دورية أكاديمية
Cerebral hemodynamic monitoring combined with infusion test in hydrocephalus.
| العنوان: | Cerebral hemodynamic monitoring combined with infusion test in hydrocephalus. |
|---|---|
| المؤلفون: | Czosnyka, Zofia, Lalou, Afroditi, Pelah, Adam I, Joanides, Alexis J, Smielewski, Peter, Placek, Michal M, Marek, Czosnyka |
| بيانات النشر: | Elsevier BV Division of Neurosurgery //dx.doi.org/10.1016/j.bas.2023.102705 Brain Spine |
| سنة النشر: | 2023 |
| المجموعة: | Apollo - University of Cambridge Repository |
| مصطلحات موضوعية: | Brain compliance, Cerebral autoregulation, Critical closing pressure, Pulsatility index, Transcranial Doppler |
| الوصف: | INTRODUCTION: Disturbance in cerebrospinal fluid (CSF) circulation may overlap with abnormality of cerebral blood flow (CBF) in hydrocephalus. Transcranial Doppler (TCD) ultrasonography is a non-invasive technique able to assess CBF velocity (CBFv) dynamics in response to a controlled rise in ICP during CSF infusion tests. RESEARCH QUESTION: Which TCD-derived cerebral hemodynamic parameters change during controlled rise of ICP, and in which direction? MATERIAL AND METHODS: Infusion tests combined with TCD monitoring and non-invasive monitoring of arterial blood pressure (ABP) were conducted in 65 hydrocephalic patients. TCD-based hemodynamic variables: spectral pulsatility index (sPI), compliance of CSF space (Ci), cerebral autoregulation index (Mx), critical closing pressure (CrCP), cerebrovascular wall tension (WT) and diastolic closing margin (DCM-distance between diastolic ABP and CrCP) were calculated retrospectively. RESULTS: During the test ICP increased on average to 25 mm Hg (p < 0.0001), with a parallel decrease in cerebral perfusion pressure (CPP, p < 0.0003). The CBFv waveform changed, showing a rise in sPI (p < 0.0001). Ci decreased inversely proportional to a rise in ICP, and correlated well with changes of compliance calculated from the Marmarou model. CrCP increased in response to rising ICP (p < 0.001) while WT decreased (p < 0.002). DCM correlated with cerebrospinal elasticity (R = -0.31; p < 0.04). Cerebral autoregulation was worse in patients with normal CSF circulation, measured as resistance to CSF outflow (Rout): Pearson correlation between Mx and Rout was R = -0.41; p < 0.02. CONCLUSION: A controlled rise in ICP affects cerebral hemodynamics in a moderate manner. Parameters like cerebral autoregulation index or DCM correlate with CSF dynamics and may be considered as supplementary variables for the diagnosis of hydrocephalus. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | https://www.repository.cam.ac.uk/handle/1810/363482Test |
| الإتاحة: | https://www.repository.cam.ac.uk/handle/1810/363482Test |
| حقوق: | Attribution-NonCommercial-NoDerivatives 4.0 International ; https://creativecommons.org/licenses/by-nc-nd/4.0Test/ |
| رقم الانضمام: | edsbas.6712A0DF |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |