Summary
In haemodynamics, the body must respond to physical activities, external temperature, and other factors by homeostatically adjusting its blood flow to deliver nutrients such as oxygen and glucose to stressed tissues and allow them to function. Haemodynamic response (HR) allows the rapid delivery of blood to active neuronal tissues. The brain consumes large amounts of energy but does not have a reservoir of stored energy substrates. Since higher processes in the brain occur almost constantly, cerebral blood flow is essential for the maintenance of neurons, astrocytes, and other cells of the brain. This coupling between neuronal activity and blood flow is also referred to as neurovascular coupling. In order to understand how blood is delivered to cranial tissues, it is important to understand the vascular anatomy of the space itself. Large cerebral arteries in the brain split into smaller arterioles, also known as pial arteries. These consist of endothelial cells and smooth muscle cells, and as these pial arteries further branch and run deeper into the brain, they associate with glial cells, namely astrocytes. The intracerebral arterioles and capillaries are unlike systemic arterioles and capillaries in that they do not readily allow substances to diffuse through them; they are connected by tight junctions in order to form the blood brain barrier (BBB). Endothelial cells, smooth muscle, neurons, astrocytes, and pericytes work together in the brain order to maintain the BBB while still delivering nutrients to tissues and adjusting blood flow in the intracranial space to maintain homeostasis. As they work as a functional neurovascular unit, alterations in their interactions at the cellular level can impair HR in the brain and lead to deviations in normal nervous function. Various cell types play a role in HR, including astrocytes, smooth muscle cells, endothelial cells of blood vessels, and pericytes. These cells control whether the vessels are constricted or dilated, which dictates the amount of oxygen and glucose that is able to reach the neuronal tissue.
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