Waveform-Derived Metrics of Intracranial Compliance: Validation and Pulsatile Dynamics.

Ihsane Olakorede, Stefan Yu Bögli, Marek Czosnyka, Peter Smielewski

Abstract read

In one paragraph

Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Ihsane OlakoredeBrain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK. imo25@cam.ac.uk.ORCID http://orcid.org/0009-0009-8283-305X

Stefan Yu BögliBrain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.

Marek CzosnykaBrain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.

Peter SmielewskiBrain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.

Funding

Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung 210839/225270

6 · The paper itself

Abstract

objectiveVisual interpretation of intracranial pressure (ICP) waveforms is widely used to assess intracranial compliance but lacks rigorous validation. We evaluated the pulse shape index (PSI) against the tidal wave (P2)/percussion wave (P1) ratio and examined the contributions of pulse amplitude, compensatory reserve [pressure-volume compensatory reserve index (RAP)] and transcranial Doppler (TCD)-derived indices.

methodsA total of 4388 non-overlapping 5-min segments from 96 high-resolution recordings of simultaneous ICP and TCD blood velocity were analysed. PSI and P2/P1 were derived from normalised ICP pulses. ICP pulse amplitude (AMP), RAP and TCD-derived arterial and intracranial compliance indices [arterial compliance (C

resultsPSI demonstrated a strong association with P2/P1 (r ≈ 0.74-0.76 across analysis levels) and high discrimination for impaired compliance [area under the curve (AUC) ≈ 0.93]. RAP and C

conclusionsPSI closely reflects P2/P1 and supports automated waveform-based compliance assessment. However, morphology alone is insufficient; amplitude and reserve indices provide complementary information, supporting a multiparametric approach to intracranial monitoring.

Indexed as

Intracranial complianceIntracranial pressure waveformNeuromonitoringPressure–volume curveTraumatic brain injury

Identifiers

PMID42547674

DOI10.1007/978-3-319-22533-3_67

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.