Alexandra Vallet

Understanding the brain's response to intracranial change of volumes trough intracranial pressure analysis

We are thrilled to announce the publication of our review paper, “Analysis of intracranial pressure pulse waveform in studies on cerebrospinal compliance,” in the Physiological Measurement journal. This paper serves as a comprehensive guide for both researchers and clinicians interested in understanding how the brain responds to changes in intracranial volumes. Read the full paper here.

Vascular pulsations and CSF coupling

With each vascular pulsation, the dilation of intracranial vessels pushes cerebrospinal fluid (CSF) from the cranial space to the spinal cord. This physiological process affects CSF flow in various compartments, including the ventricular system, the subarachnoid space, and the perivascular spaces.

The Concept of Compliance

The compliance of the system dictates the extent to which intracranial pressure increases due to changes in intracranial volume. It is often used to describe the brain’s ability to adapt to changes such as blood volume during each heartbeat.Low compliance can result in higher CSF pressure, which in turn causes greater mechanical stress on tissues and potential damage. Reduced CSF flow also hampers the efficient transport of nutrients and metabolic waste within the brain, directly impacting brain health.

The Challenge of Measuring Compliance

While there are methods to measure compliance through intracranial pressure, many of these techniques are invasive and require external manipulation of CSF volume. This is particularly problematic for patients with brain injuries, as invasive procedures can exacerbate their condition.

Leveraging Physiological Changes

Our review paper discusses how to analyze the shape of the intracranial pressure signal on a cardiac time scale. This approach allows for less invasive methods of assessing compliance, which is crucial for patients with brain injuries.

Key Methodologies

The paper reviews several methodologies for analyzing intracranial pressure pulse waveform. These range from pulse amplitude estimation to spectral techniques. One of the most exciting developments is the incorporation of artificial intelligence solutions in morphological analysis.

Clinical Implications

These less invasive methods have significant clinical implications. They offer practical, real-time solutions for assessing the brain’s ability to adapt to changes in intracranial volumes.


Special thanks to Agnieszka Kazimierska, our main writer, and Magdalena Kasprowicz for spearheading this review. We also extend our gratitude to Romain Manet and Eric Schmidt for their clinical insights, and to Zofia Czosnyka and Marek Czosnyka for their expertise in CSF dynamics.

Our review paper not only provides a comprehensive overview of existing methods for assessing the brain’s compliance but also paves the way for future research in this critical area of neuroscience and critical care.

Originally published as a Twitter thread by Alexandra Vallet @AValletResearch

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