is decreased blood flow peripherally, which can
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Whenever a
Cushing reflex occurs, there is a high probability of death in seconds to minutes. As a result, a Cushing reflex indicates a need for immediate care. Since its presence is a good detector of high ICP, it is often useful in the medical field, particularly during surgery. During any
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mediating the
Cushing response is also unknown. Some research suggests the existence of intracranial baroreceptors to trigger specific Cushing baroreceptor reflex. Experiments by Schmidt and his fellow researchers showed that the Cushing reflex is directed by
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Some researchers have also suggested a long-term effect of the
Cushing reflex. Thus far it has only been observed as an immediate acute response, but there has been some evidence to suggest that its effects could be prolonged, such as a long-term raise in
624:, while others have reported increased respiratory rates. Other researchers have found that increases in respiratory rate follow ICP decreases, while others say it is a response to ICP increase. One must also take into account the use of
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is located in an area surrounded by the skull, increased ICP consequently increases the pressure in the fluid itself. The pressure in the cerebral spinal fluid eventually rises to the point that it meets and gradually exceeds the
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have been known to cause high intracranial pressure. The
Cushing reflex can also result from low CPP, specifically below 15 mmHg. CPP normally falls between 70-90 mmHg in an adult human, and 60-90 mmHg in children.
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Pasztor, E; Fedina L; Kocsis B; et al. (1986). "Activity of peripheral sympathetic efferent nerves in experimental subarachnoid haemorrhage. Part 1: Observations at the time of intracranial hypertension".
557:, a German pathologist and contemporary of Cushing, made remarks claiming that Cushing neither cited him in Cushing's research nor expanded on any of the results that he had found in his original experiments.
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In response to rising intracranial pressure (ICP), respiratory cycles change in regularity and rate. Different patterns indicate a different location of the brain where the injury occurred. The increase in
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Subarachnoid hemorrhage as shown on a CT scan. It is denoted by the arrow. This type of injury may result in damage to the brainstem, which could initiate or worsen the symptoms of the
Cushing reflex
171:(CPP) dropped below 15 mmHg due to raised ICP. Also, the Cushing reflex is known to arise only from acute prolonged raises in ICP. Thus, it can be used as a tool by physicians to differentiate
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Marshman, LA (1997). "Cushing's 'variant' response (acute hypotension) after subarachnoid hemorrhage. Association with moderate intracra- nial tension and subacute cardiovascular collapse".
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point such that it did not create anemic conditions. Cushing's publications contain his observations and no statistical analysis. The sample size of the experiment is also not known.
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The underlying mechanisms of the reflex on a cellular level are yet to be discovered, and will likely be the next area of research if scientists and or doctors chose to do so.
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of the disease remains undetermined. The possibility that intracranial pressure (ICP) may not be the sole cause of the Cushing reflex per se came from an occurrence of Cushing
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Ogilvy, CS; Dubois AB (1987). "Effect of increased intracranial pressure on blood pressure, heart rate, respiration and catecholamine levels in neonatal and adult rabbits".
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are activated. In the first stage of the reflex, sympathetic nervous system stimulation is much greater than parasympathetic stimulation. The sympathetic response activates
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hypertension in the first phase of the reflex, and work in opposition to the baroreceptors, contributing to the combined high sympathetic and parasympathetic activation.
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89:
Defect of the blood–brain barrier after stroke shown in T1-weighted MRI images. Left image without, right image with contrast medium administration showing evidence of
287:. The body's induced hypertension is an attempt to restore blood flow to the ischemic brain. The sympathetic stimulation also increases the rate of heart
1388:
Guyton, Arthur; Hall, John (2006). "Chapter 18: Nervous Regulation of Circulation, and a Rapid Control of Arterial Pressure". In Gruliow, Rebecca (ed.).
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Although the Cushing reflex was primarily identified as a physiological response when blood flow has almost ceased, its activity has also been seen in
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is affected by the Cushing reflex, though the respiratory changes induced are still an area that needs more research. Some researchers have reported
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It has also been reported that the presence of a Cushing reflex due to an ICP increase could allow one to conclude that ischemia has occurred in the
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first expanded knowledge of what is now known as the Cushing reflex, there are still many aspects of the research that remain to be seen. The exact
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357:, which is detrimental to the physiological well-being of patients. As a result, the Cushing reflex is a last-ditch effort by the body to maintain
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Schmidt EA, Czosnyka Z, Momjian S, Czosnyka M, Bech RA, Pickard JD (2005). "Intracranial baroreflex yielding an early cushing response in human".
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Hanigan, WC; W. Ragen; M. Ludgera (1992). "Neurological surgery in the nineteenth century: the principles and techniques of Ernst von Bergmann".
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The Cushing reflex is complex and seemingly paradoxical. The reflex begins when some event causes increased intracranial pressure (ICP). Since
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response occurring before increased ICP. Some research observed symptoms of Cushing reflex, without the usual increased ICP and medullary
141:, etc.), which reflect decreased intravascular blood flow. This decreased flow often causes a reflexive HTN, or hypertension (increase in
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Kalmar, AF; JV Aken; J Caemaert; et al. (2005). "Value of Cushing Reflex as warning sign for brain ischemia during neuroendoscopy".
640:. Heightened sensitivity of neurological response systems leading to arterial hypertension is also possible, but has not been examined.
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333:. Since the brainstem controls involuntary breathing, changes in its homeostasis often results in irregular respiratory pattern and/or
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reflex to sufficiently take place. Elevated intracranial pressure can result from numerous pathways of brain impairment, including:
112:), and irregular respiration. It is caused by increased pressure inside the skull. These symptoms can be indicative of insufficient
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198:. As such, the presence of a Cushing reflex due to ICP can indicate that ischemia may be occurring due to foreign organ rejection.
465:. He continued to work on the same research project, while also simultaneously improving his methods of recording coincidence of
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Kosieradzki, M; W Rowinski (December 2008). "Ischemia/reperfusion injury in kidney transplantation: mechanisms and prevention".
757:"Concerning a definite regulatory mechanism of the vasomotor centre which controls blood pressure during cerebral compression"
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1514:
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1397:
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Woodman, OL; SF Vatner (August 1987). "Coronary vasoconstriction mediated by α1- and α2-adrenoceptors in conscious dogs".
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Wan, WH; BT Ang; E Wang (Jan 7, 2008). "The cushing response: A case for a review of its role as a physiological reflex".
283:. This constriction raises the total resistance of blood flow, elevating blood pressure to high levels, which is known as
1258:"Cerebral blood flow changes in response to elevated intracranial pressure in rabbits and bluefish: a comparative study"
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2909:
2764:
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Jones, JV (1989-02-02). "Differentiation and investigation of primary versus secondary hypertension (Cushing reflex)".
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Dickinson, CJ (1990). "Reappraisal of the Cushing reflex: the most powerful neural blood pressure stabilizing system".
980:
Fox JL, Ransdell AM, Al-Mefty O, Jinkins JR (1986). "The Cushing reflex in the absence of intracranial hypertension".
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Dagal, A; Lam AM (April 2011). "Cerebral blood flow and the injured brain: how should we monitor and manipulate it?".
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Cushing began experimenting once he obtained approval from Kocher. His experimental setup was a modified version of
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Raised ICP, tachycardia, or some other endogenous stimulus can result in distortion and/or increased pressure on the
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become compressed. Compression then results in diminished blood supply to the brain, a condition known as cerebral
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life. This activity has not been thoroughly investigated, so there is a need for more research in this area.
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Reis DJ, Nathan MA, Doba N (1975). "Two specific brainstem systems which regulate the blood pressure".
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model to similarly test the effects of brain pressure on sinus pressure, cerebrospinal fluid pressure,
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to begin testing how compression of the brain affected blood vessels. Cushing also enlisted the aid of
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response, ischemia in the cranial region has been detected with a transplanted organ that is being
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in early experimentation. Research was initially performed on animals or patients under
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detect the increase in blood pressure and trigger a parasympathetic response via the
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About Intracranial Pressure and Blood Circulation Inside the Cranium. Medical Thesis
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Grady PA, Blaumanis OR (June 1988). "Physiologic parameters of the Cushing reflex".
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Fodstad H, Kelly PJ, Buchfelder M (November 2006). "History of the cushing reflex".
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Hackett, J.G.; F. M. Abboud; A. L. Mark; P. G. Schmid; D. D. Heistad (July 1972).
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Raised intracranial pressure can ultimately result in the shifting or crushing of
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Some controversy concerning plagiarism does surround some of Cushing's research.
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1392:(Book) (11th ed.). Philadelphia, Pennsylvania: Elsevier Inc. p. 213.
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1448:"Nervous Regulation of the Circulation and Rapid Control of Arterial Pressure"
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299:. This combined with hypertension is the first stage of the Cushing reflex.
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response and the Cushing reflex and its symptoms has yet to be identified.
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Irregular, decreased respirations (caused by impaired brainstem function)
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Physiological nervous system response to increased intracranial pressure
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1484:(3rd ed.). Sunderland, MA, USA: Sinauer Associates. p. 143.
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433:. A month into his trip, Cushing received a formal proposition from
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1700:. Acta Neurochirurgica Supplementum. Vol. 95. pp. 253–6.
601:, since its physiological change has to do with the balance of the
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assistance and resources, Cushing began his research. Cushing left
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simultaneously. This three part effect is commonly referred to as
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and similar drugs. It was first described in detail by American
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rather than increasing mercury content of an intracranial bag.
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1509:(7th ed.). Jones and Bartlett Learning. p. 1665.
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Comparative Biochemistry and Physiology Part A: Physiology
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365:. It is widely accepted that the Cushing reflex acts as a
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The Cushing reflex classically presents as an increase in
46:) is a physiological nervous system response to increased
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Although a lot of progress has been made since 1901 when
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Several notable figures in the medical field, including
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refers to when all of these symptoms are seen together:
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145:) despite the actual decrease in intravascular volume.
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in the stomach, due to uncontrolled activation of the
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of increased blood pressure, irregular breathing, and
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58:. It is usually seen in the terminal stages of acute
1533:
Physiology and Pathology of the Cerebral Circulation
337:. This is the third and final stage of the reflex.
1414:
1334:The Central Nervous System: Structure and Function
1550:Mitchell Fink; Michelle Hayes; Neil Soni (2008).
488:
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1336:. Oxford University Press US. pp. 369–396.
1256:Beiner, JM; CS Olgiyy; AB DuBois (March 1997).
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441:, a known blood pressure researcher. Utilizing
390:Systolic hypertension (widening pulse pressure)
1698:Intracranial Pressure and Brain Monitoring XII
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1452:Guyton and Hall Textbook of Medical Physiology
879:
502:recorded the intracranial pressure along with
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609:. However, the specific relation between the
1602:Anatomic Studies of the Cerebral Circulation
1554:. London, England: Springer. pp. 89–90.
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686:Ayling, J (2002). "Managing head injuries".
1650:. Springfield: Charles C. Thomas. pp.
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295:. Increased heart rate is also known as
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1421:. Philadelphia: JB Lippincott. pp.
1413:P Barash; B Cullen; R Storlting (1992).
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279:, causing constriction of the body's
267:During the increase in ICP, both the
252:(MAP). When the ICP exceeds the MAP,
2839:oxygen–hemoglobin dissociation curve
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1445:
862:
819:
616:It has been determined that rate of
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518:. In later experiments performed by
1821:
1482:Neuroanatomy through clinical cases
13:
2765:hypoxic pulmonary vasoconstriction
1108:10.1016/j.transproceed.2008.10.004
1000:
964:
805:10.1227/01.NEU.0000245582.08532.7C
372:
14:
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828:Current Opinion in Anesthesiology
1604:. Paris, Bailliere. p. 642.
1579:10.1227/00006123-199205000-00017
1311:10.1152/ajpheart.1987.253.2.H388
421:. Cushing began his research in
410:Cushing's reflex is named after
1552:Classic Papers in Critical Care
1498:
1473:
1439:
1381:
1536:. London: J & A Churchill.
1454:, Elsevier, pp. 215–255,
1390:Textbook of Medical Physiology
799:(5): 1132–7, discussion 1137.
607:parasympathetic nervous system
489:Experimental setup and results
273:parasympathetic nervous system
1:
2440:Symmetrical tonic neck reflex
1670:Clin. Exp. Pharmacol. Physiol
1507:Emergency Care in the Streets
1275:10.1016/s0300-9629(96)00206-x
670:
80:
2131:
1633:(Thesis). Wurzburg, Germany.
1073:10.1016/0002-9149(89)90398-6
894:10.1016/0090-3019(88)90140-1
840:10.1097/ACO.0b013e3283445898
277:alpha-1 adrenergic receptors
250:mean arterial blood pressure
238:
120:) as well as compression of
7:
2797:Ventilation/perfusion ratio
2648:pulmonary stretch receptors
1647:Harvey Cushing. A biography
653:
348:
235:disappearance of high ICP.
169:cerebral perfusion pressure
10:
2974:
2829:alveolar–arterial gradient
1889:Charcot's neurologic triad
1030:10.1016/j.jocn.2007.05.025
688:Emergency Medical Services
603:sympathetic nervous system
481:, and one was authored by
394:
269:sympathetic nervous system
62:and may indicate imminent
2948:Cardiovascular physiology
2902:
2778:
2752:
2710:respiratory minute volume
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2622:ventral respiratory group
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1993:
1986:
1966:
1935:
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1903:Peripheral nervous system
1901:
1862:
1812:
1804:Cranial nerve examination
1794:
22:(also referred to as the
2617:dorsal respiratory group
2511:obligate nasal breathing
1799:Neurological examination
1706:10.1007/3-211-32318-x_51
1629:Friedrich Jolly (1871).
1505:Caroline, Nancy (2013).
1480:Blumenfeld, Hal (2022).
1143:10.1161/01.str.28.7.1445
611:autonomic nervous system
599:autonomic nervous system
585:distortion could be the
461:, a previous student of
206:, ischemia, meningitis,
204:subarachnoid hemorrhages
190:. Aside from the innate
2819:pulmonary gas pressures
2433:Crossed extensor reflex
2182:Pharyngeal (gag) reflex
2173:Vestibulo-ocular reflex
761:Bull Johns Hopkins Hosp
412:Harvey Williams Cushing
256:located in the brain's
184:posterior cranial fossa
2573:mechanical ventilation
2482:Respiratory physiology
2208:Brachioradialis reflex
2149:Pupillary light reflex
2007:carpal tunnel syndrome
1814:Central nervous system
715:Biology of the Neonate
660:Traumatic brain injury
407:
342:central chemoreceptors
158:
149:Differential diagnosis
93:
50:(ICP) that results in
2824:alveolar gas equation
2760:pulmonary circulation
2380:Churchill–Cope reflex
2335:Bezold–Jarisch reflex
1871:Intracranial pressure
1530:Leonard Hill (1896).
1366:10.1161/01.res.31.1.8
429:studying abroad with
402:
167:93% of the time when
156:
88:
48:intracranial pressure
2879:respiratory quotient
2734:body plethysmography
2653:Hering–Breuer reflex
2528:pulmonary surfactant
2302:Superficial reflexes
2177:Oculocephalic reflex
2154:Accommodation reflex
2051:Trendelenburg's sign
406:, Doris Ulmann 1920s
24:vasopressor response
2722:Lung function tests
2556:hyperresponsiveness
2413:Golgi tendon reflex
2355:Oculocardiac reflex
2169:Caloric reflex test
1927:Jendrassik maneuver
1672:. Suppl 2: 179–83.
1446:Hall, John (2012),
1417:Clinical Anesthesia
1332:Per Brodal (2004).
1305:(2 Pt 2): H388–93.
755:Cushing, H (1901).
589:of Cushing reflex.
561:Research directions
483:Emil Theodor Kocher
449:in 1901 to work in
435:Emil Theodor Kocher
431:Emil Theodor Kocher
245:cerebrospinal fluid
164:hemodynamic changes
104:, reduction of the
2889:diffusion capacity
2884:arterial blood gas
2864:carbonic anhydrase
2598:pneumotaxic center
2370:Reflex tachycardia
2365:Reflex bradycardia
2314:Cremasteric reflex
2245:Primitive reflexes
2046:Straight leg raise
1784:Signs and symptoms
1644:JF Fulton (1946).
1235:10.1093/bja/aei121
1182:10.1007/bf01407456
988:(Suppl 47): 9–16.
540:Ernst von Bergmann
524:subarachnoid space
408:
188:transplanted organ
159:
94:
36:Cushing phenomenon
2935:
2934:
2843:Oxygen saturation
2809:zones of the lung
2548:airway resistance
2448:
2447:
2428:Withdrawal reflex
2330:Bainbridge reflex
2228:Ankle jerk reflex
2099:
2098:
2095:
2094:
2091:
2090:
1982:
1981:
1974:Hoffmann's reflex
1897:
1896:
1715:978-3-211-24336-7
1516:978-1-4496-4151-1
1491:978-1-60535-962-5
1399:978-0-7216-0240-0
950:10.1042/cs0790543
727:10.1159/000242728
665:Bainbridge reflex
534:Other researchers
2965:
2744:nitrogen washout
2603:apneustic center
2518:respiratory rate
2475:
2468:
2461:
2452:
2451:
2423:Startle response
2398:List of reflexes
2309:Abdominal reflex
2192:Stretch reflexes
2126:
2119:
2112:
2103:
2102:
1991:
1990:
1953:Oppenheim's sign
1917:
1916:
1908:
1907:
1884:Lhermitte's sign
1819:
1818:
1786:relating to the
1777:
1770:
1763:
1754:
1753:
1748:
1747:
1741:
1737:
1735:
1727:
1693:
1682:
1681:
1665:
1656:
1655:
1641:
1635:
1634:
1626:
1620:
1619:
1613:
1605:
1600:Duret H (1878).
1597:
1591:
1590:
1562:
1556:
1555:
1547:
1538:
1537:
1527:
1521:
1520:
1502:
1496:
1495:
1477:
1471:
1470:
1469:
1468:
1443:
1437:
1436:
1420:
1410:
1404:
1403:
1385:
1379:
1378:
1368:
1344:
1338:
1337:
1329:
1323:
1322:
1294:
1288:
1287:
1277:
1253:
1247:
1246:
1228:
1208:
1202:
1201:
1164:
1155:
1154:
1126:
1120:
1119:
1096:Transplant. Proc
1091:
1085:
1084:
1056:
1050:
1049:
1013:
998:
997:
977:
962:
961:
938:Clinical Science
933:
906:
905:
877:
860:
859:
823:
817:
816:
788:
769:
768:
752:
739:
738:
710:
704:
703:
683:
512:respiratory rate
414:(1869–1939), an
340:The role of the
64:brain herniation
40:Cushing response
32:Cushing reaction
2973:
2972:
2968:
2967:
2966:
2964:
2963:
2962:
2938:
2937:
2936:
2931:
2922:oxygen toxicity
2898:
2786:ventilation (V)
2774:
2770:pulmonary shunt
2748:
2739:peak flow meter
2659:
2577:
2484:
2479:
2449:
2444:
2403:Acoustic reflex
2386:
2340:Coronary reflex
2318:
2297:
2239:
2223:Patellar reflex
2186:
2159:Jaw jerk reflex
2135:
2130:
2100:
2087:
2071:
2055:
2024:
2018:Phalen maneuver
1978:
1962:
1958:Westphal's sign
1948:Chaddock reflex
1931:
1893:
1877:Cushing's triad
1858:
1808:
1790:
1781:
1751:
1739:
1738:
1729:
1728:
1716:
1694:
1685:
1666:
1659:
1642:
1638:
1627:
1623:
1607:
1606:
1598:
1594:
1563:
1559:
1548:
1541:
1528:
1524:
1517:
1503:
1499:
1492:
1478:
1474:
1466:
1464:
1462:
1444:
1440:
1433:
1411:
1407:
1400:
1386:
1382:
1345:
1341:
1330:
1326:
1295:
1291:
1254:
1250:
1226:10.1.1.507.1734
1209:
1205:
1176:(2–4): 125–31.
1165:
1158:
1127:
1123:
1102:(10): 3279–88.
1092:
1088:
1057:
1053:
1018:J Clin Neurosci
1014:
1001:
978:
965:
934:
909:
878:
863:
824:
820:
789:
772:
753:
742:
711:
707:
684:
677:
673:
656:
563:
555:Bernhard Naunyn
548:Friedrich Jolly
536:
516:Cushing's triad
491:
397:
378:Cushing's triad
375:
373:Cushing's triad
351:
241:
151:
83:
52:Cushing's triad
17:
12:
11:
5:
2971:
2961:
2960:
2958:Medical triads
2955:
2950:
2933:
2932:
2930:
2929:
2924:
2919:
2918:
2917:
2906:
2904:
2900:
2899:
2897:
2896:
2886:
2881:
2876:
2871:
2868:chloride shift
2861:
2858:Haldane effect
2855:
2850:
2845:
2836:
2831:
2826:
2821:
2816:
2811:
2806:
2805:
2804:
2799:
2788:
2782:
2780:
2776:
2775:
2773:
2772:
2767:
2762:
2756:
2754:
2750:
2749:
2747:
2746:
2741:
2736:
2731:
2726:
2724:
2718:
2717:
2715:FEV1/FVC ratio
2712:
2707:
2705:
2701:
2700:
2695:
2690:
2685:
2680:
2675:
2669:
2667:
2661:
2660:
2658:
2657:
2656:
2655:
2645:
2644:
2643:
2638:
2630:chemoreceptors
2626:
2625:
2624:
2619:
2607:
2606:
2605:
2600:
2587:
2585:
2579:
2578:
2576:
2575:
2570:
2569:
2568:
2563:
2558:
2550:
2545:
2540:
2538:elastic recoil
2535:
2530:
2525:
2520:
2515:
2514:
2513:
2508:
2503:
2492:
2490:
2486:
2485:
2478:
2477:
2470:
2463:
2455:
2446:
2445:
2443:
2442:
2437:
2436:
2435:
2425:
2420:
2415:
2410:
2405:
2400:
2394:
2392:
2388:
2387:
2385:
2384:
2383:
2382:
2374:
2373:
2372:
2367:
2357:
2352:
2347:
2345:Cushing reflex
2342:
2337:
2332:
2326:
2324:
2323:Cardiovascular
2320:
2319:
2317:
2316:
2311:
2305:
2303:
2299:
2298:
2296:
2295:
2290:
2285:
2280:
2275:
2270:
2265:
2260:
2255:
2249:
2247:
2241:
2240:
2238:
2237:
2236:
2235:
2233:Plantar reflex
2230:
2225:
2217:
2216:
2215:
2213:Triceps reflex
2210:
2205:
2196:
2194:
2188:
2187:
2185:
2184:
2179:
2166:
2164:Corneal reflex
2161:
2156:
2151:
2145:
2143:
2137:
2136:
2129:
2128:
2121:
2114:
2106:
2097:
2096:
2093:
2092:
2089:
2088:
2086:
2085:
2079:
2077:
2073:
2072:
2070:
2069:
2063:
2061:
2057:
2056:
2054:
2053:
2048:
2043:
2038:
2032:
2030:
2026:
2025:
2023:
2022:
2021:
2020:
2015:
2003:
2001:Froment's sign
1997:
1995:
1988:
1984:
1983:
1980:
1979:
1977:
1976:
1970:
1968:
1964:
1963:
1961:
1960:
1955:
1950:
1945:
1943:Plantar reflex
1939:
1937:
1933:
1932:
1930:
1929:
1923:
1921:
1914:
1905:
1899:
1898:
1895:
1894:
1892:
1891:
1886:
1881:
1880:
1879:
1866:
1864:
1860:
1859:
1857:
1856:
1851:
1846:
1844:Myerson's sign
1841:
1839:Macewen's sign
1836:
1831:
1825:
1823:
1816:
1810:
1809:
1807:
1806:
1801:
1795:
1792:
1791:
1788:nervous system
1780:
1779:
1772:
1765:
1757:
1750:
1749:
1740:|journal=
1714:
1683:
1657:
1636:
1621:
1592:
1557:
1539:
1522:
1515:
1497:
1490:
1472:
1460:
1438:
1431:
1405:
1398:
1380:
1339:
1324:
1299:Am. J. Physiol
1289:
1248:
1203:
1170:Acta Neurochir
1156:
1137:(7): 1445–50.
1121:
1086:
1067:(6): 10C–13C.
1061:Am. J. Cardiol
1051:
999:
982:Ann. Clin. Res
963:
907:
861:
818:
770:
740:
721:(6): 327–336.
705:
674:
672:
669:
668:
667:
662:
655:
652:
638:blood pressure
592:The nature of
575:blood pressure
567:Harvey Cushing
562:
559:
535:
532:
504:blood pressure
495:Leonard Hill's
490:
487:
467:blood pressure
439:Hugo Kronecker
404:Harvey Cushing
396:
393:
392:
391:
388:
385:
374:
371:
350:
347:
320:parietal cells
316:Cushing ulcers
293:cardiac output
240:
237:
179:rises in ICP.
150:
147:
143:blood pressure
116:to the brain (
102:pulse pressure
91:brain ischemia
82:
79:
75:Harvey Cushing
28:Cushing effect
20:Cushing reflex
15:
9:
6:
4:
3:
2:
2970:
2959:
2956:
2954:
2951:
2949:
2946:
2945:
2943:
2928:
2925:
2923:
2920:
2916:
2913:
2912:
2911:
2910:high altitude
2908:
2907:
2905:
2903:Insufficiency
2901:
2894:
2890:
2887:
2885:
2882:
2880:
2877:
2875:
2874:oxyhemoglobin
2872:
2869:
2865:
2862:
2859:
2856:
2854:
2851:
2849:
2846:
2844:
2840:
2837:
2835:
2832:
2830:
2827:
2825:
2822:
2820:
2817:
2815:
2812:
2810:
2807:
2803:
2800:
2798:
2795:
2794:
2792:
2789:
2787:
2784:
2783:
2781:
2777:
2771:
2768:
2766:
2763:
2761:
2758:
2757:
2755:
2751:
2745:
2742:
2740:
2737:
2735:
2732:
2730:
2727:
2725:
2723:
2720:
2719:
2716:
2713:
2711:
2708:
2706:
2703:
2702:
2699:
2696:
2694:
2691:
2689:
2686:
2684:
2681:
2679:
2676:
2674:
2671:
2670:
2668:
2666:
2662:
2654:
2651:
2650:
2649:
2646:
2642:
2639:
2637:
2634:
2633:
2632:
2631:
2627:
2623:
2620:
2618:
2615:
2614:
2613:
2612:
2608:
2604:
2601:
2599:
2596:
2595:
2594:
2593:
2589:
2588:
2586:
2584:
2580:
2574:
2571:
2567:
2564:
2562:
2559:
2557:
2554:
2553:
2551:
2549:
2546:
2544:
2543:hysteresivity
2541:
2539:
2536:
2534:
2531:
2529:
2526:
2524:
2521:
2519:
2516:
2512:
2509:
2507:
2504:
2502:
2499:
2498:
2497:
2494:
2493:
2491:
2487:
2483:
2476:
2471:
2469:
2464:
2462:
2457:
2456:
2453:
2441:
2438:
2434:
2431:
2430:
2429:
2426:
2424:
2421:
2419:
2416:
2414:
2411:
2409:
2406:
2404:
2401:
2399:
2396:
2395:
2393:
2389:
2381:
2378:
2377:
2375:
2371:
2368:
2366:
2363:
2362:
2361:
2358:
2356:
2353:
2351:
2350:Diving reflex
2348:
2346:
2343:
2341:
2338:
2336:
2333:
2331:
2328:
2327:
2325:
2321:
2315:
2312:
2310:
2307:
2306:
2304:
2300:
2294:
2291:
2289:
2286:
2284:
2281:
2279:
2276:
2274:
2271:
2269:
2266:
2264:
2261:
2259:
2256:
2254:
2251:
2250:
2248:
2246:
2242:
2234:
2231:
2229:
2226:
2224:
2221:
2220:
2218:
2214:
2211:
2209:
2206:
2204:
2203:Biceps reflex
2201:
2200:
2198:
2197:
2195:
2193:
2189:
2183:
2180:
2178:
2174:
2170:
2167:
2165:
2162:
2160:
2157:
2155:
2152:
2150:
2147:
2146:
2144:
2142:
2141:Cranial nerve
2138:
2134:
2127:
2122:
2120:
2115:
2113:
2108:
2107:
2104:
2084:
2083:Pain stimulus
2081:
2080:
2078:
2074:
2068:
2067:Beevor's sign
2065:
2064:
2062:
2058:
2052:
2049:
2047:
2044:
2042:
2041:Hoover's sign
2039:
2037:
2036:Gowers's sign
2034:
2033:
2031:
2027:
2019:
2016:
2014:
2011:
2010:
2009:
2008:
2004:
2002:
1999:
1998:
1996:
1992:
1989:
1985:
1975:
1972:
1971:
1969:
1965:
1959:
1956:
1954:
1951:
1949:
1946:
1944:
1941:
1940:
1938:
1934:
1928:
1925:
1924:
1922:
1918:
1915:
1913:
1909:
1906:
1904:
1900:
1890:
1887:
1885:
1882:
1878:
1875:
1874:
1873:
1872:
1868:
1867:
1865:
1861:
1855:
1852:
1850:
1847:
1845:
1842:
1840:
1837:
1835:
1834:Kernig's sign
1832:
1830:
1829:Battle's sign
1827:
1826:
1824:
1820:
1817:
1815:
1811:
1805:
1802:
1800:
1797:
1796:
1793:
1789:
1785:
1778:
1773:
1771:
1766:
1764:
1759:
1758:
1755:
1745:
1733:
1725:
1721:
1717:
1711:
1707:
1703:
1699:
1692:
1690:
1688:
1679:
1675:
1671:
1664:
1662:
1653:
1649:
1648:
1640:
1632:
1625:
1617:
1611:
1603:
1596:
1588:
1584:
1580:
1576:
1572:
1568:
1561:
1553:
1546:
1544:
1535:
1534:
1526:
1518:
1512:
1508:
1501:
1493:
1487:
1483:
1476:
1463:
1461:9781455770052
1457:
1453:
1449:
1442:
1434:
1432:9780397511600
1428:
1424:
1419:
1418:
1409:
1401:
1395:
1391:
1384:
1376:
1372:
1367:
1362:
1358:
1354:
1350:
1343:
1335:
1328:
1320:
1316:
1312:
1308:
1304:
1300:
1293:
1285:
1281:
1276:
1271:
1268:(3): 245–52.
1267:
1263:
1259:
1252:
1244:
1240:
1236:
1232:
1227:
1222:
1218:
1214:
1207:
1199:
1195:
1191:
1187:
1183:
1179:
1175:
1171:
1163:
1161:
1152:
1148:
1144:
1140:
1136:
1132:
1125:
1117:
1113:
1109:
1105:
1101:
1097:
1090:
1082:
1078:
1074:
1070:
1066:
1062:
1055:
1047:
1043:
1039:
1035:
1031:
1027:
1023:
1019:
1012:
1010:
1008:
1006:
1004:
995:
991:
987:
983:
976:
974:
972:
970:
968:
959:
955:
951:
947:
944:(6): 543–50.
943:
939:
932:
930:
928:
926:
924:
922:
920:
918:
916:
914:
912:
903:
899:
895:
891:
888:(6): 454–61.
887:
883:
876:
874:
872:
870:
868:
866:
857:
853:
849:
845:
841:
837:
833:
829:
822:
814:
810:
806:
802:
798:
794:
787:
785:
783:
781:
779:
777:
775:
766:
762:
758:
751:
749:
747:
745:
736:
732:
728:
724:
720:
716:
709:
701:
697:
693:
689:
682:
680:
675:
666:
663:
661:
658:
657:
651:
648:
646:
641:
639:
633:
631:
627:
623:
619:
614:
612:
608:
604:
600:
595:
590:
588:
584:
580:
576:
572:
568:
558:
556:
551:
549:
545:
541:
531:
527:
525:
521:
517:
513:
509:
505:
500:
496:
486:
484:
480:
476:
472:
468:
464:
460:
456:
452:
448:
444:
440:
436:
432:
428:
424:
420:
417:
413:
405:
401:
389:
386:
383:
382:
381:
379:
370:
368:
364:
360:
356:
346:
343:
338:
336:
332:
327:
325:
321:
317:
313:
309:
305:
304:baroreceptors
300:
298:
294:
290:
286:
282:
278:
274:
270:
265:
263:
259:
255:
251:
246:
236:
232:
229:
225:
221:
217:
213:
209:
205:
199:
197:
193:
189:
185:
180:
178:
174:
170:
165:
155:
146:
144:
140:
136:
131:
125:
123:
119:
115:
111:
107:
103:
99:
92:
87:
78:
76:
73:
69:
65:
61:
57:
53:
49:
45:
44:Cushing's Law
41:
37:
33:
29:
25:
21:
2814:gas exchange
2779:Interactions
2704:calculations
2665:Lung volumes
2628:
2609:
2590:
2561:constriction
2523:respirometer
2376:Respiratory
2344:
2013:Tinel's sign
2005:
1869:
1697:
1669:
1646:
1639:
1630:
1624:
1601:
1595:
1573:(5): 750–7.
1570:
1567:Neurosurgery
1566:
1560:
1551:
1532:
1525:
1506:
1500:
1481:
1475:
1465:, retrieved
1451:
1441:
1416:
1408:
1389:
1383:
1356:
1352:
1342:
1333:
1327:
1302:
1298:
1292:
1265:
1261:
1251:
1219:(6): 791–9.
1216:
1213:Br J Anaesth
1212:
1206:
1173:
1169:
1134:
1130:
1124:
1099:
1095:
1089:
1064:
1060:
1054:
1024:(3): 223–8.
1021:
1017:
985:
981:
941:
937:
885:
881:
834:(2): 131–7.
831:
827:
821:
796:
793:Neurosurgery
792:
764:
760:
718:
714:
708:
691:
687:
649:
642:
634:
615:
591:
587:pathogenesis
571:pathogenesis
564:
552:
537:
528:
492:
459:Angelo Mosso
443:Kroenecker's
419:neurosurgeon
409:
377:
376:
355:brain tissue
352:
339:
328:
301:
289:contractions
285:hypertension
266:
242:
233:
210:, including
200:
181:
160:
126:
95:
72:neurosurgeon
43:
39:
35:
31:
27:
23:
19:
18:
2853:Bohr effect
2753:Circulation
2489:Respiration
2418:Optokinetic
2258:Gastrocolic
1920:Combination
1854:Hirano body
1849:Stroop test
1359:(1): 8–17.
882:Surg Neurol
626:anesthetics
618:respiration
544:Henri Duret
427:Switzerland
387:Bradycardia
359:homeostasis
312:vagus nerve
308:aortic arch
302:Meanwhile,
297:tachycardia
212:concussions
135:Mayer waves
133:present as
130:ventilation
110:bradycardia
68:epinephrine
60:head injury
56:bradycardia
2942:Categories
2915:death zone
2834:hemoglobin
2729:spirometry
2688:dead space
2641:peripheral
2566:dilatation
2552:bronchial
2533:compliance
2506:exhalation
2501:inhalation
2360:Baroreflex
2288:Tonic neck
1467:2019-11-10
671:References
630:anesthesia
583:brain stem
508:pulse rate
463:Kroenecker
367:baroreflex
324:infarction
254:arterioles
228:ventricles
192:autoimmune
122:arterioles
114:blood flow
106:heart rate
81:Definition
2791:Perfusion
2293:Parachute
1742:ignored (
1732:cite book
1610:cite book
1353:Circ. Res
1221:CiteSeerX
694:(8): 42.
594:receptors
331:brainstem
239:Mechanism
77:in 1901.
2953:Reflexes
2802:V/Q scan
2408:H-reflex
2278:Stepping
2133:Reflexes
1912:Reflexes
1724:16463859
1243:15805143
1116:19100373
1046:43225467
1038:18182296
848:21386665
813:17143247
767:: 290–2.
700:12224233
654:See also
499:arterial
416:American
349:Function
326:occurs.
281:arteries
271:and the
262:ischemia
258:cerebrum
196:rejected
118:ischemia
98:systolic
2927:hypoxia
2848:2,3-BPG
2636:central
2611:medulla
2583:Control
2283:Sucking
2273:Rooting
2076:General
1678:1102170
1587:1584389
1375:4402639
1319:2887122
1284:9102186
1198:1449385
1190:3962742
1151:9227698
1081:2643847
994:3813470
958:2176941
902:3375974
856:6025444
735:3435736
479:English
395:History
361:in the
306:in the
216:hypoxia
177:chronic
2496:breath
2253:Galant
1722:
1712:
1676:
1585:
1513:
1488:
1458:
1429:
1396:
1373:
1317:
1282:
1241:
1223:
1196:
1188:
1149:
1131:Stroke
1114:
1079:
1044:
1036:
992:
956:
900:
854:
846:
811:
733:
698:
579:anemia
510:, and
475:German
224:stroke
222:, and
220:tumors
208:trauma
38:, the
34:, the
30:, the
26:, the
2391:Other
2263:Grasp
2060:Torso
1987:Other
1863:Other
1654:–193.
1194:S2CID
1042:S2CID
852:S2CID
645:fetal
622:apnea
520:Mosso
457:with
455:Italy
451:Turin
363:brain
335:apnea
173:acute
42:, or
2893:DLCO
2793:(Q)
2592:pons
2268:Moro
2219:Leg
2199:Arm
2029:Legs
1994:Arms
1967:Arms
1936:Legs
1822:Head
1744:help
1720:PMID
1710:ISBN
1674:PMID
1616:link
1583:PMID
1511:ISBN
1486:ISBN
1456:ISBN
1427:ISBN
1394:ISBN
1371:PMID
1315:PMID
1280:PMID
1239:PMID
1186:PMID
1147:PMID
1112:PMID
1077:PMID
1034:PMID
990:PMID
954:PMID
898:PMID
844:PMID
809:PMID
731:PMID
696:PMID
605:and
477:and
469:and
447:Bern
423:Bern
291:and
175:and
100:and
2698:PEF
2678:FRC
1702:doi
1652:176
1575:doi
1423:520
1361:doi
1307:doi
1303:253
1270:doi
1266:116
1231:doi
1178:doi
1139:doi
1104:doi
1069:doi
1026:doi
946:doi
890:doi
836:doi
801:doi
723:doi
471:ICP
139:ECG
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