Significant Association of Slow Vasogenic ICP Waves with Normal Pressure Hydrocephalus Diagnosis

  • Andreas SpiegelbergEmail author
  • Matthias Krause
  • Juergen Meixensberger
  • Burkhardt Seifert
  • Vartan Kurtcuoglu
Conference paper
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 126)



We aimed to test whether there is an association of slow vasogenic wave (SVW) occurrence with positive response to external lumbar drainage (ELD) and ventriculoperitoneal shunting and to design a method for the recognition and quantification of SVWs in the intracranial pressure (ICP) signal.

Materials and methods:

We constructed SVW templates using normalized sine waves. We calculated the cross-correlation between the respective SVW template and the ICP signal. This was followed by shifting the templates forward and performing the cross-correlation analysis again until the end of the recording. Cross-correlation values above a threshold were considered to be indicative of SVWs. This threshold was previously determined and validated on a sample of ICP records of six patients. We calculated the root mean square of the recognized SVW periods as a measure of signal strength. Time-averaged signal strength was calculated over the full recording time (ICPSmean) and over the wave periods (ICPS).


We determined ICPS and ICPSmean in recordings of 2 groups of patients presenting with Hakim’s triad: 26 normal pressure hydrocephalus (NPH) patients and 20 non-NPH patients. We then tested whether there was an association between ICPS or ICPSmean and the respective diagnosis using a Mann–Whitney test. We found significant association between ICPS (p = 0.014) and ICPSmean (p = 0.022) and the diagnoses.


The described method based on pattern recognition in the time domain is suitable for the detection and quantification of SVWs in ICP signals. We found a significant association between the occurrence of SVWs and independent NPH diagnosis.


Intracranial pressure B-waves Slow waves Vasogenic waves Waveform analysis 



We gratefully acknowledge partial funding by the Swiss National Science Foundation through NCCR Kidney.CH.

Conflicts of interest statement

We declare that we have no conflict of interest.


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Andreas Spiegelberg
    • 1
    Email author
  • Matthias Krause
    • 2
  • Juergen Meixensberger
    • 2
  • Burkhardt Seifert
    • 3
  • Vartan Kurtcuoglu
    • 1
    • 4
  1. 1.The Interface Group, Institute of PhysiologyUniversity of ZurichZürichSwitzerland
  2. 2.Klinik und Poliklinik für NeurochirurgieUniversitaetsklinikum Leipzig AoeRLeipzigGermany
  3. 3.Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute (EBPI)University of ZurichZurichSwitzerland
  4. 4.Zurich Center for Integrative Human Physiology and Neuroscience Center ZurichUniversity of ZurichZurichSwitzerland

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