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Assessment of the relationship between age and continuous intracranial compliance

K L Kiening1, W Schoening, A W Unterberg

  • 1Department of Neurosurgery, Heidelberg Medical Center, Ruprecht-Karls-University, Heidelberg, Germany. karl.kiening@med.uni-heidelberg.de

Acta Neurochirurgica. Supplement
|February 9, 2006
PubMed

Insights

Continuous intracranial compliance (cICC) does not decrease with age in traumatic brain injury (TBI) patients. However, cICC declines with increasing intracranial pressure (ICP) and age, particularly in older adults, impacting TBI outcomes.

Area of Science:

  • Neuroscience
  • Critical Care Medicine
  • Trauma Surgery

Background:

  • Traumatic brain injury (TBI) is a significant cause of mortality and morbidity.
  • Age is a known factor influencing TBI outcomes, with older patients generally experiencing worse prognoses.
  • Continuous intracranial compliance (cICC) is a novel monitoring parameter for assessing intracranial dynamics.

Purpose of the Study:

  • To investigate the relationship between continuous intracranial compliance (cICC) and age in patients with severe and moderate traumatic brain injury (TBI).
  • To determine if cICC decreases with advancing age in TBI patients.
  • To explore the influence of intracranial pressure (ICP) and age on cICC.

Main Methods:

  • Prospective, open-label, descriptive study involving 30 TBI patients (Glasgow Coma Scale score ≤ 10).
  • Computerized monitoring of blood pressure, intracranial pressure (ICP), cerebral perfusion pressure, and cICC.
  • Regression analyses were performed to assess the relationship between age, ICP, and cICC.

Main Results:

  • No significant direct correlation was found between median cICC and patient age.
  • Median cICC significantly decreased as median ICP increased (e.g., 0.64 ml/mmHg at 10 mmHg ICP to 0.42 ml/mmHg at 30 mmHg ICP).
  • In higher ICP groups (20 and 30 mmHg), median cICC declined with age. Pathological cICC (< 0.05 ml/mmHg) prevalence increased with age, reaching 70% in the 61-80 years group.

Conclusions:

  • While cICC does not directly decrease with age in TBI patients, its decline with increasing ICP is more pronounced in older individuals.
  • Reduced intracranial volume challenge compensation with age may contribute to poorer outcomes in elderly TBI patients.
  • These findings highlight the age-dependent impact of ICP on intracranial compliance and TBI prognosis.

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