scholarly journals Intracranial Compliance Assessed by Intracranial Pressure Pulse Waveform

2021 ◽  
Vol 11 (8) ◽  
pp. 971
Author(s):  
Sérgio Brasil ◽  
Davi Jorge Fontoura Solla ◽  
Ricardo de Carvalho Nogueira ◽  
Manoel Jacobsen Teixeira ◽  
Luiz Marcelo Sá Malbouisson ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Decompressive Craniectomy ◽  
Pressure Pulse ◽  
Pulse Waveform ◽  
Icp Monitoring ◽  
Morphological Alterations ◽  
Intracranial Compliance ◽  
Skull Defects ◽  
Group 3 ◽  
Group 2

Background: Morphological alterations in intracranial pressure (ICP) pulse waveform (ICPW) secondary to intracranial hypertension (ICP >20 mmHg) and a reduction in intracranial compliance (ICC) are well known indicators of neurological severity. The exclusive exploration of modifications in ICPW after either the loss of skull integrity or surgical procedures for intracranial hypertension resolution is not a common approach studied. The present study aimed to assess the morphological alterations in ICPW among neurocritical care patients with skull defects and decompressive craniectomy (DC) by comparing the variations in ICPW features according to elevations in mean ICP values. Methods: Patients requiring ICP monitoring because of acute brain injury were included. A continuous record of 10 min-length for the beat-by-beat analysis of ICPW was performed, with ICP elevation produced by means of ultrasound-guided manual internal jugular vein compression at the end of the record. ICPW features (peak amplitude ratio (P2/P1), time interval to pulse peak (TTP) and pulse amplitude) were counterweighed between baseline and compression periods. Results were distributed for three groups: intact skull (exclusive burr hole for ICP monitoring), craniotomy/large fractures (group 2) or DC (group 3). Results: 57 patients were analyzed. A total of 21 (36%) presented no skull defects, 21 (36%) belonged to group 2, whereas 15 (26%) had DC. ICP was not significantly different between groups: ±15.11 for intact, 15.33 for group 2 and ±20.81 mmHg for group 3, with ICP-induced elevation also similar between groups (p = 0.56). Significant elevation was observed for the P2/P1 ratio for groups 1 and 2, whereas a reduction was observed in group 3 (elevation of ±0.09 for groups 1 and 2, but a reduction of 0.03 for group 3, p = 0.01), and no significant results were obtained for TTP and pulse amplitudes. Conclusion: In the present study, intracranial pressure pulse waveform analysis indicated that intracranial compliance was significantly more impaired among decompressive craniectomy patients, although ICPW indicated DC to be protective for further influences of ICP elevations over the brain. The analysis of ICPW seems to be an alternative to real-time ICC assessment.

scholarly journals INTRACRANIAL COMPLIANCE ASSESSED BY INTRACRANIAL PRESSURE PULSE WAVEFORM

2021 ◽  
Author(s):  
Sergio Brasil ◽  
Davi Solla ◽  
Ricardo De Carvalho Nogueira ◽  
Manoel Jacobsen Teixeira ◽  
Luiz Marcelo Sá Malbouisson ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Decompressive Craniectomy ◽  
Pressure Pulse ◽  
Waveform Analysis ◽  
Pulse Waveform ◽  
Icp Monitoring ◽  
Morphological Alterations ◽  
Intracranial Compliance ◽  
Group 3

Background: Morphological alterations in intracranial pressure pulse waveform (ICPPW) secondary to intracranial hypertension (ICP >20 mmHg) and reduction in intracranial compliance (ICC) are well known indicators of neurological severity. To date, no studies have documented the ICPPW modifications after intracranial hypertension resolution with decompressive craniectomy (DC). The present study aimed to assess the morphological alterations in ICPPW among neurocritical care patients with and without DC, by comparing the variations of ICPPW features according to elevations in mean ICP values. Methods: Patients requiring ICP monitoring because of severe traumatic or spontaneous conditions were included. Mean ICP values were compared with ICPPW features (P2/P1 ratio, TTP and pulse amplitude). Elevation in ICP was produced by means of ultrasound-guided manual internal jugular veins compression. Results were distributed for three groups: intact skull (exclusive burr hole for ICP monitoring), craniotomy/large fractures (group 2) or DC (group 3). Results: 57 patients were analyzed. 21 (36%) presented no skull defects, whereas 15 (26%) had DC. ICP was not significantly different between groups: ±13.59 for intact and ±17.66 mmHg for DC, with ICP induced elevation also similar between groups (p= 0.56). Significant elevation was observed for P2/P1 ratio for groups 1 and 2, whereas reduction was observed in group 3 (elevation of ±0.09 for groups 1 and 2, whereas reduction of 0.03 for group 3, p=0.01). Conclusion: In the present study, intracranial pressure pulse waveform analysis indicated that intracranial compliance was significantly more impaired among decompressive craniectomy patients, although ICPPW indicated DC to be protective for further influences of ICP elevations over the brain. Analysis of ICPPW seems to be an alternative to real time ICC assessment.

Effect of position on intracranial pressure and compliance: a cross-sectional study including 101 patients

2021 ◽  
pp. 1-9
Author(s):  
Linda D’Antona ◽  
Claudia Louise Craven ◽  
Fion Bremner ◽  
Manjit Singh Matharu ◽  
Lewis Thorne ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Linear Regression ◽  
Regression Models ◽  
Cross Sectional Study ◽  
Icp Monitoring ◽  
Linear Regression Models ◽  
Sectional Study ◽  
Csf Dynamics ◽  
Cross Sectional ◽  
Intracranial Compliance

OBJECTIVE A better understanding of the effect of position on intracranial pressure (ICP) and compliance is important for the development of treatment strategies that can restore normal cerebrospinal fluid (CSF) dynamics. There is limited knowledge on the effect of position on intracranial compliance. In this cross-sectional study the authors tested the association of pulse amplitude (PA) with position and the day/night cycle. Additionally, they describe the postural ICP and PA changes of patients with “normal” ICP dynamics. METHODS This single-center retrospective study included patients with suspected and/or confirmed CSF dynamics abnormalities who had been examined with elective 24-hour ICP monitoring between October 2017 and September 2019. Patients had been enrolled in a short exercise battery including four positions: supine, lumbar puncture position in the left lateral decubitus position, sitting, and standing. Each position was maintained for 2 minutes, and mean ICP and PA were calculated for each position. The 24-hour day and night median ICP and PA data were also collected. Linear regression models were used to test the correlation of PA with position and day/night cycle. All linear regressions were corrected for confounders. The postural ICP monitoring results of patients without obvious ICP dynamics abnormality were summarized. RESULTS One hundred one patients (24 males and 77 females) with a mean age of 39 ± 13years (mean ± standard deviation) were included in the study. The adjusted linear regression models demonstrated a significant association of ICP with position and day/night cycle, with upright (sitting and standing) and day ICP values lower than supine and night ICP values. The adjusted linear regression model was also significant for the association of PA with position and day/night cycle, with upright and day PA values higher than supine and night PA results. These associations were confirmed for patients with and without shunts. Patients without clear ICP dynamics abnormality had tighter control of their postural ICP changes than the other patients; however, the difference among groups was not statistically significant. CONCLUSIONS This is the largest study investigating the effect of postural changes on intracranial compliance. The results of this study suggest that PA, as well as ICP, is significantly associated with posture, increasing in upright positions compared to that while supine. Further studies will be needed to investigate the mechanism behind this association.

Analysis of the Shape of Intracranial Pressure Pulse Waveform in Traumatic Brain Injury Patients

2021 ◽  
Author(s):  
Agnieszka Kazimierska ◽  
Agnieszka Uryga ◽  
Cyprian Mataczynski ◽  
Malgorzata Burzynska ◽  
Arkadiusz Ziolkowski ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Pressure Pulse ◽  
Pulse Waveform

Analysis of the Relationship Between Intracranial Pressure Pulse Waveform and Outcome in Traumatic Brain Injury

2021 ◽  
pp. 52-57
Author(s):  
Agnieszka Kazimierska ◽  
Cyprian Mataczyński ◽  
Agnieszka Uryga ◽  
Małgorzata Burzyńska ◽  
Andrzej Rusiecki ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Pressure Pulse ◽  
Pulse Waveform ◽  
The Relationship

scholarly journals Origin of intracranial pressure pulse waveform

2020 ◽  
Vol 162 (8) ◽  
pp. 1815-1817 ◽  
Author(s):  
Marek Czosnyka ◽  
Zofia Czosnyka
Keyword(s):  
Intracranial Pressure ◽  
Pressure Pulse ◽  
Pulse Waveform

scholarly journals FE-SEM Evaluation of Dental Specimens Prepared by Different Methods forIn VitroContamination

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Vitor Cesar Nakamura ◽  
Simony Hidee Hamoy Kataoka ◽  
Giulio Gavini ◽  
Patrícia Helena Ferrari ◽  
Silvana Cai
Keyword(s):  
Control Group ◽  
Buffer Solution ◽  
Morphological Alterations ◽  
Ultrasonic Bath ◽  
Group 4 ◽  
Cement Removal ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Objective. To evaluate through FE-SEM the cleanliness and dentinal alterations promoted by different methods of dental sample preparation.Methods. Twenty-five human single-rooted teeth were used. The teeth were cleaned and autoclaved in wet medium and randomly divided into 5 groups (), according to the preparation methods employed—control group: no solutions applied; group 1: cement removal and irrigation with 5.25% % EDTA for 4 minutes each; group 2: 17%  % NaOCl (4 minutes ultrasonic bath); group 3: cement removal and 17%     buffer solution + distilled water (10 minutes ultrasonic); group 4: 17%   NaOCl (3 minutes ultrasonic bath). Specimens were analyzed by field emission scanning electron microscope (FE-SEM), at 1500x magnification. Data were submitted to qualitative analysis according to a scoring system and submitted to Kruskal-Wallis test.Results. In ascending order, as to bind parameters, (i) cleanliness: control, group 2, group 3, group 5, and group 4, (ii) dentinal alterations: group 1, group 5, group 2, group 3, and group 4.Conclusion. The proposed protocol was suitable for subsequent microbiological contamination, because it showed less dentinal morphological alterations with increased removal of organic waste.

scholarly journals Intracranial pressure following decompressive hemicraniectomy for malignant cerebral infarction: clinical and treatment correlations

2018 ◽  
Vol 76 (12) ◽  
pp. 812-815 ◽  
Author(s):  
Bruno Ferreira Funchal ◽  
Maramélia Miranda Alves ◽  
Ítalo C. Suriano ◽  
Feres Eduardo Chaddad-Neto ◽  
Maria E. M. R. Ferraz ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Cerebral Infarction ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Decompressive Craniectomy ◽  
Tertiary Hospital ◽  
National Institutes Of Health ◽  
Icp Monitoring ◽  
Decompressive Hemicraniectomy

ABSTRACT Decompressive craniectomy (DC) reduces mortality and improves outcome in patients with massive brain infarctions. The role of intracranial pressure (ICP) monitoring following DC for stroke has not been well established. Methods: We evaluated 14 patients admitted to a tertiary hospital with malignant middle cerebral artery infarctions, from October 2010 to February 2015, who underwent DC and had ICP monitoring. Patients with and without episodes of ICP elevation were compared. Results: Fourteen patients were submitted to DC and had ICP monitoring following the procedure during the period. Ten patients (71.4%) had at least one episode of sustained elevated ICP in the first seven days after surgery. Maximal ICP levels had no correlation with age, time to hemicraniectomy or Glasgow Coma Scores at admission, but had a trend toward correlation with the National Institutes of Health Stroke Scale score at admission (p = 0.1). Ventriculitis occurred in 21.4% of the patients. Conclusions: High ICP episodes and ventriculitis were common in patients following hemicraniectomy for malignant middle cerebral artery strokes. Therefore, the implications of ICP and benefits of the procedure should be firmly established.

Analysis of intracranial pressure pulse waveform and brain capillary morphology in type 2 diabetes mellitus rats

2012 ◽  
Vol 1460 ◽  
pp. 73-77 ◽  
Author(s):  
Hidetaka Onodera ◽  
Kotaro Oshio ◽  
Masashi Uchida ◽  
Yuichiro Tanaka ◽  
Takuo Hashimoto
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Intracranial Pressure ◽  
Pressure Pulse ◽  
Pulse Waveform ◽  
Brain Capillary

scholarly journals Lateral cephalometric diagnosis of asymmetry in Angle Class II subdivision compared to Class I and II

2014 ◽  
Vol 19 (4) ◽  
pp. 80-88 ◽  
Author(s):  
Aparecida Fernanda Meloti ◽  
Renata de Cássia Gonçalves ◽  
Ertty Silva ◽  
Lídia Parsekian Martins ◽  
Ary dos Santos-Pinto
Keyword(s):  
Class Ii ◽  
Diagnostic Methods ◽  
Class I ◽  
Linear Measurements ◽  
Morphological Alterations ◽  
Mandibular Asymmetry ◽  
Study Results ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

INTRODUCTION: Lateral cephalometric radiographs are traditionally required for orthodontic treatment, yet rarely used to assess asymmetries. OBJECTIVE: The objective of the present study was to use lateral cephalometric radiographs to identify existing skeletal and dentoalveolar morphological alterations in Class II subdivision and to compare them with the existing morphology in Class I and II relationship. MATERIAL AND METHODS: Ninety initial lateral cephalometric radiographs of male and female Brazilian children aged between 12 to 15 years old were randomly and proportionally divided into three groups: Group 1 (Class I), Group 2 (Class II) and Group 3 (Class II subdivision). Analysis of lateral cephalometric radiographs included angular measurements, horizontal linear measurements and two indexes of asymmetry that were prepared for this study. RESULTS: In accordance with an Index of Dental Asymmetry (IDA), greater mandibular dental asymmetry was identified in Group 3. An Index of Mandibular Asymmetry (IMA) revealed less skeletal and dental mandibular asymmetry in Group 2, greater skeletal mandibular asymmetry in Group 1, and greater mandibular dental asymmetry in Group 3. CONCLUSION: Both IDA and IMA revealed greater mandibular dental asymmetry for Group 3 in comparison to Groups 1 and 2. These results are in accordance with those found by other diagnostic methods, showing that lateral cephalometric radiography is an acceptable method to identify existing skeletal and dentoalveolar morphological alterations in malocclusions.

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