Publications by authors named "M Czosnyka"

Introduction: Secondary insults due to high intracranial pressure (ICP), low cerebral perfusion pressure (CPP) and impaired cerebral pressure reactivity (PRx) predict outcome after severe traumatic brain injury (TBI).

Research Question: What is the prevalence, co-occurrence and prognostic importance of secondary insults due to deranged ICP, CPP or PRx after TBI.

Material And Methods: Severe TBI patients requiring ICP monitoring were included.

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Background: Traumatic brain injury (TBI) can significantly disrupt autonomic nervous system (ANS) regulation, increasing the risk for secondary complications, hemodynamic instability, and adverse outcome. This retrospective study evaluated windowed time-lagged cross-correlation (WTLCC) matrices for describing cerebral hemodynamics-ANS interactions to predict outcome, enabling identifying high-risk patients who may benefit from enhanced monitoring to prevent complications.

Methods: The first experiment aimed to predict short-term outcome using WTLCC-based convolution neural network models on the Wroclaw University Hospital (WUH) database (P = 31 with 1,079 matrices, P = 16 with 573 matrices).

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Intracranial pressure (ICP), cerebral blood flow and volume are affected by craniospinal elasticity and cerebrospinal fluid dynamics, interacting in complex, nonlinear ways. Traumatic brain injury (TBI) may significantly alter this relationship. This retrospective study investigated the relationship between the vascular and parenchymal intracranial compartments by analysing two amplitudes: cerebral blood flow velocity (AmpCBFV) and ICP (AMP) during hypocapnia manoeuvre in TBI patients.

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Article Synopsis
  • * A secondary analysis found that patients in the CPPopt-targeted group had better autoregulation, indicated by a significantly lower median ΔPRx during preserved autoregulation periods compared to the control group.
  • * The study concludes that while there was no noticeable difference in overall PRx averages, targeting CPPopt appears to enhance cerebrovascular reactivity in TBI patients.
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Lumbar puncture provides an easy way of accessing the subarachnoid space. Measuring of the opening cerebrospinal fluid pressure is the most commonly used method of evaluating intracranial pressure but provides basic snapshot information only. Further insights into cerebrospinal fluid dynamics can be obtained through infusion studies, which rely on measurement of the degree of pressure change in response to addition of fluid volume into the subarachnoid space.

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