Related Experiment Videos
Origin and evolution of plateau waves. Experimental observations and a theoretical model
Journal of Neurosurgery
|February 1, 1984
Summary
Plateau waves in head injuries are linked to changes in blood pressure. These waves evolve through four phases, driven by the brain
Area of Science:
- Neuroscience
- Physiology
Background:
- Plateau waves (Lundberg A-waves) in intracranial pressure (ICP) monitoring are critical indicators of brain injury.
- Previous research suggested plateau waves might be independent of systemic circulatory events.
Purpose of the Study:
- To investigate the relationship between plateau waves and systemic circulatory events in feline models of head injury.
- To elucidate the distinct phases of plateau wave evolution and their causal links to circulatory changes.
Main Methods:
- Laboratory observations in cats subjected to fluid-percussion head injuries.
- Monitoring of intracranial pressure (ICP) and systemic arterial blood pressure (SABP).
- Analysis of cerebral perfusion pressure (CPP) dynamics during plateau wave development.
Main Results:
- Four distinct phases of plateau wave evolution were identified, causally linked to circulatory changes.
- Premonitory drift phase: ICP increases due to falling SABP, reducing CPP.
- Plateau phase: ICP rapidly rises as CPP falls; resolution phase involves ICP decline via autoregulatory vasoconstriction.
Conclusions:
- Plateau waves result from intact cerebrovascular autoregulation responding to fluctuations in CPP.
- The observed phases are logical consequences of unstable CPP impacting the cerebrovascular bed under elevated ICP and reduced compliance.