ICP curve morphology and intracranial flow-volume changes

a simultaneous ICP and cine phase contrast MRI study in humans

Mårten Unnerbäck, Johnny T. Ottesen, Peter Reinstrup

Research output: Contribution to journalJournal articleResearchpeer-review

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 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 R 2 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 R 2 = 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.
Original languageEnglish
JournalActa Neurochirurgica
Volume160
Issue number2
Pages (from-to)219-224
Number of pages6
ISSN0001-6268
DOIs
Publication statusPublished - 2018

Keywords

  • Cerebral blood flow
  • Intracranial compliance
  • Intracranial pressure
  • Magnetic resonance imaging

Cite this

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title = "ICP curve morphology and intracranial flow-volume changes: a simultaneous ICP and cine phase contrast MRI study in humans",
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 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 R 2 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 R 2 = 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.",
keywords = "Cerebral blood flow, Intracranial compliance, Intracranial pressure, Magnetic resonance imaging, Cerebral blood flow, Intracranial compliance, Intracranial pressure, Magnetic resonance imaging",
author = "M{\aa}rten Unnerb{\"a}ck and Ottesen, {Johnny T.} and Peter Reinstrup",
year = "2018",
doi = "10.1007/s00701-017-3435-2",
language = "English",
volume = "160",
pages = "219--224",
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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; Ottesen, Johnny T.; Reinstrup, Peter.

In: Acta Neurochirurgica, Vol. 160, No. 2, 2018, p. 219-224.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - ICP curve morphology and intracranial flow-volume changes

T2 - a simultaneous ICP and cine phase contrast MRI study in humans

AU - Unnerbäck, Mårten

AU - Ottesen, Johnny T.

AU - Reinstrup, Peter

PY - 2018

Y1 - 2018

N2 - 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 R 2 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 R 2 = 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.

AB - 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 R 2 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 R 2 = 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.

KW - Cerebral blood flow

KW - Intracranial compliance

KW - Intracranial pressure

KW - Magnetic resonance imaging

KW - Cerebral blood flow

KW - Intracranial compliance

KW - Intracranial pressure

KW - Magnetic resonance imaging

U2 - 10.1007/s00701-017-3435-2

DO - 10.1007/s00701-017-3435-2

M3 - Journal article

VL - 160

SP - 219

EP - 224

JO - Acta Neurochirurgica

JF - Acta Neurochirurgica

SN - 0001-6268

IS - 2

ER -