Title
A Spectral Approach to Model-Based Noninvasive Intracranial Pressure Estimation
Abstract
Background: Intracranial pressure (ICP) normally ranges from 5 to 15 mmHg. Elevation in ICP is an important clinical indicator of neurological injury, and ICP is therefore monitored routinely in several neurological conditions to guide diagnosis and treatment decisions. Current measurement modalities for ICP monitoring are highly invasive, largely limiting the measurement to critically ill patients. An accurate noninvasive method to estimate ICP would dramatically expand the pool of patients that could benefit from this cranial vital sign. Methods: This article presents a spectral approach to model-based ICP estimation from arterial blood pressure (ABP) and cerebral blood flow velocity (CBFV) measurements. The model captures the relationship between the ABP, CBFV, and ICP waveforms and utilizes a second-order model of the cerebral vasculature to estimate ICP. Results: The estimation approach was validated on two separate clinical datasets, one recorded from thirteen pediatric patients with a total duration of around seven hours, and the other recorded from five adult patients, one hour and 48 minutes in total duration. The algorithm was shown to have an accuracy (mean error) of 0.4 mmHg and $-$1.5 mmHg, and a precision (standard deviation of the error) of 5.1 mmHg and 4.3 mmHg, in estimating mean ICP (range of 1.3 mmHg to 24.8 mmHg) on the pediatric and adult data, respectively. These results are comparable to previous results and within the clinically relevant range. Additionally, the accuracy and precision in estimating the pulse pressure of ICP on a beat-by-beat basis were found to be 1.3 mmHg and 2.9 mmHg respectively. Conclusion: These contributions take a step towards realizing the goal of implementing a real-time noninvasive ICP estimation modality in a clinical setting, to enable accurate clinical-decision making while overcoming the drawbacks of the invasive ICP modalities.
Year
DOI
Venue
2020
10.1109/JBHI.2019.2961403
IEEE Journal of Biomedical and Health Informatics
Keywords
DocType
Volume
Adult,Algorithms,Blood Pressure,Brain Injuries,Cerebrovascular Circulation,Humans,Intracranial Hypertension,Intracranial Pressure,Monitoring, Physiologic,Signal Processing, Computer-Assisted,Ultrasonography, Doppler, Transcranial
Journal
24
Issue
ISSN
Citations 
8
2168-2194
0
PageRank 
References 
Authors
0.34
0
6
Name
Order
Citations
PageRank
Rohan Jaishankar100.34
Andrea Fanelli2113.33
Aristotelis Filippidis300.34
Thai Vu400.34
James Holsapple500.34
Thomas Heldt629.54