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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Dynamic Intracranial Pressure Waveform Morphology Predicts Ventriculitis.

Murad Megjhani1,2, Kalijah Terilli1,2, Lakshman Kalasapudi3

  • 1Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, 177 Fort Washington Ave, 8 Milstein - 300 Center, New York, NY, USA.

Neurocritical Care
|July 31, 2021
PubMed
Summary
This summary is machine-generated.

Intracranial pressure waveform analysis can predict ventriculitis, an infection of the brain lining. This method offers a non-invasive way to detect the condition early.

Keywords:
ClusteringExternal ventricular drainageICP waveformMachine learningNeurocritical careVentriculitis

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Area of Science:

  • Neuroscience
  • Medical Technology
  • Infectious Disease

Background:

  • Intracranial pressure (ICP) waveform morphology reflects intracranial compliance.
  • Ventriculitis, an infection of the brain's ventricles, can decrease intracranial compliance.
  • Predicting ventriculitis onset using ICP dynamics is crucial for timely intervention.

Purpose of the Study:

  • To investigate the potential of intracranial pressure (ICP) waveform morphologic analysis in predicting the onset of ventriculitis.
  • To develop and validate a computational pipeline for automated ICP waveform analysis.
  • To assess the performance of a machine learning classifier in distinguishing ventriculitis from control cases.

Main Methods:

  • A pipeline was developed to isolate ICP waveform segments and extract dominant pulses.
  • Clinician-supervised active learning identified metaclusters of waveform morphologies (triphasic, single-peak, artifactual).
  • A L2-regularized logistic regression classifier integrated metacluster distributions, temperature, and lab values to predict ventriculitis.

Main Results:

  • Analysis included 58 patients (27 with ventriculitis, 31 controls) with 1590 hours of segmented ICP data.
  • Significant differences in metacluster distributions were observed between ventriculitis and control groups (p < 0.001).
  • The classifier achieved a median area under the receiver operating characteristic curve of 0.70, with a favorable true to false alert ratio of 1.5:1.

Conclusions:

  • Intracranial pressure waveform morphology analysis demonstrates potential for classifying ventriculitis.
  • This non-invasive method may enable early detection of ventriculitis without cerebrospinal fluid sampling.
  • Further validation is warranted to integrate this technique into clinical practice for improved patient outcomes.