Characteristics of the cerebrospinal fluid pressure waveform and craniospinal compliance in idiopathic intracranial hypertension subjects

Okon, Monica; Roberts, Cynthia J.; Mahmoud, Ashraf M.; Springer, Andrew N; Small, Robert H.; McGregor, John M.; Katz, Steven E.

doi:10.1186/s12987-018-0106-5

Cited by 24 publications

(25 citation statements)

References 37 publications

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“…We did not calculate the CSFV–ICP graph and short-term ICC using our method (calculation of ICP and consequently ICC using FSI simulation) because the goal of the present study was to assess ICC in the long term. However, the results of the study by Okon et al in the short term also showed the trend of the CSFV–ICP graph was nonmonotonic ( Okon et al, 2018 ). They used the lumbar puncture to drain CSF, and their measured ICC reached 2.5 ± 1.35 ml/cm H 2 O .…”

Section: Discussionmentioning

confidence: 97%

“…The previous CSFV–ICP graphs were separated into two compensatory reserve zones: the first zone with a lower ICC value and the second zone with a higher ICC value ( Czosnyka et al, 2004 ; Okon et al, 2018 ; Heldt et al, 2019 ). However, compensatory reserve behavior in the corresponding graphs in the present study was variable and not necessarily separated in some ICC zones ( Figure 6 ).…”

Section: Discussionmentioning

confidence: 99%

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A New Definition for Intracranial Compliance to Evaluate Adult Hydrocephalus After Shunting

Gholampour

Yamini

Droessler

et al. 2022

Front. Bioeng. Biotechnol.

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The clinical application of intracranial compliance (ICC), ∆V/∆P, as one of the most critical indexes for hydrocephalus evaluation was demonstrated previously. We suggest a new definition for the concept of ICC (long-term ICC) where there is a longer amount of elapsed time (up to 18 months after shunting) between the measurement of two values (V1 and V2 or P1 and P2). The head images of 15 adult patients with communicating hydrocephalus were provided with nine sets of imaging in nine stages: prior to shunting, and 1, 2, 3, 6, 9, 12, 15, and 18 months after shunting. In addition to measuring CSF volume (CSFV) in each stage, intracranial pressure (ICP) was also calculated using fluid–structure interaction simulation for the noninvasive calculation of ICC. Despite small increases in the brain volume (16.9%), there were considerable decreases in the ICP (70.4%) and CSFV (80.0%) of hydrocephalus patients after 18 months of shunting. The changes in CSFV, brain volume, and ICP values reached a stable condition 12, 15, and 6 months after shunting, respectively. The results showed that the brain tissue needs approximately two months to adapt itself to the fast and significant ICP reduction due to shunting. This may be related to the effect of the “viscous” component of brain tissue. The ICC trend between pre-shunting and the first month of shunting was descending for all patients with a “mean value” of 14.75 ± 0.6 ml/cm H2O. ICC changes in the other stages were oscillatory (nonuniform). Our noninvasive long-term ICC calculations showed a nonmonotonic trend in the CSFV–ICP graph, the lack of a linear relationship between ICC and ICP, and an oscillatory increase in ICC values during shunt treatment. The oscillatory changes in long-term ICC may reflect the clinical variations in hydrocephalus patients after shunting.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

A New Definition for Intracranial Compliance to Evaluate Adult Hydrocephalus After Shunting

Gholampour

Yamini

Droessler

et al. 2022

Front. Bioeng. Biotechnol.

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“…One possible interpretation of our results is that the venous changes are likely to have had less of an impact due to the changes we see in CSF pulse amplitude. As is well documented within the literature, decreases in CSF pulse amplitude are considered an indicator of increased intracranial compliance [31]. Since increased venous pressure would be expected to increase intracranial pressure, the observed decreases in CSF pulse amplitude and correlated increases in intracranial compliance are not consistent.…”

Section: Discussionmentioning

confidence: 91%

Quantification of Arterial, Venous, and Cerebrospinal Fluid Flow Dynamics by Magnetic Resonance Imaging Under Simulated Micro-Gravity Conditions: A Prospective Cohort Study

Zahid

Martin

Collins

et al. 2020

Preprint

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Abstract Background: Astronauts undergoing long-duration spaceflight are exposed to numerous health risks, including Spaceflight-Associated Neuro-Ocular Syndrome (SANS), a spectrum of ophthalmic changes that can result in permanent loss of visual acuity. The etiology of SANS is not well understood but is thought to involve changes in cerebrovascular flow dynamics in response to microgravity. There is a paucity of knowledge in this area; in particular, cerebrospinal fluid (CSF) flow dynamics have not been well characterized under microgravity conditions. Our study was designed to determine the effect of simulated microgravity (head-down tilt [HDT]) on cerebrovascular flow dynamics. We hypothesized that under microgravity conditions simulated by HDT, increased pressure in the intracranial space would alter intracranial CSF and venous flow dynamics by causing: 1) increased venous pressure reflected by increased venous cross-sectional area; and 2) a decrease in cardiac-related pulsatile CSF flow.Methods: In a prospective cohort study, we measured flow in major cerebral arteries, veins, and CSF spaces in fifteen healthy volunteers using phase contrast magnetic resonance (PCMR) before and during 15° HDT.Results: We found a significant increase in venous cross-sectional area with HDT (p=0.005), indicating increased venous pressure, along with a decrease in all CSF flow variables [systolic peak flow (p=0.009), and peak-to-peak pulse amplitude (p=0.001)]. Arterial average flow (p=0.04), systolic peak flow (p=0.04), and peak-to-peak pulse amplitude (p=0.02) all also significantly decreased.Conclusions: These results collectively demonstrate that acute application of 15° HDT caused a reduction in CSF flow variables (systolic peak flow and peak-to-peak pulse amplitude), coupled with an increase in venous CSA suggesting increased venous pressure with HDT.

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“…The ICP waveform morphology is a significant tool for evaluating intracranial hypertension and compliance [25], [26], [29], [60], [61]. The ICP pulse waveform, thus far studied using the invasive method, can be characterized based on some of the following items [62]- [66] (Figure 3a):…”

Section: B Icp Waveform Parametersmentioning

confidence: 99%

A Nanometer Resolution Wearable Wireless Medical Device for Non Invasive Intracranial Pressure Monitoring

Andrade¹,

Oshiro²,

Miyazaki³

et al. 2021

IEEE Sensors J.

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The non-invasive intracranial pressure (NIICP) method based on a skull deformation has been proven to be a significant tool for an assessment of the intracranial pressure (ICP) and compliance. Herein, we present the development and characterization of a novel wireless sensor that uses this method as its working principle and was designed to be easy to use, to have a high resolution, and to achieve a good accessibility. Initially, a brief review of the physiology fundamentals of the ICP and the historic evolution of the NIICP method are mentioned. The sensor architecture and the rationale for the chosen components are then presented, aiming to ensure nanometer displacement measurements, the conversion of analog resolution to digital at a high speed, the fewest amount of distortion, wireless communication, and signal calibration. The NIICP signal has a typical amplitude of 5 µm, and thus a resolution of at least 1% of this amplitude is required for an NIICP waveform analysis. We also demonstrate a 40-nm resolution of the sensor using a nanometric displacement test system that can also respond dynamically for NIICP signals from 50 to 180 bpm without any significant distortion (maximum deviation of P2/P1 ratio of 2.6%). The future applications for this device are broad and can enhance a clinical assessment of the intracranial dynamics.

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Characteristics of the cerebrospinal fluid pressure waveform and craniospinal compliance in idiopathic intracranial hypertension subjects

Cited by 24 publications

References 37 publications

A New Definition for Intracranial Compliance to Evaluate Adult Hydrocephalus After Shunting

A New Definition for Intracranial Compliance to Evaluate Adult Hydrocephalus After Shunting

Quantification of Arterial, Venous, and Cerebrospinal Fluid Flow Dynamics by Magnetic Resonance Imaging Under Simulated Micro-Gravity Conditions: A Prospective Cohort Study

A Nanometer Resolution Wearable Wireless Medical Device for Non Invasive Intracranial Pressure Monitoring

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