Abstract
Background: The dynamic relationship between pulse waveform of intracranial pressure (ICP) and transcranial Doppler (TCD) cerebral blood flow velocity (CBFV) may contain information about cerebrospinal compliance. This study investigated the possibility by focusing on the phase shift between fundamental harmonics of CBFV and ICP. Methods: Thirty-seven normal pressure hydrocephalus patients (20 men, mean age 58) underwent the cerebrospinal fluid (CSF) infusion tests. The infusion was performed via pre-implanted Ommaya reservoir. The TCD FV was recorded in the middle cerebral artery. Resulting continuous ICP and pressure-volume (PV) signals were analyzed by ICM+ software. Results: In initial stage of the CSF infusion, the phase shift was negative (median value = −11°, range = +60 to −117). There was significant inverse association of phase shift with brain elasticity (R = −0.51; p = 0.0009). In all tests, phase shift consistently decreased during gradual elevation of ICP (p = 0.00001). Magnitude of decrease in phase shift was inversely related to the peak-to-peak amplitude of ICP pulse waveform at a baseline (R = −0.51; p = 0.001). Conclusions: Phase shift between fundamental harmonics of ICP and TCD waveforms decreases during elevation of ICP. This is caused by an increase of time delay between systolic peak of flow velocity wave and ICP pulse.
| Original language | English |
|---|---|
| Pages (from-to) | 633-638 |
| Number of pages | 6 |
| Journal | Acta Neurochirurgica |
| Volume | 157 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2015 |
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Keywords
- Cerebrospinal compliance
- Intracranial pressure
- Transcranial Doppler
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Phase-shift between arterial flow and ICP pulse during infusion test. / Kim, Dong Ju; Czosnyka, Marek; Kim, Hakseung; Balédent, Olivier; Smielewski, Piotr; Garnett, Matthew R.; Czosnyka, Zofia.
In: Acta Neurochirurgica, Vol. 157, No. 4, 2015, p. 633-638.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Phase-shift between arterial flow and ICP pulse during infusion test
AU - Kim, Dong Ju
AU - Czosnyka, Marek
AU - Kim, Hakseung
AU - Balédent, Olivier
AU - Smielewski, Piotr
AU - Garnett, Matthew R.
AU - Czosnyka, Zofia
PY - 2015
Y1 - 2015
N2 - Background: The dynamic relationship between pulse waveform of intracranial pressure (ICP) and transcranial Doppler (TCD) cerebral blood flow velocity (CBFV) may contain information about cerebrospinal compliance. This study investigated the possibility by focusing on the phase shift between fundamental harmonics of CBFV and ICP. Methods: Thirty-seven normal pressure hydrocephalus patients (20 men, mean age 58) underwent the cerebrospinal fluid (CSF) infusion tests. The infusion was performed via pre-implanted Ommaya reservoir. The TCD FV was recorded in the middle cerebral artery. Resulting continuous ICP and pressure-volume (PV) signals were analyzed by ICM+ software. Results: In initial stage of the CSF infusion, the phase shift was negative (median value = −11°, range = +60 to −117). There was significant inverse association of phase shift with brain elasticity (R = −0.51; p = 0.0009). In all tests, phase shift consistently decreased during gradual elevation of ICP (p = 0.00001). Magnitude of decrease in phase shift was inversely related to the peak-to-peak amplitude of ICP pulse waveform at a baseline (R = −0.51; p = 0.001). Conclusions: Phase shift between fundamental harmonics of ICP and TCD waveforms decreases during elevation of ICP. This is caused by an increase of time delay between systolic peak of flow velocity wave and ICP pulse.
AB - Background: The dynamic relationship between pulse waveform of intracranial pressure (ICP) and transcranial Doppler (TCD) cerebral blood flow velocity (CBFV) may contain information about cerebrospinal compliance. This study investigated the possibility by focusing on the phase shift between fundamental harmonics of CBFV and ICP. Methods: Thirty-seven normal pressure hydrocephalus patients (20 men, mean age 58) underwent the cerebrospinal fluid (CSF) infusion tests. The infusion was performed via pre-implanted Ommaya reservoir. The TCD FV was recorded in the middle cerebral artery. Resulting continuous ICP and pressure-volume (PV) signals were analyzed by ICM+ software. Results: In initial stage of the CSF infusion, the phase shift was negative (median value = −11°, range = +60 to −117). There was significant inverse association of phase shift with brain elasticity (R = −0.51; p = 0.0009). In all tests, phase shift consistently decreased during gradual elevation of ICP (p = 0.00001). Magnitude of decrease in phase shift was inversely related to the peak-to-peak amplitude of ICP pulse waveform at a baseline (R = −0.51; p = 0.001). Conclusions: Phase shift between fundamental harmonics of ICP and TCD waveforms decreases during elevation of ICP. This is caused by an increase of time delay between systolic peak of flow velocity wave and ICP pulse.
KW - Cerebrospinal compliance
KW - Intracranial pressure
KW - Transcranial Doppler
UR - http://www.scopus.com/inward/record.url?scp=84925543843&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84925543843&partnerID=8YFLogxK
U2 - 10.1007/s00701-015-2353-4
DO - 10.1007/s00701-015-2353-4
M3 - Article
C2 - 25646851
AN - SCOPUS:84925543843
VL - 157
SP - 633
EP - 638
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
SN - 0001-6268
IS - 4
ER -