Estimating intracranial pressure using pulsatile cerebral blood flow measured with diffuse correlation spectroscopy

Ruesch, Alexander; Yang, Jason; Schmitt, Samantha; Acharya, Deepshikha; Ma, Smith; Kainerstorfer, Jana M.

doi:10.1364/boe.386612

Cited by 42 publications

(55 citation statements)

References 43 publications

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“…Derivatives of the above described static, dynamic, and pseudo-dynamic measurements have been proposed in order to reduce the need of invasive ICP sensors and improve reliability. Such methods often replace ICP or ABP with other hemodynamic measurements such as hemoglobin concentrations, tissue oxygenation or blood volume and summaries of them can be found elsewhere [15,[23][24][25], including non-invasive diffuse optical methods used in this article [26,27]. Despite many decades of research and a large variety of measurement methods, a consensus on the effectiveness and use of CA measurements to guide clinical treatment has not yet been reached.…”

Section: Introductionmentioning

confidence: 99%

Comparison of static and dynamic cerebral autoregulation under anesthesia influence in a controlled animal model

et al. 2021

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The brain’s ability to maintain cerebral blood flow approximately constant despite cerebral perfusion pressure changes is known as cerebral autoregulation (CA) and is governed by vasoconstriction and vasodilation. Cerebral perfusion pressure is defined as the pressure gradient between arterial blood pressure and intracranial pressure. Measuring CA is a challenging task and has created a variety of evaluation methods, which are often categorized as static and dynamic CA assessments. Because CA is quantified as the performance of a regulatory system and no physical ground truth can be measured, conflicting results are reported. The conflict further arises from a lack of healthy volunteer data with respect to cerebral perfusion pressure measurements and the variety of diseases in which CA ability is impaired, including stroke, traumatic brain injury and hydrocephalus. To overcome these differences, we present a healthy non-human primate model in which we can control the ability to autoregulate blood flow through the type of anesthesia (isoflurane vs fentanyl). We show how three different assessment methods can be used to measure CA impairment, and how static and dynamic autoregulation compare under challenges in intracranial pressure and blood pressure. We reconstructed Lassen’s curve for two groups of anesthesia, where only the fentanyl anesthetized group yielded the canonical shape. Cerebral perfusion pressure allowed for the best distinction between the fentanyl and isoflurane anesthetized groups. The autoregulatory response time to induced oscillations in intracranial pressure and blood pressure, measured as the phase lag between intracranial pressure and blood pressure, was able to determine autoregulatory impairment in agreement with static autoregulation. Static and dynamic CA both show impairment in high dose isoflurane anesthesia, while low isoflurane in combination with fentanyl anesthesia maintains CA, offering a repeatable animal model for CA studies.

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Section: Introductionmentioning

confidence: 99%

Comparison of static and dynamic cerebral autoregulation under anesthesia influence in a controlled animal model

et al. 2021

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“…Over the years, non-invasive methods for measuring ICP have emerged, including fundoscopy examinations and optical coherence tomography (OCT) (21), flash visual evoked potential (VEP) (22), IOP and venous ophthalmodynamometry (23), tympanic membrane displacement (24), electroencephalogram (25), retinal blood pressure (26), blood flow velocity pulsatility index (27), and cerebral blood flow (28). Due to the large variation and difficulty in implementation, some of these methods are gradually reduced, however, there are several non-invasive methods to detect ICP, which are considered to be more useful.…”

Section: Review Articlementioning

confidence: 99%

Non-invasive detection of intracranial pressure related to the optic nerve

Li¹,

Wan²

2021

Quant Imaging Med Surg

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Intracranial pressure (ICP) is associated with a variety of diseases. Early diagnosis and the timely intervention of elevated ICP are effective means to clinically reduce the morbidity and mortality of some diseases. The detection and judgment of reduced ICP are beneficial to glaucoma doctor and neuro ophthalmologist to diagnose optic nerve disease earlier. It is important to evaluate and monitor ICP clinically.Although invasive ICP detection is the gold standard, it can have complications. Most non-invasive ICP tests are related to the optic nerve and surrounding tissues due to their anatomical characteristics. Ultrasound, magnetic resonance imaging, transcranial Doppler, papilledema on optical coherence tomography, visual evoked potential, ophthalmodynamometry, the assessment of spontaneous retinal venous pulsations, and eye-tracking have potential for application. Although none of these methods can completely replace invasive technology; however, its repeatable, low risk, high accuracy, gradually attracted people's attention. This review summarizes the non-invasive ICP detection methods related to the optic nerve and the role of the diagnosis and prognosis of neurological disorders and glaucoma. We discuss the advantages and challenges and predict possible areas of development in the future.

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“…A recent study using invasive monitoring methods simultaneously recorded ICP and CBF waveform in non-human primate, reported that a higher ICP led to a broadening and rightward shift of the ICP and CBF pulse wave [50] , although the strength of this effect differed between subjects. In patients with NPH underwent CSF drainage, the arterial pulse became thinner, and peaked earlier than pre-drainage [43] .…”

Section: Interpretation Of the Prolonged Ttpmentioning

confidence: 99%

Phase-Contrast MRI Indices can Reflect Intracranial Compliance Deterioration Induced by Intra-Abdominal/ Thoracic Hypertension

Feng

Liu³

et al. 2021

Preprint

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BackgroundIdentifying elevated intracranial pressure (ICP) and decreased intracranial compliance (ICC) is imperative for optimizing patient management in neurocritical care settings. Intra-abdominal hypertension (IAH) and intrathoracic hypertension (ITH) is common in trauma patients, which affects homeostasis of ICP/ICC. Knowledge of this effects is little and monitoring this effect is difficult. In the current study, we examined whether the indices generated from 2D cine phase contrast MRI (2D cine PC-MRI) could reflect ICC/ICP alterations induced by elevated IAH/ITH during VM.MethodsA total of 50 healthy young volunteers participated in this study (male: female = 24:26), and took a 2D cine PC-MRI during normal breath and VM respectively. Cross-section area (CSA) of dominant IJV and ipsilateral ICA, the maximum blood flow (Fmax), minimum blood flow (Fmin), mean blood flow (MBF), pulsatility index (PI), arteriovenous delay (AVD) and time to peak of arterial pulse (TTP) were gauged from images or calculated from the blood flow curves generated from 2D cine PC-MRI. ResultsDuring VM state, in comparison to NB, CSAIJV increased significantly (p<0.0001), indicating an elevation of cerebral venous outflow resistance; Fmax_ICA, Fmax_IJV, Fmean_ICA and Fmean_IJV decreased significantly (p<0.0001, p<0.0001, p<0.001, p<0.0001, respectively); PI_ICA and PI_IJV decreased significantly (p<0.0001, p<0.0001); both absolute and normalized AVD decreased significantly (p<0.0001, p<0.0001), while absolute and normalized TTP increased significantly (p=0.0329, p=0.0376).Conclusions Indices generated from 2D cine PC-MRI, especially AVD and TTP, can reveal the ICC/ICP dynamics induced by elevated IAP/ITP. These indices have potential clinical application in ICC/ICP monitoring in patients who was speculated with an IAH or ITH.

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Estimating intracranial pressure using pulsatile cerebral blood flow measured with diffuse correlation spectroscopy

Cited by 42 publications

References 43 publications

Comparison of static and dynamic cerebral autoregulation under anesthesia influence in a controlled animal model

Comparison of static and dynamic cerebral autoregulation under anesthesia influence in a controlled animal model

Non-invasive detection of intracranial pressure related to the optic nerve

Phase-Contrast MRI Indices can Reflect Intracranial Compliance Deterioration Induced by Intra-Abdominal/ Thoracic Hypertension

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