Clinical study of craniospinal compliance non-invasive monitoring method.

BACKGROUND: The ability to quantify non-invasively the effect of posture on intracranial physiology by using cine phase-contrast MRI may lead to the development of new diagnostic tests to evaluate such functions as regulation of CBF and ICP, and the effect of pathologies on these functions. METHODS: Results similar to MRI technology can be obtained using non-invasive ultrasonic method (Vittamed) for intracranial blood volume pulse wave (IBVPW) measurement and intracraniospinal compliance (ICC) monitoring. FINDINGS: IBVPW have been investigated in supine and upright positions of healthy volunteers using Vittamed technology. A group of 13 healthy volunteers (nine females, four males, mean age 25.1 +/- 3.4) was studied. More than 3,000 IBVPW were analysed in order to show the difference of shape and amplitude in supine and upright positions. Averaged shape of ten IBVPW waves was presented in the normalized window with dimensions 1.0 x 1.0. CONCLUSIONS: The results show significant difference between averaged IBVPW shapes in upright (highest intracraniospinal compliance) and supine (lower intracraniospinal compliance) body positions. Body posture caused IBVPW subwave P2 and P3 changes deltaP2 = 18% and deltaP3 = 11%. Amplitude of IBVPW in upright body position was significantly higher than in the supine one. The value of IBVPW amplitude's ratio in supine and upright positions was 1.55 +/- 0.61.

The clinical application of non-invasive intracranial blood volume pulse wave monitoring.

An ultrasonic method was used to non-invasively measure intracranial blood volume (IBV) pulse waveforms. This technology has previously shown a strong association between invasively recorded ICP pulse waves and non-invasively recorded IBV pulse waves. The objective of the present study was to investigate the diagnostic value of non-invasively measured IBV pulse waves in the cases of different pathologies. A total of 75 patients were examined and these included cases of acute, chronic and stabilized hydrocephalus, spinal cord injury and terminal blood flow. These were compared to a control group of 53 healthy volunteers. The object of comparison was normalized and averaged IBV pulse waves. Pathological IBV pulse waveforms were compared with IBV pulse waveforms of the normal group using sub-wave values, the area under waveform curve and the Euclidean distance calculation. The non-invasively measured IBV pulse waveform is not significantly dependent on acoustic path, gender or age. A detectable change in IBV pulse waveform shape was observed in situations when disturbance in intracranial hydrodynamics was present, e.g. during hypoventilation tests, in cases of terminal blood flow and hydrocephaly, depicting the level of hydrocephalus activity and the patient's compensatory capabilities as well as the effect of treatment.