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Validation of a mathematical model for understanding intracranial pressure curve morphology

Unnerbäck, Mårten LU ; Ottesen, Johnny T. LU and Reinstrup, Peter LU (2020) In Journal of Clinical Monitoring and Computing 34(3). p.469-481
Abstract

The physiology underlying the intracranial pressure (ICP) curve morphology is not fully understood. Recent research has suggested that the morphology could be dependent on arterial cerebral inflow and the physiological and pathophysiological properties of the intracranial cavity. If understood, the ICP curve could provide information about the patient’s cerebrovascular state important in individualizing treatment in neuro intensive care patients. A mathematical model based on known physiological properties of the intracranial compartment was created. Clinical measurements from ten neuro intensive care patients in whom intracranial arterial blood inflow, venous blood outflow and cerebrospinal fluid flow over the foramen magnum had been... (More)

The physiology underlying the intracranial pressure (ICP) curve morphology is not fully understood. Recent research has suggested that the morphology could be dependent on arterial cerebral inflow and the physiological and pathophysiological properties of the intracranial cavity. If understood, the ICP curve could provide information about the patient’s cerebrovascular state important in individualizing treatment in neuro intensive care patients. A mathematical model based on known physiological properties of the intracranial compartment was created. Clinical measurements from ten neuro intensive care patients in whom intracranial arterial blood inflow, venous blood outflow and cerebrospinal fluid flow over the foramen magnum had been measured with phase contrast MRI, concomitant with ICP measurements were used to validate the model. In nine patients the mathematical model was able to create an ICP curve mimicking the measured by using arterial intracranial inflow and adjusting physiological parameters of the model. The venous outflow and cerebrospinal fluid (CSF) flow over the foramen magnum predicted by the model were within physiologically reasonable limits and in most cases followed the MRI measured values in close adjunct. The presented model could produce an ICP curve in close resemblance of the in vivo measured curves. This strengthens the hypothesis that the ICP curve is shaped by the arterial intracranial inflow and the physiological properties of the intracranial cavity.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cerebral blood flow, Intracranial pressure, Mathematical modelling, Phase contrast magnetic resonance imaging
in
Journal of Clinical Monitoring and Computing
volume
34
issue
3
pages
13 pages
publisher
Springer
external identifiers
  • pmid:31264130
  • scopus:85068805158
ISSN
1387-1307
DOI
10.1007/s10877-019-00342-8
language
English
LU publication?
yes
id
23532e04-2a93-4b67-bb63-031b5c8c64bf
date added to LUP
2019-07-24 09:20:58
date last changed
2024-04-16 16:51:47
@article{23532e04-2a93-4b67-bb63-031b5c8c64bf,
  abstract     = {{<p>The physiology underlying the intracranial pressure (ICP) curve morphology is not fully understood. Recent research has suggested that the morphology could be dependent on arterial cerebral inflow and the physiological and pathophysiological properties of the intracranial cavity. If understood, the ICP curve could provide information about the patient’s cerebrovascular state important in individualizing treatment in neuro intensive care patients. A mathematical model based on known physiological properties of the intracranial compartment was created. Clinical measurements from ten neuro intensive care patients in whom intracranial arterial blood inflow, venous blood outflow and cerebrospinal fluid flow over the foramen magnum had been measured with phase contrast MRI, concomitant with ICP measurements were used to validate the model. In nine patients the mathematical model was able to create an ICP curve mimicking the measured by using arterial intracranial inflow and adjusting physiological parameters of the model. The venous outflow and cerebrospinal fluid (CSF) flow over the foramen magnum predicted by the model were within physiologically reasonable limits and in most cases followed the MRI measured values in close adjunct. The presented model could produce an ICP curve in close resemblance of the in vivo measured curves. This strengthens the hypothesis that the ICP curve is shaped by the arterial intracranial inflow and the physiological properties of the intracranial cavity.</p>}},
  author       = {{Unnerbäck, Mårten and Ottesen, Johnny T. and Reinstrup, Peter}},
  issn         = {{1387-1307}},
  keywords     = {{Cerebral blood flow; Intracranial pressure; Mathematical modelling; Phase contrast magnetic resonance imaging}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{469--481}},
  publisher    = {{Springer}},
  series       = {{Journal of Clinical Monitoring and Computing}},
  title        = {{Validation of a mathematical model for understanding intracranial pressure curve morphology}},
  url          = {{http://dx.doi.org/10.1007/s10877-019-00342-8}},
  doi          = {{10.1007/s10877-019-00342-8}},
  volume       = {{34}},
  year         = {{2020}},
}