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Intracranial pulse pressure waveform analysis using the higher harmonics centroid.

Agnieszka P Zakrzewska1, Michał M Placek1,2, Marek Czosnyka1,3

  • 1Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.

Acta Neurochirurgica
|August 13, 2021
PubMed
Summary
This summary is machine-generated.

The higher harmonics centroid (HHC) of intracranial pressure (ICP) waveforms correlates with ICP levels. A decrease in HHC during ICP plateau waves may indicate rising intracranial pressure, offering a potential early warning sign.

Keywords:
ICP monitoringIntracranial pressureIntracranial pressure pulse waveformPlateau wavesTraumatic brain injury

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Area of Science:

  • Biomedical Engineering
  • Neuroscience
  • Clinical Monitoring

Background:

  • Intracranial pressure (ICP) pulse waveform analysis is clinically valuable.
  • The higher harmonics centroid (HHC) is a novel metric derived from ICP waveform harmonics.
  • HHC may offer insights into ICP dynamics beyond simple pressure readings.

Purpose of the Study:

  • To introduce and define the higher harmonics centroid (HHC) of the ICP pulse waveform.
  • To investigate the relationship between HHC and ICP levels, including during plateau waves.
  • To assess the potential clinical utility of HHC in ICP monitoring.

Main Methods:

  • Analysis of ICP recordings from 325 patients (2002-2010).
  • Identification of 26 patients with ICP plateau waves.
  • Correlation analysis of HHC and ICP, both overall and during specific ICP events.

Main Results:

  • A significant positive correlation was found between HHC and mean ICP (R=0.45, p=0.022).
  • During ICP plateau waves, HHC significantly decreased as ICP rose (p<10^-5).
  • HHC demonstrated robustness against zero drift errors affecting mean ICP.

Conclusions:

  • HHC shows significant correlation with ICP, supporting waveform analysis.
  • Declining HHC during elevated ICP may serve as an early warning for intracranial hypertension.
  • Further research is needed to validate HHC as a clinical indicator and explore breakpoint significance.