Why Intracranial Compliance Is Not Utilized as a Common Practical Tool in Clinical Practice
Intracranial compliance (ICC) holds significant potential in neuromonitoring, serving as a diagnostic tool and contributing to the evaluation of treatment outcomes. Despite its comprehensive concept, which allows consideration of changes in both volume and intracranial pressure (ICP), ICC monitoring...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/11/3083 |
| _version_ | 1797460020098498560 |
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| author | Seifollah Gholampour |
| author_facet | Seifollah Gholampour |
| author_sort | Seifollah Gholampour |
| collection | DOAJ |
| description | Intracranial compliance (ICC) holds significant potential in neuromonitoring, serving as a diagnostic tool and contributing to the evaluation of treatment outcomes. Despite its comprehensive concept, which allows consideration of changes in both volume and intracranial pressure (ICP), ICC monitoring has not yet established itself as a standard component of medical care, unlike ICP monitoring. This review highlighted that the first challenge is the assessment of ICC values, because of the invasive nature of direct <i>measurement</i>, the time-consuming aspect of non-invasive <i>calculation</i> through computer simulations, and the inability to quantify ICC values in <i>estimation</i> methods. Addressing these challenges is crucial, and the development of a rapid, non-invasive computer simulation method could alleviate obstacles in quantifying ICC. Additionally, this review indicated the second challenge in the clinical application of ICC, which involves the dynamic and time-dependent nature of ICC. This was considered by introducing the concept of time elapsed (TE) in measuring the <i>changes</i> in volume or ICP in the ICC equation (volume change/ICP change). The choice of TE, whether short or long, directly influences the ICC values that must be considered in the clinical application of the ICC. Compensatory responses of the brain exhibit non-monotonic and variable changes in long TE assessments for certain disorders, contrasting with the mono-exponential pattern observed in short TE assessments. Furthermore, the recovery behavior of the brain undergoes changes during the treatment process of various brain disorders when exposed to short and long TE conditions. The review also highlighted differences in ICC values across brain disorders with various strain rates and loading durations on the brain, further emphasizing the dynamic nature of ICC for clinical application. The insight provided in this review may prove valuable to professionals in neurocritical care, neurology, and neurosurgery for standardizing ICC monitoring in practical application related to the diagnosis and evaluation of treatment outcomes in brain disorders. |
| first_indexed | 2024-03-09T16:59:16Z |
| format | Article |
| id | doaj.art-1ce4a01858874ae0b032be5bf6983b64 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-09T16:59:16Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-1ce4a01858874ae0b032be5bf6983b642023-11-24T14:31:25ZengMDPI AGBiomedicines2227-90592023-11-011111308310.3390/biomedicines11113083Why Intracranial Compliance Is Not Utilized as a Common Practical Tool in Clinical PracticeSeifollah Gholampour0Department of Neurological Surgery, University of Chicago, Chicago, IL 60637, USAIntracranial compliance (ICC) holds significant potential in neuromonitoring, serving as a diagnostic tool and contributing to the evaluation of treatment outcomes. Despite its comprehensive concept, which allows consideration of changes in both volume and intracranial pressure (ICP), ICC monitoring has not yet established itself as a standard component of medical care, unlike ICP monitoring. This review highlighted that the first challenge is the assessment of ICC values, because of the invasive nature of direct <i>measurement</i>, the time-consuming aspect of non-invasive <i>calculation</i> through computer simulations, and the inability to quantify ICC values in <i>estimation</i> methods. Addressing these challenges is crucial, and the development of a rapid, non-invasive computer simulation method could alleviate obstacles in quantifying ICC. Additionally, this review indicated the second challenge in the clinical application of ICC, which involves the dynamic and time-dependent nature of ICC. This was considered by introducing the concept of time elapsed (TE) in measuring the <i>changes</i> in volume or ICP in the ICC equation (volume change/ICP change). The choice of TE, whether short or long, directly influences the ICC values that must be considered in the clinical application of the ICC. Compensatory responses of the brain exhibit non-monotonic and variable changes in long TE assessments for certain disorders, contrasting with the mono-exponential pattern observed in short TE assessments. Furthermore, the recovery behavior of the brain undergoes changes during the treatment process of various brain disorders when exposed to short and long TE conditions. The review also highlighted differences in ICC values across brain disorders with various strain rates and loading durations on the brain, further emphasizing the dynamic nature of ICC for clinical application. The insight provided in this review may prove valuable to professionals in neurocritical care, neurology, and neurosurgery for standardizing ICC monitoring in practical application related to the diagnosis and evaluation of treatment outcomes in brain disorders.https://www.mdpi.com/2227-9059/11/11/3083intracranial compliance (ICC)viscous componentgradual onset brain disordersbrain disorderneurosurgerycerebrospinal fluid |
| spellingShingle | Seifollah Gholampour Why Intracranial Compliance Is Not Utilized as a Common Practical Tool in Clinical Practice Biomedicines intracranial compliance (ICC) viscous component gradual onset brain disorders brain disorder neurosurgery cerebrospinal fluid |
| title | Why Intracranial Compliance Is Not Utilized as a Common Practical Tool in Clinical Practice |
| title_full | Why Intracranial Compliance Is Not Utilized as a Common Practical Tool in Clinical Practice |
| title_fullStr | Why Intracranial Compliance Is Not Utilized as a Common Practical Tool in Clinical Practice |
| title_full_unstemmed | Why Intracranial Compliance Is Not Utilized as a Common Practical Tool in Clinical Practice |
| title_short | Why Intracranial Compliance Is Not Utilized as a Common Practical Tool in Clinical Practice |
| title_sort | why intracranial compliance is not utilized as a common practical tool in clinical practice |
| topic | intracranial compliance (ICC) viscous component gradual onset brain disorders brain disorder neurosurgery cerebrospinal fluid |
| url | https://www.mdpi.com/2227-9059/11/11/3083 |
| work_keys_str_mv | AT seifollahgholampour whyintracranialcomplianceisnotutilizedasacommonpracticaltoolinclinicalpractice |