Plateau waves and baroreflex sensitivity in patients with head injury: A case study

The study aimed to investigate baroreceptor reflex sensitivity in a patient with head injury for whom plateau waves of intracranial pressure (ICP) were recorded. Baroreflex sensitivity index was separately estimated on top of plateau waves and during intermediate intervals between two consecutive waves. The EuroBaVar data set was utilized to verify and validate the results. A very high baroreflex sensitivity associated with dominant parasympathetic activity was observed spontaneous to the acute elevations of ICP. The high vagal afferent discharge was found to be suggestive for the high firing rate of carotid baroreceptors and probably an active Cushing reflex mechanism during plateau waves.

[1]  Solange Akselrod,et al.  Time versus frequency domain techniques for assessing baroreflex sensitivity , 2001, Journal of hypertension.

[2]  Tomas McKelvey,et al.  Harmonics tracking of intracranial and arterial blood pressure waves , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[3]  H. Brooks,et al.  Medical physiology , 1961 .

[4]  L. Naccache,et al.  The relationship of intracranial pressure Lundberg waves to electroencephalograph fluctuations in patients with severe head trauma , 2005, Acta Neurochirurgica.

[5]  H. I. Chen,et al.  Systemic and pulmonary hemodynamic responses to intracranial hypertension. , 1984, The American journal of physiology.

[6]  C. Miller,et al.  The relation of cerebral ischemia, hypoxia, and hypercarbia to the Cushing response. , 1978, Journal of neurosurgery.

[7]  Karel H Wesseling,et al.  Time-domain cross-correlation baroreflex sensitivity: performance on the EUROBAVAR data set , 2004, Journal of hypertension.

[8]  M. Rosner,et al.  Origin and evolution of plateau waves. Experimental observations and a theoretical model. , 1984, Journal of neurosurgery.

[9]  Antonio Pedotti,et al.  Advancements in Estimating Baroreflex Function Exploring Different Aspects of Autonomic Control of the Heart through the Sequence Technique , 2001 .

[10]  M. Ursino,et al.  A simple mathematical model of the interaction between intracranial pressure and cerebral hemodynamics. , 1997, Journal of applied physiology.

[11]  Ming-Che Lee,et al.  A severe vicious cycle in uncontrolled subarachnoid hemorrhage: the effects on cerebral blood flow and hemodynamic responses upon intracranial hypertension. , 2006, The Chinese journal of physiology.

[12]  Marek Czosnyka,et al.  Plateau Waves in Head Injured Patients Requiring Neurocritical Care , 2009, Neurocritical care.

[13]  T.C. Wu,et al.  Baroreflex sensitivity evaluation by Volterra Wiener model and the Laguerre expansion technique , 2008, 2008 Computers in Cardiology.

[14]  N. Lundberg,et al.  Continuous recording and control of ventricular fluid pressure in neurosurgical practice. , 1962, Acta psychiatrica Scandinavica. Supplementum.

[15]  Pablo Laguna,et al.  Time domain baroreflex sensitivity assessment by joint analysis of spontaneous SBP and RR series , 2009, Biomed. Signal Process. Control..

[16]  T. Ducker,et al.  Increased intracranial pressure and pulmonary edema. 2. The hemodynamic response of dogs and monkeys to increased intracranial pressure. , 1968, Journal of neurosurgery.

[17]  H. Sakamoto,et al.  Efferent discharges of sympathetic and parasympathetic nerve fibers during increased intracranial pressure in anesthetized cats in the absence and presence of pressor response , 1984, Brain Research.

[18]  Marek Czosnyka,et al.  The monitoring of relative changes in compartmental compliances of brain , 2009, Physiological measurement.

[19]  A Pedotti,et al.  Advancements in estimating baroreflex function. , 2001, IEEE engineering in medicine and biology magazine : the quarterly magazine of the Engineering in Medicine & Biology Society.

[20]  Alberto Porta,et al.  Comparison of various techniques used to estimate spontaneous baroreflex sensitivity (the EuroBaVar study). , 2004, American journal of physiology. Regulatory, integrative and comparative physiology.

[21]  M. Ursino,et al.  Effect of cushing response on systemic arterial pressure , 2009, IEEE Engineering in Medicine and Biology Magazine.

[22]  Y. Tzeng,et al.  Respiratory modulation of cardiovagal baroreflex sensitivity. , 2009, Journal of applied physiology.

[23]  C. Su,et al.  EFFECTS OF INTRACRANIAL HYPERTENSION ON STEADY AND PULSATILE HAEMODYNAMICS IN DOGS , 1999, Clinical and experimental pharmacology & physiology.

[24]  Robert W. Anderson,et al.  Increased Intracranial Pressure and Pulmonary Edema , 1968 .