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Sawicki K, Placek MM, Łysoń T, et al. Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure. Brain Sci. 2021;11(8)doi: 10.3390/brainsci11081000.
Sawicki, K., Placek, M. M., Łysoń, T., Mariak, Z., Chrzanowski, R., & Czosnyka, M. (2021). Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure. Brain sciences, 11(8), . https://doi.org/10.3390/brainsci11081000
Sawicki, Karol, et al. "Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure." Brain sciences vol. 11,8 (2021). doi: https://doi.org/10.3390/brainsci11081000
Sawicki K, Placek MM, Łysoń T, Mariak Z, Chrzanowski R, Czosnyka M. Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure. Brain Sci. 2021 Jul 29;11(8). doi: 10.3390/brainsci11081000. PMID: 34439619; PMCID: PMC8391497.
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Brain Sci. 2021 Jul 29;11(8). doi: 10.3390/brainsci11081000.

Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure.

Brain sciences

Karol Sawicki, Michał M Placek, Tomasz Łysoń, Zenon Mariak, Robert Chrzanowski, Marek Czosnyka

Affiliations

  1. Department of Neurosurgery, Medical University of Bialystok, 15-089 Bia?ystok, Poland.
  2. Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK.
  3. Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroc?aw University of Science and Technology, 50-370 Wroc?aw, Poland.
  4. Institute of Electronic Systems, Warsaw University of Technology, 00-661 Warsaw, Poland.

PMID: 34439619 PMCID: PMC8391497 DOI: 10.3390/brainsci11081000

Abstract

A reliable method for non-invasive detection of dangerous intracranial pressure (ICP) elevations is still unavailable. In this preliminary study, we investigate quantitatively our observation that superimposing waveforms of transcranial Doppler blood flow velocity (FV) and arterial blood pressure (ABP) may help in non-invasive identification of ICP plateau waves. Recordings of FV, ABP and ICP in 160 patients with severe head injury (treated in the Neurocritical Care Unit at Addenbrookes Hospital, Cambridge, UK) were reviewed retrospectively. From that cohort, we identified 18 plateau waves registered in eight patients. A "measure of dissimilarity" (Dissimilarity/Difference Index, DI) between ABP and FV waveforms was calculated in three following steps: 1. fragmentation of ABP and FV signal according to cardiac cycle; 2. obtaining the normalised representative ABP and FV cycles; and finally; 3. assessing their difference, represented by the area between both curves. DI appeared to discriminate ICP plateau waves from baseline episodes slightly better than conventional pulsatility index did: area under ROC curve 0.92 vs. 0.90, sensitivity 0.81 vs. 0.69, accuracy 0.88 vs. 0.84, respectively. The concept of DI, if further tested and improved, might be used for non-invasive detection of ICP plateau waves.

Keywords: intracranial pressure; non-invasive plateau waves detection; transcranial Doppler

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