Intracranial pressure dynamics are not linked to aqueductal cerebrospinal fluid stroke volume

Tain, Rong Wen; Alperin, Noam

doi:10.1152/japplphysiol.00357.2013

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…30 This study reported an association between ASV and a temporal subpeak of the ICP wave, but the result was based on a small cohort of 7 patients and the clinical significance of the findings has been disputed. 31 In our study, a high proportion of the patients in the iNPH cohort had signs of reduced intracranial compliance by increased MWA after overnight ICP monitoring (17/21). MWA of Ն4 mm Hg or the percentage of MWA of Ն5 mm Hg in Ն10% of recording time or both were previously reported to predict shunt response in iNPH 19 and have been considered as indicative of impaired intracranial compliance.…”

Section: Discussionmentioning

confidence: 54%

Aqueductal Stroke Volume: Comparisons with Intracranial Pressure Scores in Idiopathic Normal Pressure Hydrocephalus

Ringstad¹,

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Geier

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Aqueductal stroke volume from phase-contrast MR imaging has been proposed for predicting shunt response in normal pressure hydrocephalus. However, this biomarker has remained controversial in use and has a lack of validation with invasive intracranial monitoring. We studied how aqueductal stroke volume compares with intracranial pressure scores in the presurgical work-up and clinical score, ventricular volume, and aqueduct area and assessed the patient's response to shunting.

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Section: Discussionmentioning

confidence: 54%

Aqueductal Stroke Volume: Comparisons with Intracranial Pressure Scores in Idiopathic Normal Pressure Hydrocephalus

Ringstad¹,

Emblem

Geier

et al. 2015

AJNR Am J Neuroradiol

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“…The data from this study shows a strong exponential correlation between the ICP changes and ΔICV. To our knowledge, this link between concomitant ICV and ICP changes over the cardiac cycle has been proposed, but not fully demonstrated [ 3 , 7 , 30 ]. In a transcranial Doppler (TCD) study, Carrera et al showed a relation between ΔCBV and ICP [ 13 ] when assuming a constant venous outflow based on previous research [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, several studies have demonstrated that the venous outflow from the cranial cavity is pulsatile [ 3 , 4 , 25 ] and Carrera et al do not compensate for CSF fluctuations, as there was no measurement of CSF flow from the cranial cavity through the foramen magnum secondary to the change in CBV. Consequently, it could be argued that they demonstrated a relation between changes in aCBV and changes in ICP [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

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

2017

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BackgroundThe 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.MethodsCine 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.ResultsExcluding 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.ConclusionThe 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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“…At this time, both venous outflow and CSF flow from the cranium to the spinal canal occur immediately following increased arterial inflow to accommodate the increase in intracranial pressure [28]. As the intracranial-pressure waveform depends on the arterial-inflow waveform as the driving force [29], the increase in ∆PG reflects an increase of intracranial pressure produced by an increase of CBF after full inspiration. Our results suggested that the comparison of ∆PG with both breath-holding maneuvers at full inspiration and at the end of expiration can be used as a noninvasive stress test to assess intracranial hydrodynamics, which may enhance the sensitivity of the detection of impaired pressure-compensation capacity.…”

Section: Discussionmentioning

confidence: 99%

Fast Phase-Contrast Cine MRI for Assessing Intracranial Hemodynamics and Cerebrospinal Fluid Dynamics

et al. 2020

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We propose fast phase-contrast cine magnetic resonance imaging (PC-cine MRI) to allow breath-hold acquisition, and we compared intracranial hemo- and hydrodynamic parameters obtained during breath holding between full inspiration and end expiration. On a 3.0 T MRI, using electrocardiogram (ECG)-synchronized fast PC-cine MRI with parallel imaging, rectangular field of view, and segmented k-space, we obtained velocity-mapped phase images at the mid-C2 level with different velocity encoding for transcranial blood flow and cerebrospinal-fluid (CSF) flow. Next, we calculated the peak-to-peak amplitudes of cerebral blood flow (ΔCBF), cerebral venous outflow, intracranial volume change, CSF pressure gradient (ΔPG), and intracranial compliance index. These parameters were compared between the proposed and conventional methods. Moreover, we compared these parameters between different utilized breath-hold maneuvers (inspiration, expiration, and free breathing). All parameters derived from the fast PC method agreed with those from the conventional method. The ΔPG was significantly higher during full inspiration breath holding than at the end of expiration and during free breathing. The proposed fast PC-cine MRI reduced scan time (within 30 s) with good agreement with conventional methods. The use of this method also makes it possible to assess the effects of respiration on intracranial hemo- and hydrodynamics.

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Intracranial pressure dynamics are not linked to aqueductal cerebrospinal fluid stroke volume

Cited by 4 publications

References 5 publications

Aqueductal Stroke Volume: Comparisons with Intracranial Pressure Scores in Idiopathic Normal Pressure Hydrocephalus

Aqueductal Stroke Volume: Comparisons with Intracranial Pressure Scores in Idiopathic Normal Pressure Hydrocephalus

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

Fast Phase-Contrast Cine MRI for Assessing Intracranial Hemodynamics and Cerebrospinal Fluid Dynamics

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