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Intracranial Pressure and Brain Monitoring XIV pp 147–151Cite as

Monitoring of the Association Between Cerebral Blood Flow Velocity and Intracranial Pressure

Part of the Acta Neurochirurgica Supplementum book series (NEUROCHIRURGICA,volume 114)

Abstract

Slow waves in intracranial pressure (ICP) are believed to originate from changes in cerebral blood volume secondary to adjustments in arteriolar diameter. Blood flow velocity (FV) signals recorded with transcranial Doppler ultrasound show similar oscillations. We investigated a continuous measure of FV/ICP association and its relationship to cerebral perfusion pressure (CPP), ICP, cerebral autoregulation (CA) and outcome after severe traumatic brain injury (TBI). We analysed recordings of arterial blood pressure (ABP), FV and ICP from 187 TBI patients treated at Addenbrooke’s Hospital, Cambridge, UK, from 1993 to 1998. Monitored data were recorded and the flow–ICP index (Flx) was derived as a moving correlation between the two signals over 4-min periods using ICM+. FIx was compared with the autoregulatory index (Mx), pressure reactivity index (PRx), ICP, CPP and outcome. FIx correlated with ICP (Spearman’s R = −0.40, p < 0.01), Mx (R = −0.54, p < 0.00005) and CPP (R = 0.34, p < 0.01), but not with PRx (p = 0.84). FIx was significantly associated with outcome after grouping into Glasgow Outcome Score (GOS) 1–3 or GOS 4–5 (Mann–Whitney p = 0.009). FIx may provide unique insights into the behaviour of the cerebral circulation during intracranial hypertension.

Keywords

  • Traumatic brain injury
  • Transcranial Doppler
  • Intracranial pressure
  • Compliance

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Conflict of interest statement

Peter Smielewski and Marek Czosnyka have a financial interest in a part of the licensing fee for ICM+. All other authors have no conficts of interest to disclose.

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Authors and Affiliations

  1. Department of Neurosurgery, Alfred Hospital, Prahran, VIC, 3181, Australia

    Philip M. Lewis & Jeffrey V. Rosenfeld

  2. Department of Surgery, Monash University, Prahran, VIC, Australia

    Philip M. Lewis & Jeffrey V. Rosenfeld

  3. Department of Neurosurgery, Addenbrooke’s Hospital, Cambridge, UK

    Peter Smielewski, John D. Pickard & Marek Czosnyka

Authors
  1. Philip M. Lewis
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  2. Peter Smielewski
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  3. Jeffrey V. Rosenfeld
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  4. John D. Pickard
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  5. Marek Czosnyka
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Corresponding author

Correspondence to Philip M. Lewis .

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Editors and Affiliations

  1. Universitätsklinikum, Klinik für Neurochirurgie, Eberhard-Karls-Universität, Hoppe-Seyler-Strasse 3, Tübingen, 72076, Germany

    Martin U. Schuhmann

  2. Addenbrooke's Hospital, Department of Neurosurgery, University of Cambridge, Hills Road, Cambridge, CB2 2QQ, United Kingdom

    Marek Czosnyka

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© 2012 Springer-Verlag/Wien

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Lewis, P.M., Smielewski, P., Rosenfeld, J.V., Pickard, J.D., Czosnyka, M. (2012). Monitoring of the Association Between Cerebral Blood Flow Velocity and Intracranial Pressure. In: Schuhmann, M., Czosnyka, M. (eds) Intracranial Pressure and Brain Monitoring XIV. Acta Neurochirurgica Supplementum, vol 114. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0956-4_27

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  • DOI: https://doi.org/10.1007/978-3-7091-0956-4_27

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  • Print ISBN: 978-3-7091-0955-7

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