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Characterization of the Relationship Between Intracranial Pressure and Electroencephalographic Monitoring in Burst-Suppressed Patients

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Abstract

Background

The objective of this study is to characterize the relationship between ICP and EEG

Methods

Simultaneous ICP and EEG data were obtained from burst-suppressed patients and segmented by EEG bursts. Segments were categorized as increasing/decreasing and peak/valley to investigate relationship between ICP changes and EEG burst duration. A generalized ICP response was obtained by averaging all segments time-aligned at burst onsets. A vasodilatation index (VDI) was derived from the ICP pulse waveform and calculated on a sliding interval to investigate cerebrovascular changes post-burst.

Results

Data from two patients contained 309 bursts. 246 ICP segments initially increased, of which 154 peaked. 63 ICP segments decreased, and zero reached a valley. The change in ICP (0.54 ± 0.85 mmHg) was significantly correlated with the burst duration (p < 0.001). Characterization of the ICP segments showed a peak at 8.1 s and a return to baseline at 14.7 s. The VDI for increasing segments was significantly elevated (median 0.56, IQR 0.31, p < 0.001) and correlated with burst duration (p < 0.001).

Conclusions

Changes in the ICP and pulse waveform shape after EEG burst suggest that these signals can be related within the context of neurovascular coupling.

Significance

Existence of a physiological relationship between ICP and EEG may allow the study of neurovascular coupling in acute brain injury patients.

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Acknowledgments

XH support from the National Institutes of Health Award Number NS076738 and the University of California, San Francisco Institute of Computational Health Sciences. NRG support from National Institute of neurological Disorders and Stroke of the National Institutes of Health under Award Number K23NS079477.

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Authors and Affiliations

  1. Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    Mark Connolly, Paul Vespa, Nader Pouratian, Nestor R. Gonzalez & Xiao Hu

  2. Departments of Physiological Nursing/Neurosurgery, Institute for Computational Health Sciences, University of California San Francisco, San Francisco, CA, 94143-0610, USA

    Xiao Hu

  3. Institue of Computational Health Sciences, University of California San Francisco, San Francisco, CA, USA

    Xiao Hu

Authors
  1. Mark Connolly
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  2. Paul Vespa
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  3. Nader Pouratian
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  4. Nestor R. Gonzalez
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  5. Xiao Hu
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Correspondence to Xiao Hu.

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Connolly, M., Vespa, P., Pouratian, N. et al. Characterization of the Relationship Between Intracranial Pressure and Electroencephalographic Monitoring in Burst-Suppressed Patients. Neurocrit Care 22, 212–220 (2015). https://doi.org/10.1007/s12028-014-0059-8

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  • DOI: https://doi.org/10.1007/s12028-014-0059-8

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