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ICP curve morphology and intracranial flow-volume changes : a simultaneous ICP and cine phase contrast MRI study in humans

Unnerbäck, Mårten LU ; Ottesen, Johnny T. and Reinstrup, Peter LU (2017) In Acta Neurochirurgica p.1-6
Abstract

Background: The intracranial pressure (ICP) curve with its different peaks has been extensively studied, but the exact physiological mechanisms behind its morphology are still not fully understood. Both intracranial volume change (ΔICV) and transmission of the arterial blood pressure have been proposed to shape the ICP curve. This study tested the hypothesis that the ICP curve correlates to intracranial volume changes. Methods: Cine phase contrast magnetic resonance imaging (MRI) examinations were performed in neuro-intensive care patients with simultaneous ICP monitoring. The MRI was set to examine cerebral arterial inflow and venous cerebral outflow as well as flow of cerebrospinal fluid over the foramen magnum. The difference in... (More)

Background: The intracranial pressure (ICP) curve with its different peaks has been extensively studied, but the exact physiological mechanisms behind its morphology are still not fully understood. Both intracranial volume change (ΔICV) and transmission of the arterial blood pressure have been proposed to shape the ICP curve. This study tested the hypothesis that the ICP curve correlates to intracranial volume changes. Methods: Cine phase contrast magnetic resonance imaging (MRI) examinations were performed in neuro-intensive care patients with simultaneous ICP monitoring. The MRI was set to examine cerebral arterial inflow and venous cerebral outflow as well as flow of cerebrospinal fluid over the foramen magnum. The difference in total flow into and out from the cranial cavity (Flowtot) over time provides the ΔICV. The ICP curve was compared to the Flowtot and the ΔICV. Correlations were calculated through linear and logarithmic regression. Student’s t test was used to test the null hypothesis between paired samples. Results: Excluding the initial ICP wave, P1, the mean R2 for the correlation between the ΔICV and the ICP was 0.75 for the exponential expression, which had a higher correlation than the linear (p = 0.005). The first ICP peaks correlated to the initial peaks of Flowtot with a mean R2 = 0.88. Conclusion: The first part, or the P1, of the ICP curve seems to be created by the first rapid net inflow seen in Flowtot while the rest of the ICP curve seem to correlate to the ΔICV.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Cerebral blood flow, Intracranial compliance, Intracranial pressure, Magnetic resonance imaging
in
Acta Neurochirurgica
pages
6 pages
publisher
Springer
external identifiers
  • scopus:85038814520
ISSN
0001-6268
DOI
10.1007/s00701-017-3435-2
language
English
LU publication?
yes
id
f86bf4e9-2597-46d1-99cf-de488982c4a7
date added to LUP
2018-01-02 15:09:09
date last changed
2018-01-10 11:41:44
@article{f86bf4e9-2597-46d1-99cf-de488982c4a7,
  abstract     = {<p>Background: The intracranial pressure (ICP) curve with its different peaks has been extensively studied, but the exact physiological mechanisms behind its morphology are still not fully understood. Both intracranial volume change (ΔICV) and transmission of the arterial blood pressure have been proposed to shape the ICP curve. This study tested the hypothesis that the ICP curve correlates to intracranial volume changes. Methods: Cine phase contrast magnetic resonance imaging (MRI) examinations were performed in neuro-intensive care patients with simultaneous ICP monitoring. The MRI was set to examine cerebral arterial inflow and venous cerebral outflow as well as flow of cerebrospinal fluid over the foramen magnum. The difference in total flow into and out from the cranial cavity (Flow<sub>tot</sub>) over time provides the ΔICV. The ICP curve was compared to the Flow<sub>tot</sub> and the ΔICV. Correlations were calculated through linear and logarithmic regression. Student’s t test was used to test the null hypothesis between paired samples. Results: Excluding the initial ICP wave, P1, the mean R<sup>2</sup> for the correlation between the ΔICV and the ICP was 0.75 for the exponential expression, which had a higher correlation than the linear (p = 0.005). The first ICP peaks correlated to the initial peaks of Flow<sub>tot</sub> with a mean R<sup>2</sup> = 0.88. Conclusion: The first part, or the P1, of the ICP curve seems to be created by the first rapid net inflow seen in Flow<sub>tot</sub> while the rest of the ICP curve seem to correlate to the ΔICV.</p>},
  author       = {Unnerbäck, Mårten and Ottesen, Johnny T. and Reinstrup, Peter},
  issn         = {0001-6268},
  keyword      = {Cerebral blood flow,Intracranial compliance,Intracranial pressure,Magnetic resonance imaging},
  language     = {eng},
  month        = {12},
  pages        = {1--6},
  publisher    = {Springer},
  series       = {Acta Neurochirurgica},
  title        = {ICP curve morphology and intracranial flow-volume changes : a simultaneous ICP and cine phase contrast MRI study in humans},
  url          = {http://dx.doi.org/10.1007/s00701-017-3435-2},
  year         = {2017},
}