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Analysis of epidural pressure pulse wave (EDP-PW) and common carotid blood velocity (CBFV) in acute intracranial hypertension
Authors:Minoru Shigemori  Takashi Tokutomi  Tomuyuki Kawaba  Hironori Nakashima  Shinken Kuramoto
Institution:Department of Neurosurgery, Kurume University School of Medicine, 67, Asahimachi, Kurume 830, Japan
Abstract:The changes in the two consistent components of epidural pressure pulse wave (EDP-PW), P1 and P2 waves, and mean velocity of common carotid blood flow (CBFV) were studied in 21 patients with acute intracranial hypertension to investigate the origin of the amplitude change in these components. The amplitudes of P2 wave increased progressively with the rise of EDP, but those of P1 wave remained nearly in variable at EDP of more than20–30 mmHg which is incompatible with the changes in CBFV. Jugular vein compression caused in rapid rise of EDP and a proportionate increase in the magnitudes of both waves. Hyperventilation and mannitol administration caused a disproportionate reduction in the amplitudes of P2 wave with a fall of EDP. But mannitol at high EDP (more than 40 mmHg) causeda mild fall of EDP and some increase in the amplitudes of P2 wave. These results indicate that the variations in the amplitudes of P1 wave reflect the changes in vascular resistance of the large intracranial conductive arteries, while those of P2 wave result from the changes in the volume of the cerebral bulk. The increase in the amplitudes of P2 wave induced by mannitol at high EDP may suggest a defective autoregulation of the cerebral vessels.
Keywords:Hypertension  epidural pressure pulse wave  vascular resistance  cerebral bulk  autoregulation
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