Chapter title |
Cerebral Critical Closing Pressure During Infusion Tests.
|
---|---|
Chapter number | 43 |
Book title |
Intracranial Pressure and Brain Monitoring XV
|
Published in |
Acta neurochirurgica Supplement, January 2016
|
DOI | 10.1007/978-3-319-22533-3_43 |
Pubmed ID | |
Book ISBNs |
978-3-31-922532-6, 978-3-31-922533-3
|
Authors |
Varsos, Georgios V, Czosnyka, Marek, Smielewski, Peter, Garnett, Matthew R, Liu, Xiuyun, Adams, Hadie, Pickard, John D, Czosnyka, Zofia, Georgios V. Varsos MSc, Marek Czosnyka PhD, Peter Smielewski PhD, Matthew R. Garnett MD, Xiuyun Liu MSc, Hadie Adams MD, John D. Pickard FMedSci, PhD, Zofia Czosnyka PhD, Varsos, Georgios V., Garnett, Matthew R., Pickard, John D., Georgios V. Varsos, Marek Czosnyka, Peter Smielewski, Matthew R. Garnett, Xiuyun Liu, Hadie Adams, John D. Pickard, Zofia Czosnyka |
Editors |
Beng-Ti Ang |
Abstract |
We studied possible correlations between cerebral hemodynamic indices based on critical closing pressure (CrCP) and cerebrospinal fluid (CSF) compensatory dynamics, as assessed during lumbar infusion tests. Our data consisted of 34 patients with normal-pressure hydrocephalus who undertook an infusion test, in conjunction with simultaneous transcranial Doppler ultrasonography (TCD) monitoring of blood flow velocity (FV). CrCP was calculated from the monitored signals of ICP, arterial blood pressure (ABP), and FV, whereas vascular wall tension (WT) was estimated as CrCP - ICP. The closing margin (CM) expresses the difference between ABP and CrCP. ICP increased during infusion from 6.67 ± 4.61 to 24.98 ± 10.49 mmHg (mean ± SD; p < 0.001), resulting in CrCP rising by 22.93 % (p < 0.001), with WT decreasing by 11.33 % (p = 0.005) owing to vasodilatation. CM showed a tendency to decrease, albeit not significantly (p = 0.070), because of rising ABP (9.12 %; p = 0.005), and was significantly different from zero for the whole duration of the tests (52.78 ± 22.82 mmHg; p < 0.001). CM at baseline correlated inversely with brain elasticity (R = -0.358; p = 0.038). Neither CrCP nor WT correlated with CSF compensatory parameters. Overall, CrCP increases and WT decreases during infusion tests, whereas CM at baseline pressure may act as a characterizing indicator of the cerebrospinal compensatory reserve. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 20 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Bachelor | 6 | 30% |
Student > Postgraduate | 3 | 15% |
Student > Ph. D. Student | 2 | 10% |
Student > Master | 2 | 10% |
Researcher | 2 | 10% |
Other | 2 | 10% |
Unknown | 3 | 15% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 10 | 50% |
Neuroscience | 3 | 15% |
Sports and Recreations | 1 | 5% |
Agricultural and Biological Sciences | 1 | 5% |
Computer Science | 1 | 5% |
Other | 1 | 5% |
Unknown | 3 | 15% |