Article
Health Care Sciences & Services
Sergio Brasil, Davi Jorge Fontoura Solla, Ricardo de Carvalho Nogueira, Manoel Jacobsen Teixeira, Luiz Marcelo Sa Malbouisson, Wellingson da Silva Paiva
Summary: A new noninvasive tool, B4C, was validated to assess intracranial pressure waveform morphology in neurocritical patients and correlated with invasive catheter monitoring. The study showed that B4C provided biometric amplitude ratios correlated with ICPW variation morphology and is useful for noninvasive critical care monitoring.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Review
Biophysics
Agnieszka Kazimierska, Romain Manet, Alexandra Vallet, Eric Schmidt, Zofia Czosnyka, Marek Czosnyka, Magdalena Kasprowicz
Summary: Continuous monitoring of mean intracranial pressure (ICP) is crucial in neurocritical care. The ability of the cerebrospinal system to buffer changes in volume without substantial increases in ICP, known as cerebrospinal pressure-volume compensation, is important in preventing adverse effects associated with ICP elevation. Current assessment methods are not suitable for brain injured patients. Recent studies have suggested that the ICP pulse waveform may provide information on cerebrospinal compensatory reserve.
PHYSIOLOGICAL MEASUREMENT
(2023)
Review
Critical Care Medicine
Daniel Agustin Godoy, Sergio Brasil, Corrado Iaccarino, Wellingson Paiva, Andres M. Rubiano
Summary: For decades, the management of severe acute brain injury has focused on controlling intracranial hypertension (IH). However, the thresholds for determining IH have changed over time without clear evidence. Recent developments in understanding intracranial content dynamics and monitoring techniques suggest that targeting intracranial compliance (ICC) may be a more reliable approach. This perspective review discusses the concept of intracranial compartmental syndrome (ICCS) and proposes an integrative model for assessing IH and ICC using modern invasive and noninvasive techniques.
Article
Critical Care Medicine
Agnieszka Kazimierska, Agnieszka Uryga, Cyprian Mataczynski, Marek Czosnyka, Erhard W. Lang, Magdalena Kasprowicz
Summary: This study investigates the relationship between intracranial pressure pulse shape and CT features in traumatic brain injury patients. The results reveal that pulse shape index is associated with intracranial mass lesions (including midline shift and space-occupying lesions) and correlates significantly with the extent of the lesions and CT scores.
Article
Neurosciences
Sergio Brasil, Davi Jorge Fontoura Solla, Ricardo de Carvalho Nogueira, Manoel Jacobsen Teixeira, Luiz Marcelo Sa Malbouisson, Wellingson Silva Paiva
Summary: This study aimed to compare the impact of skull defects and decompressive craniectomy (DC) on intracranial pressure pulse waveform (ICPW) features by analyzing the variations in ICPW features under different mean ICP values. The results showed that intracranial compliance was significantly more impaired among decompressive craniectomy patients, although ICPW indicated DC to be protective for further influences of ICP elevations over the brain. The analysis of ICPW may serve as an alternative to real-time intracranial compliance assessment.
Article
Cardiac & Cardiovascular Systems
Matheus Martins da Costa, Ana Luiza Lima Sousa, Mikaelle Costa Correia, Sayuri Inuzuka, Thiago Oliveira Costa, Priscila Valverde O. Vitorino, Polyana Vulcano de Toledo Piza, Gustavo Frigieri, Antonio Coca, Weimar Kunz Sebba Barroso
Summary: This study evaluated intracranial pressure waveform in long-term essential hypertensive patients and found a prevalence of 45.6% of intracranial hypertension, particularly in women and those over 65 years old. This highlights the importance of evaluating intracranial pressure behavior in these patients and raises questions about the ability of cerebral autoregulation and vascular barriers to protect the brain.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Neurosciences
Lauren M. Green, Thomas Wallis, Martin U. Schuhmann, Matthias Jaeger
Summary: Idiopathic normal pressure hydrocephalus (iNPH) and late-onset idiopathic aqueductal stenosis (LIAS) are two forms of chronic adult hydrocephalus with different etiology, showing differences in intracranial pressure (ICP) levels and pulse wave amplitudes, while both exhibit impaired reserve capacity and compliance. Additionally, iNPH patients tend to be older compared to LIAS patients.
FLUIDS AND BARRIERS OF THE CNS
(2021)
Article
Computer Science, Information Systems
Hack-Jin Lee, Hakseung Kim, Young-Tak Kim, Kanghee Won, Marek Czosnyka, Dong-Joo Kim
Summary: The study proposed a novel parameter for predicting potentially life-threatening IH events and developed a machine learning model for predicting LTH events. By analyzing the association between LTH parameters and mortality, the model demonstrated reasonable predictive capacity for mortality. The CatBoost model was able to anticipate whether an IH event would progress into an LTH event.
IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS
(2021)
Article
Clinical Neurology
Agnieszka P. Zakrzewska, Michal M. Placek, Marek Czosnyka, Magdalena Kasprowicz, Erhard W. Lang
Summary: The study found that there is a significant correlation between HHC and ICP during monitoring, particularly during ICP plateau waves, where HHC decreases significantly.
ACTA NEUROCHIRURGICA
(2021)
Article
Clinical Neurology
Sergio Brasil, Daniel A. Godoy, Wellingson S. Paiva
Summary: Based on recent research, intracranial pressure management based on predetermined thresholds is not accurate, and physicians need to combine other neuromonitoring techniques to comprehensively evaluate patients' neurological conditions.
WORLD NEUROSURGERY
(2023)
Article
Critical Care Medicine
Frank A. Rasulo, Stefano Calza, Chiara Robba, Fabio Silvio Taccone, Daniele G. Biasucci, Rafael Badenes, Simone Piva, Davide Savo, Giuseppe Citerio, Jamil R. Dibu, Francesco Curto, Martina Merciadri, Paolo Gritti, Paola Fassini, Soojin Park, Massimo Lamperti, Pierre Bouzat, Paolo Malacarne, Arturo Chieregato, Rita Bertuetti, Raffaele Aspide, Alfredo Cantoni, Victoria McCredie, Lucrezia Guadrini, Nicola Latronico
Summary: This study evaluated the reliability of transcranial Doppler (ICPtcd) as a screening test for excluding intracranial hypertension. The results showed that ICPtcd has a high negative predictive value and can accurately exclude intracranial hypertension. It can be useful in situations where invasive methods are not available or cannot be used.
Article
Critical Care Medicine
Jennifer C. Laws, E. Haley Vance, Kristina A. Betters, Jessica J. Anderson, Sydney Fleishman, Christopher M. Bonfield, John C. Wellons III, Meng Xu, James C. Slaughter, Dario A. Giuse, Neal Patel, Lori C. Jordan, Michael S. Wolf
Summary: This retrospective observational study assessed the acute effects of ketamine on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in children with severe traumatic brain injury (TBI). The results showed that ketamine reduced ICP during ICP crises, but had no significant effect when used for sedation. These findings suggest that ketamine may be considered as a treatment for intracranial hypertension in children with severe TBI.
CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Tatiana Birg, Fabrizio Ortolano, Eveline J. A. Wiegers, Peter Smielewski, Yan Savchenko, Bogdan A. Ianosi, Raimund Helbok, Sandra Rossi, Marco Carbonara, Tommaso Zoerle, Nino Stocchetti
Summary: Fever is frequent after traumatic brain injury (TBI), and it may influence brain physiology by affecting intracranial pressure (ICP) and cerebral perfusion pressure (CPP). A study revealed an association between brain temperature (BT) exceeding 37.5 degrees Celsius and higher ICP levels, but not for lower BT ranges. Rapid temperature changes seem to have a significant impact on ICP and CPP.
NEUROCRITICAL CARE
(2021)
Article
Clinical Neurology
Agnieszka Uryga, Arkadiusz Ziolkowski, Agnieszka Kazimierska, Agata Pudelko, Cyprian Mataczynski, Erhard W. Lang, Marek Czosnyka, Magdalena Kasprowicz
Summary: This study aimed to analyze cerebrospinal pressure-volume compensation in traumatic brain injury (TBI) patients using intracranial pressure (ICP) pulse waveform analysis. The results showed that the pulse amplitude of ICP (AMP), high frequency centroid (HFC), and higher harmonics centroid (HHC) could predict mortality, while the pulse shape index (PSI) could potentially serve as an early warning sign of intracranial hypertension. Among patients with low ICP, elevated AMP, PSI, and HFC were associated with poor outcome.
JOURNAL OF NEUROSURGERY
(2023)
Review
Medicine, General & Internal
Charikleia S. Vrettou, Spyros D. Mentzelopoulos
Summary: In this review, the treatment of intracranial hypertension in patients with severe traumatic brain injury is discussed, including the rationale for the approach, the benefits and risks of different therapeutic modalities, and how it can be adapted in low- and middle-income countries.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Anesthesiology
Jeconias Neiva Lemos, Lavinia Dantas Cardoso Neiva Lemos, Davi Jorge Fontoura Solla, Danilo Dantas Cardoso Neiva Lemos, Norma Sueli Pinheiro Modolo
Summary: This study used the Heidelberg Peri-anaesthetic Questionnaire to evaluate the peri-anesthetic care provided by the anesthesia service in an ambulatory surgery unit. It found that patients were dissatisfied with fear of anesthesia and surgery, feeling cold, the urgent need to urinate, pain at the surgical site, and the team's level of concern and speed of response in relieving the patient's pain.
BRAZILIAN JOURNAL OF ANESTHESIOLOGY
(2023)
Article
Geriatrics & Gerontology
Renan Salomao Rodrigues, Nicollas Nunes Rabelo, Joao Paulo Mota Telles, Davi Jorge Fontoura Solla, Antonio Carlos Samaia da Silva Coelho, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
Summary: The thickness and area of the temporal muscle, as indicators of sarcopenia, are associated with functional outcomes after interventions for intracranial aneurysms (IAs). A lower temporal muscle thickness below 6.25 mm predicts unfavorable functional outcomes.
Review
Endocrinology & Metabolism
Ronney B. Panerai, Patrice Brassard, Joel S. Burma, Pedro Castro, Jurgen A. H. R. Claassen, Johannes J. van Lieshout, Jia Liu, Samuel Je Lucas, Jatinder S. Minhas, Georgios D. Mitsis, Ricardo C. Nogueira, Shigehiko Ogoh, Stephen J. Payne, Caroline A. Rickards, Andrew D. Robertson, Gabriel D. Rodrigues, Jonathan D. Smirl, David M. Simpson
Summary: This study improved the evaluation method of cerebral autoregulation (CA) by introducing guidelines for data acquisition, analysis, and reporting, and proposed new recommendations to reflect recent advances in the field. The implementation of these recommendations is crucial for improving the reliability and reproducibility of studies.
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
(2023)
Article
Critical Care Medicine
Natalia Vasconcellos de Oliveira Souza, Carolina Rouanet, Davi Jorge Fontoura Solla, Caio Vinicius Barroso de Lima, Caio Augusto de Souza, Flavio Rezende, Maramelia Miranda Alves, Airton Leonardo de Oliveira Manuel, Feres Chaddad Neto, Michel Frudit, Gisele Sampaio Silva
Summary: The study evaluated a multiethnic cohort of aSAH patients and used the VASOGRADE grading scale to predict the risk of cerebral ischemia and functional outcomes. It found that VASOGRADE-Green accurately predicted patients' ischemic risk and favorable recovery outcomes.
NEUROCRITICAL CARE
(2023)
Article
Physiology
Sergio Brasil, Ricardo C. Nogueira, Angela S. M. Salinet, Marcia H. Yoshikawa, Manoel J. Teixeira, Wellingson Paiva, Luiz M. S. Malbouisson, Edson Bor-Seng-Shu, Ronney B. Panerai
Summary: This study found that in patients with acute brain injury, intracranial pressure (ICP) contributes less to cerebral blood flow autoregulation compared to mean arterial blood pressure (MAP). This has implications for the management of arterial blood pressure in neurocritical patients.
AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY
(2023)
Review
Medicine, Research & Experimental
Wellingson Silva Paiva, Emanuele Zippo, Carolina Miranda, Sergio Brasil, Daniel Augustin Godoy, Almir Ferreira De Andrade, Iuri Neville, Gustavo Cartaxo Patriota, Renan Domingues, Manoel Jacobsen Teixeira
Summary: Intracranial hematomas (ICH) are a common condition in neurosurgical and neurological practices, and experimental research has played a fundamental role in understanding the pathophysiology and developing therapeutic interventions. Various animal models have been used to study ICH, including autologous blood or bacterial collagenase injection, inflation of intracranial balloon, and avulsion of cerebral vessels. These models have improved our understanding of intracranial hypertension, neuroinflammation, immunology, and brain hemodynamics, and have contributed to the development of therapeutic strategies.
EXPERIMENTAL AND THERAPEUTIC MEDICINE
(2023)
Article
Critical Care Medicine
Sergio Brasil, Ricardo de Carvalho Nogueira, Angela Salomao Macedo Salinet, Marcia Harumy Yoshikawa, Manoel Jacobsen Teixeira, Wellingson Paiva, Luiz Marcelo Sa Malbouisson, Edson Bor-Seng-Shu, Ronney B. Panerai
Summary: This study evaluates the effects of intracranial pressure (ICP) variability on critical closing pressure (CrCP) and resistance-area product (RAP) among patients with acute brain injury (ABI). The results show a strong correlation between changes in ICP and corresponding changes in CrCP. Patients who underwent neurosurgical interventions have elevated cerebrovascular resistance despite increased arterial blood pressure responses.
NEUROCRITICAL CARE
(2023)
Article
Neurosciences
Adilson Jose Manuel de Oliveira, Nicollas Nunes Rabelo, Joao Paulo Mota Telles, Davi Jorge Fontoura Solla, Antonio Carlos Samaia da Silva Coelho, Guilherme Bitencourt Barbosa, Natalia Camargo Barbato, Marcia Harumy Yoshikawa, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
Summary: This study aimed to investigate if neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with angiographic vasospasm and functional outcome. The results showed that NLR and PLR at admission were not predictive of functional outcome or risk of angiographic vasospasm.
ARQUIVOS DE NEURO-PSIQUIATRIA
(2023)
Letter
Critical Care Medicine
Sergio Brasil, Juliana Caldas, Lucy Beishon, Jatinder S. Minhas, Ricardo C. Nogueira
NEUROCRITICAL CARE
(2023)
Article
Critical Care Medicine
Sergio Brasil, Hannah Romeijn, Esther K. Haspels, Wellingson Paiva, Arjen Schaafsma
Summary: This study compares the predictive value of the pulsatile apparent resistance (PaR) index versus the pulsatility index (PI) for intracranial hypertension (ICP > 20 mm Hg) in patients with traumatic brain injury. The results show that the discriminative power of PaR for discriminating intracranial hypertension was superior to PI. PaR seems to be a reliable noninvasive parameter for detecting intracranial hypertension.
NEUROCRITICAL CARE
(2023)
Article
Clinical Neurology
Sergio Brasil, Daniel A. Godoy, Wellingson S. Paiva
Summary: Based on recent research, intracranial pressure management based on predetermined thresholds is not accurate, and physicians need to combine other neuromonitoring techniques to comprehensively evaluate patients' neurological conditions.
WORLD NEUROSURGERY
(2023)
Letter
Clinical Neurology
Sergio Brasil, Daniel Agustin Godoy
ACTA NEUROCHIRURGICA
(2023)
Review
Critical Care Medicine
Daniel Agustin Godoy, Sergio Brasil, Corrado Iaccarino, Wellingson Paiva, Andres M. Rubiano
Summary: For decades, the management of severe acute brain injury has focused on controlling intracranial hypertension (IH). However, the thresholds for determining IH have changed over time without clear evidence. Recent developments in understanding intracranial content dynamics and monitoring techniques suggest that targeting intracranial compliance (ICC) may be a more reliable approach. This perspective review discusses the concept of intracranial compartmental syndrome (ICCS) and proposes an integrative model for assessing IH and ICC using modern invasive and noninvasive techniques.
