BACKGROUND:  Intracranial pressure (ICP), as used in clinical applications, is either measured as the pressure in brain fluids or tissues, both of which are measurements that are achieved through invasive procedures. ICP can be used to monitor physiological changes in the clinical state of the brain. Knowledge of these changes are useful, especially following incidents such as traumatic brain injury, brain aneurysms rupture, and stroke, as these patients are at high risk for secondary insults. Currently, the average value of the ICP is the only metrics that commercial devices deliver to clinicians. Nevertheless, there is much more information that can be extracted from processing ICP recordings. Because measuring ICP is an invasive procedure, there is a clinical and ethical need for maximizing the information that can be obtained from this measurement.

INNOVATION:  Researchers at UCLA have identified an algorithm - Morphological Clustering and Analysis of Intracranial Pressure Pulse (MOCAIP) - for extracting various morphological features of ICP pulses. For patients who are suffering from a brain-related health condition, this data would be useful in characterizing dynamic physiological changes such as spasms of blood vessels in the brain (cerebral vasospasm) and changes of brain ventricle size. This algorithm has been tested using adequate clinical recordings and proved to be robust to noise and artifacts because of its built-in legitimate ICP pulse recognition.

POTENTIAL APPLICATIONS 

• Monitoring of the effects of brain injuries in patients
• Predicting the likelihood of further undesirable events in the brain
• Detecting brain ventricle enlargement

ADVANTAGES

• Because the required data can be extracted from current ICP measurements, no additional procedures are needed.
• Effective noise and artifact handling through legitimate ICP pulse recognition.
• Continuous assessment of cerebral vascular changes may be possible.

DEVELOPMENT-TO-DATE:  Core algorithms have been developed in the MATLAB software program and have been utilized for testing on approximately 64 patients. Further experimental and clinical studies are underway in order to investigate the assertion that analysis of ICP pulse morphology will lead to continuous assessment of cerebral vascular and ventricle volume changes. In addition, implementation of algorithm using digital signal processing (DSP) chips is being pursuit. It is anticipated that the MOCAIP algorithm could be built into current ICP bedside monitors.

Related Papers (Selected)

• Hu, X.; Xu, P.; Lee, D.J.; Vespa, P.; Baldwin, K.; Bergsneider, M. "An algorithm for extracting intracranial pressure latency relative to electrocardiogram R wave." Physiol. Meas. 2008, 29, 459-471. [more]

Reference: UCLA Case No. 2008-036