Intracranial Pressure and Neuromonitoring XVII (Acta Neurochirurgica Supplement, 131) 3030594351, 9783030594350

This book gathers the proceedings of the 17th International Conference on Intracranial Pressure and Neuromonitoring, hel

125 24 22MB

English Pages 386 [348] Year 2021

Report DMCA / Copyright

DOWNLOAD PDF FILE

Table of contents :
Preface (17th International Conference on Intracranial Pressure and Neuromonitoring)
Contents
Part I: Neuromonitoring and Management in Adult Traumatic Brain Injury
Microcirculatory Biomarkers of Secondary Cerebral Ischemia in Traumatic Brain Injury
Introduction
Materials and Methods
Statistical Analysis
Results
Discussion
Conclusion
References
Visualization of Intracranial Pressure Insults After Severe Traumatic Brain Injury: Influence of Individualized Limits of Reactivity
Introduction
Materials and Methods
Participants
Data Acquisition
Lower Limit of Reactivity Calculation
ICP Visualization
Results
Discussion
References
Impacts of a Pressure Challenge on Cerebral Critical Closing Pressure and Effective Cerebral Perfusion Pressure in Patients with Traumatic Brain Injury
Introduction
Patients and Methods
Patient Management
Pressure Challenge
Data Acquisition, Processing, and Analysis
Data Acquisition
Data Processing and Analysis
Results
Discussion
Conclusion
References
Semi-automated Computed Tomography Volumetry as a Proxy for Intracranial Pressure in Patients with Severe Traumatic Brain Injury: Clinical Feasibility Study
Introduction
Materials and Methods
Patients and Data Acquisition
CT Volumetry
Data Analysis
Results
Relationship Between the CSF/ICV Ratio and Invasive ICP on the Admission CT Scan
Discussion
Conclusion
References
Errors and Consequences of Inaccurate Estimation of Mean Blood Flow Velocity in Cerebral Arteries
Introduction
Materials and Methods
Results
Discussion
References
Analysis of the Association Between Lung Function and Brain Tissue Oxygen Tension in Severe Traumatic Brain Injury
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Comparison of Two Intracranial Pressure Calculation Methods and Their Effects on the Mean Intracranial Pressure and Intracranial Pressure Dose
Introduction
Methods
Data Processing
Statistical Analysis
Results
Discussion
References
External Hydrocephalus After Traumatic Brain Injury: Retrospective Study of 102 Patients
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Analysis of Cardio-Cerebral Crosstalk Events in an Adult Cohort from the CENTER-TBI Study
Introduction
Data Set
Methods
Results
Discussion and Conclusion
References
Cerebrovascular Consequences of Elevated Intracranial Pressure After Traumatic Brain Injury
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Part II: Neuromonitoring and Management in Adult Nontraumatic Brain Injury
Assessment of Cerebral Autoregulation in the Perifocal Zone of a Chronic Subdural Hematoma
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Noninvasive Intracranial Pressure Monitoring in Chronic Stroke Patients with Sedentary Behavior: A Pilot Study
Introduction
Materials and Methods
Participants
Physical Activity Monitoring
Intracranial Pressure Monitoring
Statistical Analysis
Results
Discussion
Conclusion
References
Use of Clustering to Investigate Changes in Intracranial Pressure Waveform Morphology in Patients with Ventriculitis
Introduction
Materials and Methods
Study Population and Data Collection
Outcome Definition
Data Analysis
Statistical Analysis
Results
Discussion
References
Perioperative Dynamics of Intracranial B-waves of Blood Flow Velocity in the Basal Cerebral Arteries in Patients with Brain Arteriovenous Malformation
Introduction
Materials and Methods
Results
Discussion
References
Part III: Neuromonitoring and Management in Adult Mixed Brain Injury Populations
Effects of Hyperthermia on Intracranial Pressure and Cerebral Autoregulation in Patients with an Acute Brain Injury
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
A Comparative Study of the Effects of Early Versus Late Cranioplasty on Cognitive Function
Introduction
Methods
Results
Discussion
Conclusion
References
Effects of Cranioplasty After Decompressive Craniectomy on Neurological Function and Cerebral Hemodynamics in Traumatic Versus Nontraumatic Brain Injury
Introduction
Methods
Results
Discussion
References
Brain Multimodal Monitoring in Severe Acute Brain Injury: Is It Relevant to Patient Outcome and Mortality?
Introduction
Materials and Methods
Patient Selection
Data Collection
Statistical Analysis
Results
Discussion
Conclusion
References
Long-Term Outcome After Decompressive Craniectomy in a Developing Country
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Predictors of Successful Extubation in Neurocritical Care Patients
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Part IV: Neuromonitoring and Management in the Pediatric Population
Impaired Autoregulation Following Resuscitation Correlates with Outcome in Pediatric Patients: A Pilot Study
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Brain Biomarkers in Children After Mild and Severe Traumatic Brain Injury
Introduction
Materials and Methods
Results
Discussion
References
Decompressive Craniectomy for Traumatic Intracranial Hypertension in Children
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Use of Direct Intracranial Pressure and Brain Tissue Oxygen Monitoring in Perioperative Management of Patients with Moyamoya Disease
Introduction
Materials and Methods
Results
Discussion
References
Part V: Neuromonitoring Technology
Variability of the Optic Nerve Sheath Diameter on the Basis of Sex and Age in a Cohort of Healthy Volunteers
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
A Noninvasive Method for Monitoring Intracranial Pressure During Postural Changes
Introduction
Materials and Methods
Tilt Table Study
Results
Discussion
References
Arterial and Venous Cerebral Blood Flow Velocities in Healthy Volunteers
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Comparison of Waveforms Between Noninvasive and Invasive Monitoring of Intracranial Pressure
Introduction
Methods
Subjects
Experimental Protocol
Inclusion Criteria
Data Acquisition and Data Processing
Statistical Analysis
Results
Discussion
Conclusion
References
Part VI: Cerebrovascular Autoregulation in Acute Brain Injury and Cardiac Surgery
An Update on the COGiTATE Phase II Study: Feasibility and Safety of Targeting an Optimal Cerebral Perfusion Pressure as a Patient-Tailored Therapy in Severe Traumatic Brain Injury
Introduction
Methods
The CPPopt Concept and COGiTATE
Results
Discussion
Conclusion
References
Quick Assessment of the Lower Limit of Autoregulation by Use of Transcranial Doppler Ultrasound During Cardiac Surgery
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Influence of Patient Demographics on Optimal Cerebral Perfusion Pressure Following Traumatic Brain Injury
Introduction
Materials and Methods
Results
Discussion
Conclusions
References
Secondary Cerebral Ischemia at Traumatic Brain Injury Is More Closely Related to Cerebrovascular Reactivity Impairment than to Intracranial Hypertension
Introduction
Material and Methods
Results
Discussion
Conclusions
References
Usability of Noninvasive Counterparts of Traditional Autoregulation Indices in Traumatic Brain Injury
Introduction
Materials and Methods
Results
Discussion
References
Patient’s Clinical Presentation and CPPopt Availability: Any Association?
Introduction
Material and Methods
Results
Discussion
Conclusions
References
Optimal Cerebral Perfusion Pressure Based on Intracranial Pressure-Derived Indices of Cerebrovascular Reactivity: Which One Is Better for Outcome Prediction in Moderate/Severe Traumatic Brain Injury?
Introduction
Methods
Patient Demographics
Data Acquisition
Signal Processing
Calculation of Indices of Cerebrovascular Reactivity (PRx, PAx, and RAC)
Calculation of CPPopt
Statistical Analysis
Results
Patient Characteristics
Indices of Autoregulation and CPPopt
Time/Dose of CPP Below CPPopt
Outcome Prediction Using Time/Dose of CPP Below CPPopt
Discussion
References
Optimal Cerebral Perfusion Pressure Assessed with a Multi-Window Weighted Approach Adapted for Prospective Use: A Validation Study
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Monitoring of Cerebrovascular Reactivity in Intracerebral Hemorrhage and Its Relation with Survival
Introduction
Materials and Methods
Results
Discussion
References
Part VII: Neuroinformatics and Artificial Intelligence
Spectral Cerebral Blood Volume Accounting for Noninvasive Estimation of Changes in Cerebral Perfusion Pressure in Patients with Traumatic Brain Injury
Introduction
Material and Methods
Patients
Monitoring and Data Analysis
Noninvasive CPP Formula
Statistical Analysis
Results
Discussion
Limitations
References
Empirical Mode Decomposition-Based Method for Artefact Removal in Raw Intracranial Pressure Signals
Introduction
Methods
EMD Algorithm
Proposed EMD-Based Algorithm
Results
Discussion
Conclusion
References
RAQ: A Noise-Resistant Calibration-Independent Compliance Surrogate
Introduction
Methods
Material
Results
Discussion
Conclusion
References
Methodological Consideration on Monitoring Refractory Intracranial Hypertension and Autonomic Nervous System Activity
Introduction
Materials and Methods
Data Collection
Data Processing
Statistical Analysis
Results
Discussion
References
Evaluation of Software for Automated Measurement of Adherence to ICP-Monitoring Threshold Guideline
Introduction
Materials and Methods
Pilot Study Outline
Results
Event and Treatment Counts
Patient 1
Patient 3
Discussion
Conclusion
References
Time Series Analysis and Prediction of Intracranial Pressure Using Time-Varying Dynamic Linear Models
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Automatic Pulse Classification for Artefact Removal Using SAX Strings, a CENTER-TBI Study
Introduction
Materials and Methods
Results
Discussion
References
DeepClean: Self-Supervised Artefact Rejection for Intensive Care Waveform Data Using Deep Generative Learning
Introduction
Methods
Results
Discussion
Data and Code Availability
References
Comparison of Two Algorithms Analysing the Intracranial Pressure Curve in Terms of the Accuracy of Their Start-Point Detection and Resistance to Artefacts
Introduction
Background
Objective
Materials and Methods
Dataset
Algorithm Design
Study Design
Results
Conclusion
Discussion
References
Plateau Waves of Intracranial Pressure: Methods for Automatic Detection and Prediction
Introduction
Materials and Methods
Available Data
Plateau Wave Definition
Development of Algorithm for Plateau Wave Detection
Results
Discussion
Conclusion
References
Python-Embedded Plugin Implementation in ICM+: Novel Tools for Neuromonitoring Time Series Analysis with Examples Using CENTER-TBI Datasets
Introduction
Materials and Methods
Python Plugin for ICM+
Facilitating Creation of Custom Python Functions for ICM+
Dealing with Missing Data
Assessing Performance
Results
Example of a Python Function Extension for ICM+
Performance
Discussion
References
Part VIII: Laboratory and Translational Research
Physical Model for Investigating Intracranial Pressure with Clinical Pressure Sensors and Diagnostic Ultrasound: Preliminary Results
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Augmented Reality-Assisted Neurosurgical Drain Placement (ARANED): Technical Note
Introduction
Materials and Methods
Hardware and Software
Preclinical and Clinical Validation
Results
HoloLens Software Solution
Remote Planning Station
Data Transfer to Device
HoloLens Functionalities and User Interface
Infrared Tracking
Hologram-to-Patient Registration
User Interface
Preclinical and Clinical Validation
Discussion
Conclusion
References
Lower Limit of Reactivity Assessed with PRx in an Experimental Setting
Introduction
Methods
Results
Discussion
References
Analysis of Intracranial Pressure Pulse–Pressure Relationship: Experimental Validation
Introduction
Materials and Methods
Animals and Experimental Paradigms
Data Acquisition and Analysis
Statistical Analysis
Results
Discussion
References
Cerebrovascular Impedance During Hemodynamic Change in Rabbits: A Pilot Study
Introduction
Materials and Methods
Material and Data Acquisition
Data Analysis
Results
Discussion
References
Improved Cerebral Perfusion Pressure and Microcirculation by Drag Reducing Polymer-Enforced Resuscitation Fluid After Traumatic Brain Injury and Hemorrhagic Shock
Introduction
Methods
Overall Study Design
Surgical Preparation
DRP Preparation
Two-Photon Laser Scanning Microscopy
Animal Perfusion and Vessel Painting
Results
Discussion
Conclusions
References
Critical Closing Pressure by Diffuse Correlation Spectroscopy in a Neonatal Piglet Model
Background
Materials and Methods
Anesthesia
Surgery and Physiologic Data Processing
Signal Sampling
Statistical Analyses
Results
Discussion
References
Part IX: Hydrocephalus and Cerebrospinal Fluid Biophysics
Diffusion and Flow MR Imaging to Investigate Hydrocephalus Patients Before and After Endoscopic Third Ventriculostomy
Introduction
Materials and Methods
Statistics
Results
DTI Analysis
Flow Analysis
Discussion
References
Lower Breakpoint of Intracranial Amplitude-Pressure Relationship in Normal Pressure Hydrocephalus
Introduction
Materials and Methods
Results
Discussion
References
Single Center Experience in Cerebrospinal Fluid Dynamics Testing
Introduction
Materials and Methods
Results
Discussion
References
Why Hydrocephalus Patients Suffer When the Weather Changes: A New Hypothesis
Introduction
Methods
Results
Discussion
Conclusion
References
Transcranial Doppler Plateau Wave in a Patient with Pseudo-Chiari Malformation
Introduction
Case Report
Discussion
References
Telemetric Intracranial Pressure: A Snapshot Does not Give the Full Story
Introduction
Materials and Methods
Results
Discussion
References
Noninvasive Intracranial Pressure Assessment in Patients with Suspected Idiopathic Intracranial Hypertension
Introduction
Materials and Methods
Patients
Monitoring
Results
Discussion
Limitations
Conclusion
References
Should the Impact of Postural Change of Intracranial Pressure After Surgical Repair of Skull Base Cerebrospinal Fluid Leaks Be Considered? A Preliminary Survey
Introduction
Materials and Methods
Results
Resting Position
Exceptions to Resting Position
Discussion
Conclusion
References
Assessment of Pressure-Volume Index During Lumbar Infusion Study: What Is the Optimal Method?
Introduction
Material and Methods
Results
Discussion
References
Postural Regulation of Intracranial Pressure: A Critical Review of the Literature
Introduction
Method
Results
ICP Behaviour During Postural Changes
The Spinal Buffer
Jugular Collapse
Discussion
References
Differences in Cerebrospinal Fluid Dynamics in Posttraumatic Hydrocephalus Versus Atrophy, Including Effect of Decompression and Cranioplasty
Introduction
Material and Methods
Patient Selection
Data Collection and Analysis
Results
Groupings
Imaging
Effect of Cranioplasty
Discussion
References
Global Cerebral Autoregulation, Resistance to Cerebrospinal Fluid Outflow and Cerebrovascular Burden in Normal Pressure Hydrocephalus
Introduction
Material and Methods
Patients, Data Collection, and Processing
Statistical Analysis
Results
Predictive Power of Individual Parameters
Predictive Power of Combined Variables
Discussion
Influence of Hypertension and Autoregulation on Rout
Arterial Blood Pressure and Autoregulation in NPH
Clinical Applications
Ethical Approval and Consent to Participate
Consent for Publication
References
Comparison of Assessment for Shunting with Infusion Studies Versus Extended Lumbar Drainage in Suspected Normal Pressure Hydrocephalus
Introduction
Material and Methods
Results
Discussion
Rout ≥11 and >20 Versus ELD Response
Rout
Recommend Papers

Intracranial Pressure and Neuromonitoring XVII (Acta Neurochirurgica Supplement, 131)
 3030594351, 9783030594350

  • 0 0 0
  • Like this paper and download? You can publish your own PDF file online for free in a few minutes! Sign Up
File loading please wait...
Citation preview

Acta Neurochirurgica Supplement 131

Bart Depreitere Geert Meyfroidt Fabian Güiza   Editors

Intracranial Pressure and Neuromonitoring XVII

Acta Neurochirurgica Supplement 131 Series Editor Hans-Jakob Steiger Department of Neurosurgery Heinrich Heine University Düsseldorf, Germany

ACTA NEUROCHIRURGICA’s Supplement Volumes provide a unique opportunity to publish the content of special meetings in the form of a Proceedings Volume. Proceedings of international meetings concerning a special topic of interest to a large group of the neuroscience community are suitable for publication in ACTA NEUROCHIRURGICA. Links to ACTA NEUROCHIRURGICA’s distribution network guarantee wide dissemination at a comparably low cost. The individual volumes should comprise between 120 and max. 250 printed pages, corresponding to 20-50 papers. It is recommended that you get in contact with us as early as possible during the preparatory stage of a meeting. Please supply a preliminary program for the planned meeting. The papers of the volumes represent original publications. They pass a peer review process and are listed in PubMed and other scientific databases. Publication can be effected within 6 months. Hans-Jakob Steiger is the Editor of ACTA NEUROCHIRURGICA’s Supplement Volumes. Springer Verlag International is responsible for the technical aspects and calculation of the costs. If you decide to publish your proceedings in the Supplements of ACTA NEUROCHIRURGICA, you can expect the following: • An editing process with editors both from the neurosurgical community and professional language editing. After your book is accepted, you will be assigned a developmental editor who will work with you as well as with the entire editing group to bring your book to the highest quality possible. • Effective text and illustration layout for your book. • Worldwide distribution through Springer-Verlag International’s distribution channels. More information about this series at http://www.springer.com/series/4

Bart Depreitere  •  Geert Meyfroidt Fabian Güiza Editors

Intracranial Pressure and Neuromonitoring XVII

Editors Bart Depreitere Department of Neurosurgery University Hospitals Leuven Leuven Belgium

Geert Meyfroidt Department of Intensive Care Medicine University Hospitals Leuven Leuven Belgium

Fabian Güiza Department of Intensive Care Medicine University Hospitals Leuven Leuven Belgium

ISSN 0065-1419     ISSN 2197-8395 (electronic) Acta Neurochirurgica Supplement ISBN 978-3-030-59435-0    ISBN 978-3-030-59436-7 (eBook) https://doi.org/10.1007/978-3-030-59436-7 © Springer Nature Switzerland AG 2021, corrected publication 2021, 2022 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Preface (17th International Conference on Intracranial Pressure and Neuromonitoring)

Since its first edition in 1972, the International Symposium on Intracranial Pressure and Neuromonitoring (also called the ICP Conference) has been an excellent high level and multidisciplinary forum for the exchange of ideas and results on clinical management and research associated with the monitoring of intracranial pressure, cerebrovascular autoregulation, and additional physiological and metabolic signals of the brain relevant to conditions as traumatic brain injury, subarachnoid hemorrhage, stroke, spinal cord injury, hydrocephalus, and cerebrovascular fluid disorders. What initially started with the investigation of the information concealed within the ICP signal and the association with clinical variables, has expanded over the past decades to include advanced imaging methods, metabolic monitoring, and sophisticated mathematical modeling. One of the great strengths of the ICP Conference has always been that it brings together all the disciplines involved and facilitates direct communication between neuroscientists, engineers, computer scientists, mathematicians, and clinicians from a variety of backgrounds. In all of the fascinating developments that were subjects of the ICP Conferences, the dedication to those who suffer devastating acute brain and spinal cord injuries and cerebrospinal fluid disorders has always remained central. The 17th ICP Conference was held in Leuven, Belgium from September 8 through 11 2019 and we were proud to host it. The Conference welcomed 360 delegates from all over the world. It featured 202 contributed presentations and attained a high level of interaction and discussion. In addition, it hosted four satellite events, amongst which a data challenge, ICM+ users group meeting, annual meeting of the Brain-IT group and the 9th annual meeting of CARNet. A cross-section of the research presented in Leuven is included in this Proceedings volume. The 70 papers that were selected for this volume give an accurate insight into current thought and direction in the research on brain monitoring. We are happy to present them and are confident that these contributions will inspire future work and ideas. Therefore, we are already looking forward to the 18th edition of the ICP Conference, that will take place in Cape Town, South Africa in 2022, at which the 50th anniversary of the ICP Conference will be celebrated. The editors wish to thank the ICP2019 Scientific Committee, the International Advisory Committee and Mrs. Marie-Laure Bettens and Ann Moerenhout for their enormous administrative support. Leuven, Belgium  

Bart Depreitere Geert Meyfroidt Fabian Güiza

v

Contents

Part I Neuromonitoring and Management in Adult Traumatic Brain Injury  icrocirculatory Biomarkers of Secondary Cerebral Ischemia M in Traumatic Brain Injury ����������������������������������������������������������������������������������������������  3 Alex Trofimov, Antony Dubrovin, Dmitry Martynov, Darya Agarkova, Ksenia Trofimova, Ann Zorkova, and Denis E. Bragin

 isualization of Intracranial Pressure Insults After Severe Traumatic V Brain Injury: Influence of Individualized Limits of Reactivity����������������������  7 Joseph Donnelly, Frederick A. Zeiler, Fabian Güiza, Erta Beqiri, Simon J. Mitchell, Marcel J. Aries, Marek Czosnyka, and Peter Smielewski

I mpacts of a Pressure Challenge on Cerebral Critical Closing Pressure and Effective Cerebral Perfusion Pressure in Patients with Traumatic Brain Injury������������������������������������������������������������������������������������������ 11 Leandro Moraes, Bernardo Yelicich, Mayda Noble, Alberto Biestro, and Corina Puppo

 emi-automated Computed Tomography Volumetry as a Proxy S for Intracranial Pressure in Patients with Severe Traumatic Brain Injury: Clinical Feasibility Study�������������������������������������������������������������������������������� 17 Ilse H. van de Wijgert, Jacobus F. A. Jansen, Jeanette Tas, Fred A. Zeiler, Paulien H. M. Voorter, Vera H. J. van Hal, and Marcel J. Aries

 rrors and Consequences of Inaccurate Estimation of Mean E Blood Flow Velocity in Cerebral Arteries���������������������������������������������������������������� 23 Andras Czigler, Marta Fedriga, Erta Beqiri, Afroditi D. Lalou, Leanne A. Calviello, Manuel Cabeleira, Peter Toth, Peter Smielewski, and Marek Czosnyka

 nalysis of the Association Between Lung Function and Brain A Tissue Oxygen Tension in Severe Traumatic Brain Injury ������������������������������ 27 Shadnaz Asgari, Chiara Robba, Erta Beqiri, Joseph Donnelly, Amit Gupta, Rafael Badenes, Mypinder Sekhon, Peter J. Hutchinson, Paolo Pelosi, and Arun Gupta

 omparison of Two Intracranial Pressure Calculation Methods C and Their Effects on the Mean Intracranial Pressure and Intracranial Pressure Dose�������������������������������������������������������������������������������������������� 31 Ka Hing Chu, Erta Beqiri, Marek Czosnyka, and Peter Smielewski

vii

viii

 xternal Hydrocephalus After Traumatic Brain Injury: E Retrospective Study of 102 Patients������������������������������������������������������������������������ 35 Laurent Gergelé, Romain Manet, A. Kolias, Marek Czosnyka, A. Lalou, Peter Smielewski, Peter J. Hutchinson, and Zofia H. Czosnyka

 nalysis of Cardio-Cerebral Crosstalk Events in an Adult Cohort A from the CENTER-TBI Study������������������������������������������������������������������������������������������ 39 Giovanna Maria Dimitri, Erta Beqiri, Marek Czosnyka, Ari Ercole, Peter Smielewski, Pietro Lio, and CENTER-TBI High Resolution Substudy Participants and Investigators

 erebrovascular Consequences of Elevated Intracranial Pressure C After Traumatic Brain Injury���������������������������������������������������������������������������������������� 43 Leanne Alexis Calviello, Frederick A. Zeiler, Joseph Donnelly, András Czigler, Andrea Lavinio, Peter J. Hutchinson, Marek Czosnyka, and Peter Smielewski

Part II Neuromonitoring and Management in Adult Nontraumatic Brain Injury  ssessment of Cerebral Autoregulation in the Perifocal Zone A of a Chronic Subdural Hematoma ���������������������������������������������������������������������������� 51 Svetlana Trofimova, Alex Trofimov, Antony Dubrovin, Darya Agarkova, Ksenia Trofimova, Michael Dobrzeniecki, Ann Zorkova, and Denis E. Bragin

 oninvasive Intracranial Pressure Monitoring in Chronic N Stroke Patients with Sedentary Behavior: A Pilot Study�������������������������������� 55 Gabriela Nagai Ocamoto, Deusdedit Lineu Spavieri Junior, Jean Alex Matos Ribeiro, Gustavo Henrique Frigieri Vilela, Aparecida Maria Catai, and Thiago Luiz Russo

 se of Clustering to Investigate Changes in Intracranial Pressure U Waveform Morphology in Patients with Ventriculitis�������������������������������������� 59 Murad Megjhani, Kalijah Terilli, Aaron Kaplan, Brendan K. Wallace, Ayham Alkhachroum, Xiao Hu, and Soojin Park

 erioperative Dynamics of Intracranial B-waves of Blood Flow P Velocity in the Basal Cerebral Arteries in Patients with Brain Arteriovenous Malformation �������������������������������������������������������������������������������������� 63 Vladimir Semenyutin, Vugar Aliev, Grigory Panuntsev, and Andreas Patzak

Part III Neuromonitoring and Management in Adult Mixed Brain Injury Populations  ffects of Hyperthermia on Intracranial Pressure and Cerebral E Autoregulation in Patients with an Acute Brain Injury������������������������������������ 71 Andrey Oshorov, Anastasya Baranich, Alexander Polupan, Alexander Sychev, Ivan Savin, and Alexander Potapov

 Comparative Study of the Effects of Early Versus Late A Cranioplasty on Cognitive Function������������������������������������������������������������������������ 75 Carla B. Rynkowski, Chiara Robba, Ricardo Vigolo de Oliveira, Rodrigo Fabretti, Thais Malickovski Rodrigues, Angelos G. Kolias, Guilherme Finger, Marek Czosnyka, and Marino Muxfeldt Bianchin

Contents

Contents

ix

 ffects of Cranioplasty After Decompressive Craniectomy on E Neurological Function and Cerebral Hemodynamics in Traumatic Versus Nontraumatic Brain Injury ���������������������������������������������������������������������������� 79 Carla B. Rynkowski, Chiara Robba, Melina Loreto, Ana Carolina Wickert Theisen, Angelos G. Kolias, Guilherme Finger, Marek Czosnyka, and Marino Muxfeldt Bianchin

 rain Multimodal Monitoring in Severe Acute Brain Injury: B Is It Relevant to Patient Outcome and Mortality?���������������������������������������������� 83 Elisabete Monteiro, António Ferreira, Edite Mendes, Cláudia Camila Dias, Marek Czosnyka, José Artur Paiva, and Celeste Dias

 ong-Term Outcome After Decompressive Craniectomy L in a Developing Country������������������������������������������������������������������������������������������������ 87 Carla B. Rynkowski, Luciano Silveira Basso, Angelos G. Kolias, and Marino Muxfeldt Bianchin

Predictors of Successful Extubation in Neurocritical Care Patients���������� 91 Walter Videtta, Jeanette Vallejos, Gisela Roda, Hugo Collazos, Nico Naccarelli, Alex Tamayo, Noelia Calderón, Ariadna Bairaclioti, Martín Yoshida, Gabriel Vandaele, Ruth Toloza, Juan Quartino, Pablo Dunne, Maria G. Rodríguez, Marcos A. Teheran Wilches, Jhimmy J. Morales Vasquez, Brenda L. Fernandez Fernandez, and On Behalf of the Merlo ICU Research Group

Part IV Neuromonitoring and Management in the Pediatric Population I mpaired Autoregulation Following Resuscitation Correlates with Outcome in Pediatric Patients: A Pilot Study�������������������������������������������� 97 Julian Zipfel, Konstantin L. Hockel, Ines Gerbig, Ellen Heimberg, Martin U. Schuhmann, and Felix Neunhoeffer

 rain Biomarkers in Children After Mild and Severe B Traumatic Brain Injury����������������������������������������������������������������������������������������������������103 Elena G. Sorokina, Zhanna B. Semenova, Valentin P. Reutov, Elena N. Arsenieva, Olga V. Karaseva, Andrey P. Fisenko, Leonid M. Roshal, and Vsevolod G. Pinelis

 ecompressive Craniectomy for Traumatic Intracranial D Hypertension in Children����������������������������������������������������������������������������������������������109 Zhanna B. Semenova, Semen Meshcheryakov, Valery Lukyanov, and Sergey Arsenyev

 se of Direct Intracranial Pressure and Brain Tissue Oxygen U Monitoring in Perioperative Management of Patients with Moyamoya Disease����������������������������������������������������������������������������������������������������������115 Maya Kommer, Michael Canty, Emer Campbell, Meharpal Sangra, Anthony Amato-Watkins, Simon Young, Christopher Hawthorne, Laura Moss, Ian Piper, Martin Shaw, and Roddy O’Kane

Part V Neuromonitoring Technology  ariability of the Optic Nerve Sheath Diameter on the Basis V of Sex and Age in a Cohort of Healthy Volunteers ��������������������������������������������121 Karthikka Chandrapatham, Danilo Cardim, Marek Czosnyka, Alessandro Bertuccio, Anna Di Noto, Francesco Corradi, Joseph Donnelly, Paolo Pelosi, Peter J. Hutchinson, and Chiara Robba

x

 Noninvasive Method for Monitoring Intracranial Pressure A During Postural Changes����������������������������������������������������������������������������������������������125 Michele L. Pierro, Nikole M. Shooshan, Saukhyda Deshmukh, and Gordon B. Hirschman

 rterial and Venous Cerebral Blood Flow Velocities A in Healthy Volunteers������������������������������������������������������������������������������������������������������131 Karthikka Chandrapatham, Danilo Cardim, Francesco Corradi, Mypinder Sekhon, Donald Griesdale, Marek Czosnyka, and Chiara Robba

 omparison of Waveforms Between Noninvasive and Invasive C Monitoring of Intracranial Pressure ������������������������������������������������������������������������135 Inês Gomes, Juliana Shibaki, Bruno Padua, Felipe Silva, Thauan Gonçalves, Deusdedit L. Spavieri-Junior, Gustavo Frigieri, Sérgio Mascarenhas, and Celeste Dias

Part VI Cerebrovascular Autoregulation in Acute Brain Injury and Cardiac Surgery  n Update on the COGiTATE Phase II Study: Feasibility and A Safety of Targeting an Optimal Cerebral Perfusion Pressure as a Patient-Tailored Therapy in Severe Traumatic Brain Injury������������������������143 Jeanette Tas, Erta Beqiri, C. R. van Kaam, Ari Ercole, Gert Bellen, D. Bruyninckx, Manuel Cabeleira, Marek Czosnyka, Bart Depreitere, Joseph Donnelly, Marta Fedriga, Peter J. Hutchinson, D. Menon, Geert Meyfroidt, Annalisa Liberti, J. G. Outtrim, C. Robba, C. W. E. Hoedemaekers, Peter Smielewski, and Marcel J. Aries

 uick Assessment of the Lower Limit of Autoregulation by Use of Q Transcranial Doppler Ultrasound During Cardiac Surgery����������������������������149 Laurent Gergelé, Younes Khadraoui, Romain Manet, and Olivier Desebbe

I nfluence of Patient Demographics on Optimal Cerebral Perfusion Pressure Following Traumatic Brain Injury ����������������������������������������������������������153 Jennifer Young, Laura Moss, Martin Shaw, Elizabeth Cahya, Maya Kommer, and Christopher Hawthorne

 econdary Cerebral Ischemia at Traumatic Brain Injury Is More S Closely Related to Cerebrovascular Reactivity Impairment than to Intracranial Hypertension���������������������������������������������������������������������������������������159 Michael Dobrzeniecki, Alex Trofimov, Dmitry Martynov, Darya Agarkova, Ksenia Trofimova, Zhanna B. Semenova, and Denis E. Bragin

 sability of Noninvasive Counterparts of Traditional U Autoregulation Indices in Traumatic Brain Injury����������������������������������������������163 Andras Czigler, Leanne A. Calviello, Frederick A. Zeiler, Peter Toth, Peter Smielewski, and Marek Czosnyka

 atient’s Clinical Presentation and CPPopt Availability: P Any Association?����������������������������������������������������������������������������������������������������������������167 Annalisa Liberti, Erta Beqiri, Ari Ercole, Manuel Cabeleira, Jeanette Tas, Frederick A. Zeiler, Marek Czosnyka, Peter Smielewski, Marcel J. Aries, and CENTER-TBI High Resolution Substudy Participants and Investigators

Contents

Contents

xi

Optimal Cerebral Perfusion Pressure Based on Intracranial Pressure-Derived Indices of Cerebrovascular Reactivity: Which One Is Better for Outcome Prediction in Moderate/Severe Traumatic Brain Injury?��������������������������������������������������������������������������������������������������173 Alexander Lilja-Cyron, Frederick A. Zeiler, Erta Beqiri, Manuel Cabeleira, Peter Smielewski, and Marek Czosnyka

 ptimal Cerebral Perfusion Pressure Assessed with a O Multi-­Window Weighted Approach Adapted for Prospective Use: A Validation Study��������������������������������������������������������������������������������������������������181 Erta Beqiri, Ari Ercole, Marcel J. Aries, Manuel Cabeleira, Andras Czigler, Annalisa Liberti, Jeanette Tas, Joseph Donnelly, Xiuyun Liu, Marta Fedriga, Ka Hing Chu, Frederick A. Zeiler, Marek Czosnyka, and Peter Smielewski

 onitoring of Cerebrovascular Reactivity in Intracerebral M Hemorrhage and Its Relation with Survival����������������������������������������������������������187 Ana V. Ferreira, Isabel Maia, and Celeste Dias

Part VII Neuroinformatics and Artificial Intelligence  pectral Cerebral Blood Volume Accounting for Noninvasive S Estimation of Changes in Cerebral Perfusion Pressure in Patients with Traumatic Brain Injury������������������������������������������������������������������������������������������193 Danilo Cardim, Peter Smielewski, and Marek Czosnyka

 mpirical Mode Decomposition-Based Method for Artefact E Removal in Raw Intracranial Pressure Signals����������������������������������������������������201 Isabel Martinez-Tejada, Jens E. Wilhjelm, Marianne Juhler, and Morten Andresen

 AQ: A Noise-Resistant Calibration-Independent Compliance R Surrogate������������������������������������������������������������������������������������������������������������������������������207 Andreas Spiegelberg, Matthias Krause, Juergen Meixensberger, and Vartan Kurtcuoglu

 ethodological Consideration on Monitoring Refractory Intracranial M Hypertension and Autonomic Nervous System Activity��������������������������������211 Marta Fedriga, András Czigler, Nathalie Nasr, Frederick A. Zeiler, Erta Beqiri, Stefan Wolf, Shirin K. Frisvolf, Peter Smielewski, and Marek Czosnyka

 valuation of Software for Automated Measurement of E Adherence to ICP-Monitoring Threshold Guideline������������������������������������������217 Anthony Stell, Laura Moss, Christopher Hawthorne, Roddy O’Kane, Maya Kommer, Martin Shaw, and Ian Piper

 ime Series Analysis and Prediction of Intracranial Pressure T Using Time-Varying Dynamic Linear Models ������������������������������������������������������225 Martin Shaw, Chris Hawthorne, Laura Moss, Maya Kommer, Roddy O’Kane, Ian Piper, and On Behalf of the BrainIT Group

 utomatic Pulse Classification for Artefact Removal Using A SAX Strings, a CENTER-TBI Study ������������������������������������������������������������������������������231 Manuel Cabeleira, Marta Fedriga, and Peter Smielewski

xii

 eepClean: Self-Supervised Artefact Rejection for Intensive Care D Waveform Data Using Deep Generative Learning ��������������������������������������������235 Tom Edinburgh, Peter Smielewski, Marek Czosnyka, Manuel Cabeleira, Stephen J. Eglen, and Ari Ercole

 omparison of Two Algorithms Analysing the Intracranial C Pressure Curve in Terms of the Accuracy of Their Start-Point Detection and Resistance to Artefacts��������������������������������������������������������������������243 Anna-Li Schönenberg-Tu, Benjamin Pätzold, Adam Lichota, Christa Raak, Ghaith Al Assali, Friedrich Edelhäuser, Dirk Cysarz, Martin Marsch, and Wolfram Scharbrodt

 lateau Waves of Intracranial Pressure: Methods for Automatic P Detection and Prediction����������������������������������������������������������������������������������������������249 Sofia Moreira, Maria Celeste Dias, and Miguel Velhote Correia

 ython-Embedded Plugin Implementation in ICM+: Novel P Tools for Neuromonitoring Time Series Analysis with Examples Using CENTER-TBI Datasets������������������������������������������������������������������������������������������255 Michał M. Placek, Abdelhakim Khellaf, Benjamin L. Thiemann, Manuel Cabeleira, and Peter Smielewski

Part VIII Laboratory and Translational Research  hysical Model for Investigating Intracranial Pressure with Clinical P Pressure Sensors and Diagnostic Ultrasound: Preliminary Results����������263 Rikke von Barm, Isabel Martinez Tejada, Marianne Juhler, Morten Andresen, and Jens E. Wilhjelm

 ugmented Reality-Assisted Neurosurgical Drain Placement A (ARANED): Technical Note ��������������������������������������������������������������������������������������������267 Frederick Van Gestel, Taylor Frantz, Mumtaz Hussain Soomro, Shirley A. Elprama, Cedric Vannerom, An Jacobs, Jef Vandemeulebroucke, Bart Jansen, Thierry Scheerlinck, and Johnny Duerinck

 ower Limit of Reactivity Assessed with PRx in an Experimental L Setting������������������������������������������������������������������������������������������������������������������������������������275 Erta Beqiri, Ken M. Brady, Jennifer K. Lee, Joseph Donnelly, Frederick A. Zeiler, Marek Czosnyka, and Peter Smielewski

 nalysis of Intracranial Pressure Pulse–Pressure Relationship: A Experimental Validation������������������������������������������������������������������������������������������������279 Katarzyna Kaczmarska, Piotr Śmielewski, Magdalena Kasprowicz, Agnieszka Kazimierska, Antoni Grzanka, Zofia H. Czosnyka, and Marek Czosnyka

 erebrovascular Impedance During Hemodynamic Change C in Rabbits: A Pilot Study������������������������������������������������������������������������������������������������283 Agnieszka Kazimierska, Magdalena Kasprowicz, Michał M. Placek, and Marek Czosnyka

Contents

Contents

xiii

I mproved Cerebral Perfusion Pressure and Microcirculation by Drag Reducing Polymer-Enforced Resuscitation Fluid After Traumatic Brain Injury and Hemorrhagic Shock������������������������������������������������289 Denis E. Bragin, Olga A. Bragina, Alex Trofimov, Lucy Berliba, Marina V. Kameneva, and Edwin M. Nemoto

 ritical Closing Pressure by Diffuse Correlation Spectroscopy C in a Neonatal Piglet Model��������������������������������������������������������������������������������������������295 Leah I. Elizondo, Eric L. Vu, Kathleen K. Kibler, Danielle R. Rios, R. Blaine Easley, Dean Andropoulos, Sebastian Acosta, Craig Rusin, Kenneth Brady, and Christopher J. Rhee

Part IX Hydrocephalus and Cerebrospinal Fluid Biophysics  iffusion and Flow MR Imaging to Investigate Hydrocephalus D Patients Before and After Endoscopic Third Ventriculostomy ��������������������303 Olivier Balédent, Cyrille Capel, Serge Metanbou, and Roger Bouzerar

 ower Breakpoint of Intracranial Amplitude-Pressure L Relationship in Normal Pressure Hydrocephalus����������������������������������������������307 Zofia H. Czosnyka, Afroditi D. Lalou, Eva Nabbanja, Matthew Garnett, Nicole C. Keong, Eric A. Schmidt, D. J. Kim, and Marek Czosnyka

Single Center Experience in Cerebrospinal Fluid Dynamics Testing ��������311 Zofia H. Czosnyka, Marek Czosnyka, Piotr Smielewski, Afroditi D. Lalou, Eva Nabbanja, Matthew Garnett, Slawomir Barszcz, Eric A. Schmidt, Shahan Momjian, Magda Kasprowicz, Gianpaolo Petrella, Brian Owler, Nicole C. Keong, Peter J. Hutchinson, and John D. Pickard

 hy Hydrocephalus Patients Suffer When the Weather W Changes: A New Hypothesis����������������������������������������������������������������������������������������315 Andreas Spiegelberg, Lennart Stieglitz, and Vartan Kurtcuoglu

 ranscranial Doppler Plateau Wave in a Patient with Pseudo-­Chiari T Malformation����������������������������������������������������������������������������������������������������������������������319 Leandro Moraes, Mayda Noble, Bernardo Yelicich, Federico Salle, Karina DiCienzo, Alberto Biestro, and Corina Puppo

 elemetric Intracranial Pressure: A Snapshot Does not Give T the Full Story ����������������������������������������������������������������������������������������������������������������������323 Maya Kommer, Richard G. Boulton, Lynette Loi, Sophie Robinson, Christopher Hawthorne, Martin Shaw, Ian Piper, Laura Moss, Anthony Amato-Watkins, Emer Campbell, Meharpal Sangra, and Roddy O’Kane

 oninvasive Intracranial Pressure Assessment in Patients N with Suspected Idiopathic Intracranial Hypertension������������������������������������325 Bernhard Schmidt, Marek Czosnyka, Danilo Cardim, and Bernhard Rosengarten

 hould the Impact of Postural Change of Intracranial Pressure S After Surgical Repair of Skull Base Cerebrospinal Fluid Leaks Be Considered? A Preliminary Survey ��������������������������������������������������������������������329 Valentin Favier, Louis Crampette, Laurent Gergelé, Generoso De Cristofaro, Emmanuel Jouanneau, and Romain Manet

xiv

 ssessment of Pressure-Volume Index During Lumbar Infusion A Study: What Is the Optimal Method? ����������������������������������������������������������������������335 Alexandra Vallet, Laurent Gergelé, Emmanuel Jouanneau, Eric A. Schmidt, and Romain Manet

 ostural Regulation of Intracranial Pressure: A Critical Review P of the Literature ����������������������������������������������������������������������������������������������������������������339 Laurent Gergelé and Romain Manet

 ifferences in Cerebrospinal Fluid Dynamics in Posttraumatic D Hydrocephalus Versus Atrophy, Including Effect of Decompression and Cranioplasty ��������������������������������������������������������������������������������������������������������������343 Virginia Levrini, Afroditi D. Lalou, Zofia H. Czosnyka, Angelos G. Kolias, Laurent Gergelé, Matthew Garnett, Peter J. Hutchinson, and Marek Czosnyka

 lobal Cerebral Autoregulation, Resistance to Cerebrospinal Fluid G Outflow and Cerebrovascular Burden in Normal Pressure Hydrocephalus ������������������������������������������������������������������������������������������������������������������349 Afroditi D. Lalou, Shadnaz Asgari, Matthew Garnett, Eva Nabbanja, Marek Czosnyka, and Zofia H. Czosnyka

 omparison of Assessment for Shunting with Infusion C Studies Versus Extended Lumbar Drainage in Suspected Normal Pressure Hydrocephalus�������������������������������������������������������������������������������355 Virginia Levrini, Matthew Garnett, Eva Nabbanja, Marek Czosnyka, Zofia H. Czosnyka, and Afroditi D. Lalou

 he Role of Cerebrospinal Fluid Dynamics in Normal Pressure T Hydrocephalus Diagnosis and Shunt Prognostication������������������������������������359 Afroditi D. Lalou, Shadnaz Asgari, Marek Czosnyka, Eva Nabbanja, Matthew Garnett, and Zofia H. Czosnyka

Part X Spinal Cord Injury  afety and Feasibility of Lumbar Cerebrospinal Fluid Pressure S and Intraspinal Pressure Studies in Cervical Stenosis: A Case Series������������������������������������������������������������������������������������������������������������������������367 Carl Moritz Zipser, José Miguel Spirig, José Aguirre, Anna-Sophie Hofer, Nikolai Pfender, Markus Hupp, Armin Curt, Mazda Farshad, and Martin Schubert

 orrection to: Comparison of Two Algorithms Analysing the C Intracranial Pressure Curve in Terms of the Accuracy of Their Start-Point Detection and Resistance to Artefacts����������������������������������������������C1 Anna-Li Schönenberg-Tu, Benjamin Pätzold, Adam Lichota, Christa Raak, Ghaith Al Assali, Friedrich Edelhäuser, Dirk Cysarz, Martin Marsch, and Wolfram Scharbrodt

 orrection to: Why Hydrocephalus Patients Suffer When the Weather C Changes: A New Hypothesis������������������������������������������������������������������������������������������C3 Andreas Spiegelberg, Lennart Stieglitz, and Vartan Kurtcuoglu

Contents

Part I Neuromonitoring and Management in Adult Traumatic Brain Injury

Microcirculatory Biomarkers of Secondary Cerebral Ischemia in Traumatic Brain Injury Alex Trofimov, Antony Dubrovin, Dmitry Martynov, Darya Agarkova, Ksenia Trofimova, Ann Zorkova, and Denis E. Bragin

Introduction

Severity Score (ISS) greater than 60. All patients were subjected to multiphase PCT using a 64-slice Philips Ingenuity CT tomograph (Philips Medical Systems, Cleveland, OH, Secondary cerebral ischemia (SCI) is still one of the leading USA). PCT was performed 1–4  days after TBI (mean causes of mortality and disability in patients who have expe3.3  ±  0.5  days). The perfusion examination report included rienced a traumatic brain injury (TBI) [1]; however, changes initial contrast-free CT of the brain. Further extended scanning in microcirculation parameters that occur with posttraumatic with a contrast agent was performed within 60 s, focusing on SCI still remain underinvestigated [2]. The purpose of this 16 areas of interest, 160 mm in thickness. The scanning work was to study changes in cerebral microcirculation parameters were 160 kVp, 160 mA, 70 mAs, 512 × 512. The parameters in the development of SCI. contrast agent Ultravist 370 (Schering, Berlin, Germany) was administered, using a syringe injector (Medrad Stellant, Bayer HealthCare, Whippany, NJ, USA), into a peripheral vein Materials and Methods through a standard 20 G catheter at a rate of 4–5 mL/s in a dose of 30–50  mL per examination. After the scanning, the This retrospective, observational, nonrandomized, single-­ data were transferred to a KIR picture-archiving and commucenter study was conducted as an analysis of a prospectively nication system (PACS) (JSC, Kazan, Russia) and a Philips maintained database cohort (2013–2018) and included patients Extended Brilliance Workspace workstation (Philips with a head injury and unilateral foci of posttraumatic isch- HealthCare, Amsterdam, the Netherlands) with MATLAB emia. The protocol of the study was reviewed and approved by 2013b (The MathWorks, Natick, MA, USA). Artery and vein the institutional ethics committee, and conformed to the stan- marks were automatically recorded, followed by manual condards of the Declaration of Helsinki. Neuromonitoring param- trol of indices in the time–concentration diagram. The region eters were measured as part of standard patient care, and the of interest was established on the basis of subcortical areas of data were archived in a physiological monitoring database. the middle cerebral artery (MCA). Errors introduced by delay Age, sex, injury severity, and clinical condition data were and dispersion of the contrast bolus before arrival in the cererecorded in this database at the time of monitoring. The study bral circulation were corrected by use of a block-­circulant inclusion criteria were as follows: moderate or severe TBI deconvolution algorithm. Quantitative perfusion indices, within 6  h after head injury, with a Glasgow Coma Scale including cerebral blood flow (CBF), were calculated on a (GCS) score ≤ 12, and unilateral foci of posttraumatic isch- voxel-wise basis and were used to generate color-­coded maps. emia on perfusion computed tomography (PCT). We excluded Voxels with CBF >100 mL/100 g/min or cerebral blood volpatients who were younger than 16  years or had an Injury ume (CBV) >8 mL/100 g were assumed to contain vessels and removed from the perfusion map [3]. Core infarction on PCT was defined as CBV 38% in comparison with the contralateral hemisphere K. Trofimova · A. Zorkova Department of Neurosurgery, Privolzhsky Research Medical [4]. Immediately after PCT, Doppler ultrasound of the MCA University, Nizhniy Novgorod, Russia was recorded bilaterally with 2 MHz probes (Sonomed 300 M, D. E. Bragin Spektromed, Moscow, Russia). A Centaurus 2.0 neuromonitor Lovelace Biomedical Research Institute, Albuquerque, NM, USA (Privolzhsky State Medical University, Nizhny Novgorod, Department of Neurosurgery, University of New Mexico School of Russia) was used to monitor the cerebral complex during the Medicine, Albuquerque, NM, USA B. Depreitere et al. (eds.), Intracranial Pressure and Neuromonitoring XVII, Acta Neurochirurgica Supplement 131, https://doi.org/10.1007/978-3-030-59436-7_1, © Springer Nature Switzerland AG 2021

3

4

A. Trofimov et al.

study. Arterial blood pressure and its amplitude (MAPamp) were measured noninvasively using a Cardex MAP-03 monitor (Cardex, Nizhny Novgorod, Russia). The cerebrovascular resistance (CVR), cerebral arterial compliance (CAC), cerebrovascular time constant (CTC), and critical closing pressure (CCP) were measured using a complex neuromonitoring, as described previously [5, 6].

Statistical Analysis To determine whether the data were normally distributed, a Shapiro–Wilk test was used. The data were expressed as mean ± standard deviation. A statistical analysis of all results was performed using a paired Student’s t test. To specify the structure of the relationship of the variables, factor analysis was performed. We used a two-factor model with a raw varimax rotation. P values 25 cm3

24

11.9

III

Swelling

28

12.7

IV

Shift

37

16.8

V

Evacuated mass lesion

113

51.4

VI

Nonevacuated mass lesion

0

0

values were significantly higher than normal reference values (P