A fast method of estimating the elastance of the intracranial system

Szewczykowski, J; Sliwka, S; Kunicki, A; Dytko, P; Korsak-Sliwka, J

doi:10.3171/jns.1977.47.1.0019

Cited by 111 publications

(59 citation statements)

References 12 publications

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“…Our results are supported by findings in ten patients without intracranial pathology (Szewczykowski et al 1977), although no transitional phase was identified in that study. The Marmarou model is only valid for the upper, linear phase (Czosnyka et al 2004, Juniewicz et al 2005 and should according to the current study only be assumed for pressures above the transitional phase.…”

Section: Pulsatility Curve -Model Of the Relationship Between P And ∆Psupporting

confidence: 90%

The pulsatility curve—the relationship between mean intracranial pressure and pulsation amplitude

2010

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Amplitude of cardiac related pulsations in intracranial pressure has recently been suggested as useful for selecting patients for shunt surgery in hydrocephalus. To better understand how shunting affects these pulsations, we aim to model the relationship of mean pressure and pulsation amplitude in a wide range, including the low pressures typically found after shunt surgery. Twenty-five patients with probable INPH were examined with lumbar constant pressure infusion investigations including drainage of cerebrospinal fluid. Mean pressure and pulsation amplitude were determined for consecutive 1.5 second intervals, starting at peak pressure (ca 35 mm Hg), after infusion, continuing during spontaneous return to baseline and drainage to 0 mm Hg. The amplitude versus pressure relationship revealed a linear phase at higher pressures (14-32 mm Hg, lack of fit test: p=0.79), a transitional phase, and an essentially constant phase at low pressures (0-10 mm Hg, slope=-0.02, lack of fit test: p=0.88). Individual patients' baseline values were found in all three phases. The model and methodology presented in this paper can be used to preoperatively identify patients with potential for postoperative amplitude decrease and to predict how much the amplitude can be reduced.Keywords: normal pressure hydrocephalus, pulse pressure, amplitudes, cerebrospinal fluid pressure, intracranial pressure, infusion test, arterial pulsationsThe pulsatility curve -Relationship between mean ICP and pulsation amplitude 3 All symbols and abbreviations are listed and explained in table 1.

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Section: Pulsatility Curve -Model Of the Relationship Between P And ∆Psupporting

confidence: 90%

The pulsatility curve—the relationship between mean intracranial pressure and pulsation amplitude

2010

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“…The whole-brain volume measurements were subsequently used to determine the variation of ICP. The established relationship between ICP and intracranial volume (Marmarou et al, 1975;Ryder et al, 1953;Sklar and Elashvili, 1977;Szewczykowski et al, 1977) is governed by the Monro-Kellie doctrine (Andrews and Citerio, 2004). In clinical practice, a measurement is made of the cerebrospinal fluid (CSF) expelled into a shunt or catheter, quantifying the pressure inside the skull and hence the change in brain volume.…”

Section: Magnetic Resonance Imaging: Brain Volumetrymentioning

confidence: 99%

“…A reduction in CSF significantly influences the elasticity of mechanical properties of the brain tissue (Kuroiwa et al, 2007). As the volume of the brain reaches the terminal disturbance level of ICP, the elasticity of the brain tissue tends to reduce as the brain swells and the CSF is driven from the system (Gefen et al, 2003;Muthupillai et al, 1995;Sklar and Elashvili, 1977;Szewczykowski et al, 1977). The reduction in CSF can also lead to hyponatremia.…”

Section: Fig 5 Depletion Of Cerebrospinal Fluid (Csf) Over the 5-h mentioning

confidence: 99%

Quantitative MRI Analysis of Brain Volume Changes due to Controlled Cortical Impact

Colgan

Cronin

Gobbo

et al. 2010

Journal of Neurotrauma

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More than 85% of reported brain traumas are classified clinically as ''mild'' using the Glasgow Coma Scale (GCS); qualitative MRI findings are scarce and provide little correspondence to clinical symptoms. Our goal, therefore, was to establish in vivo sequelae of traumatic brain injury (TBI) following lower and higher levels of impact to the frontal lobe using quantitative MRI analysis and a mechanical model of penetrating impact injury. To investigate time-based morphological and physiological changes of living tissue requires a surrogate for the human central nervous system. The present model for TBI was a systematically varied and controlled cortical impact on deeply-anaesthetized Sprague-Dawley rats, that was designed to mimic different injury severities. Whole-brain MRI scans were performed on each rat prior to either a lower-or a higher-level of impact, and then at hourly intervals for 5 h post-impact. Both brain volume and specific anatomical structures were segmented from MR images for inter-subject comparisons post-registration. Animals subjected to lower and higher impact levels exhibited elevated intracranial pressure (ICP) in the low compensatory reserve (i.e., nearly exhausted), and terminal disturbance (i.e., exhausted) ranges, respectively. There was a statistically significant drop in cerebrospinal fluid (CSF) of 35% in the lower impacts, and 65% in the higher impacts, at 5 h compared to sham controls. There was a corresponding increase in corpus callosum volume starting at 1 h, of 60-110% and 30-40% following the lower-and higher-impact levels, respectively. A statistically significant change in the abnormal tissue from 2 h to 5 h was observed for both impact levels, with greater significance for higher impacts. Furthermore, a statistically significant difference between the lower impacts and the sham controls occurred at 3 h. These results are statistically substantiated by a fluctuation in the physical size of the corpus callosum, a decrease in the volume of CSF, and elevated levels of atrophy in the cerebral cortex.

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“…Стабильность церебральной гемодинамики обусловлена функционированием сложной, многокомпонентной системы регуляции мозгового кровотока [12][13][14]. Помимо количе-ственной оценки каждого из внутричерепных объе-мов (мозговая ткань, кровь и ликвор), существенное значение имеет суммарная характеристика кранио-вертебральных объемных соотношений (КВОС), которая определяется как «теснота» (tightness) [15][16][17] всей цереброспинальной системы в целом. С этой целью изучается зависимость между дополни-тельным объемом, вводимым в ликворное про-странство, и возникающими при этом изменениями внутричерепного давления (ВЧД).…”

Section: методика собственных исследованийunclassified

“…С этой целью изучается зависимость между дополни-тельным объемом, вводимым в ликворное про-странство, и возникающими при этом изменениями внутричерепного давления (ВЧД). В качестве до-полнительного объема обычно используется сте-рильный физраствор, вводимый эндолюмбально, причем одновременно оцениваются изменения ВЧД (инфузионный тест) [15][16][17][18]. К сожалению, инвазивность этого метода значительно ограничи-вает возможности его клинического применения.…”

Section: методика собственных исследованийunclassified

Cerebrovenous orthostatic reactivity in pathology of the craniovertebral junction (Chiari malformation)

et al. 2015

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A fast method of estimating the elastance of the intracranial system

Cited by 111 publications

References 12 publications

The pulsatility curve—the relationship between mean intracranial pressure and pulsation amplitude

The pulsatility curve—the relationship between mean intracranial pressure and pulsation amplitude

Quantitative MRI Analysis of Brain Volume Changes due to Controlled Cortical Impact

Cerebrovenous orthostatic reactivity in pathology of the craniovertebral junction (Chiari malformation)

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