Abstract
Raised intracranial pressure (ICP) is a key concern following acute brain injury as it may be associated with cerebral hypoperfusion and poor outcome. In this research we describe a mathematical physiological model designed to interpret cerebral physiology from neuromonitoring: ICP, near-infrared spectroscopy and transcranial Doppler flow velocity. This aims to characterise the complex dynamics of cerebral compliance, cerebral blood volume, cerebral blood flow and their regulation in individual patients. Analysis of data from six brain-injured patients produces cohesive predictions of cerebral biomechanics suggesting reduced cerebral compliance, reduced volume compensation and impaired blood flow autoregulation. Patient-specific physiological modelling has the potential to predict the key biomechanical and haemodynamic changes following brain injury in individual patients, and might be used to inform individualised treatment strategies.
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Acknowledgments
This work was undertaken at University College London Hospitals and partially funded by the Department of Health’s National Institute for Health Research Centres funding scheme. Support was also been provided by the Medical Research Council and Wellcome Trust. The authors are indebted to the medical and nursing staff of the Neurocritical Care Unit at the National Hospital for Neurology and Neurosurgery and to the study patients and their families.
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Highton, D., Panovska-Griffiths, J., Smith, M., Elwell, C.E. (2013). Mathematical Modelling of Near-Infrared Spectroscopy Signals and Intracranial Pressure in Brain-Injured Patients. In: Van Huffel, S., Naulaers, G., Caicedo, A., Bruley, D.F., Harrison, D.K. (eds) Oxygen Transport to Tissue XXXV. Advances in Experimental Medicine and Biology, vol 789. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7411-1_46
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DOI: https://doi.org/10.1007/978-1-4614-7411-1_46
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