Systems analysis applied to intracranial pressure waveforms and correlation with clinical status in head injured patients.

Abstract

Intracranial pressure waveforms (ICPWF) in head injured patients vary with the nature and severity of injury. Clinical interpretation of ICPWF shape is not defined. Spectral analysis provides an objective method of measuring changes in waveform shape, but the indices most suitable for clinical use remain unknown. Spectral analysis has been applied to ICPWF recorded from 30 patients with head injury, classified on clinical grounds into good, poor and intermediate groups. Normalized indices derived from ratios of certain characteristics of the ICP waveform to those of the arterial pressure (AP) waveform, were different (P less than 0.05) in all groups. A simple index examined was the harmonic count ratio (Nc:Na) which decreased with increasing severity of injury. ICP/AP harmonic transfer functions were derived, and demonstrated a peaked response in the range 10-12 Hz. Increasing attenuation of this peaked response occurred with increasing severity of injury. These results suggest that transfer functions may be a clinically useful index of intracranial conditions.