Other

University of California

David S Liebeskind

Mindaugas Pranevicius

Osvaldas Pranevicius

Henrikas Pranevicius

Fabien Scalzo

Egidijus Marcinkevicius

An apparatus and methodological framework are provided, named perfusion angiography, for the quantitative analysis and visualization of blood flow parameters from DSA images. The parameters, including cerebral blood flow (CBF) and cerebral blood volume (CBV), mean transit time (MTT), time-to-peak (TTP), and T, are computed using a bolus tracking method based on the deconvolution of time-density curves on a pixel-by-pixel basis. Individual contrast concentration curves of overlapping vessels can be delineated with multivariate Gamma fitting. The extracted parameters are each transformed into parametric maps of the target that can be color coded with different colors to represent parameter values within a particular set range. Side by side parametric maps with corresponding DSA images allow expert evaluation and condition diagnosis.

Perfusion digital subtraction angiography

A patient in whom blood diversion due to cerebral venous steal is present, and abolishment of the cerebral venous steal is indicated, is treated by increasing the cerebral venous pressure in the patient. This increase in cerebral venous pressure restores the collapsed cerebral vasculature, thereby increasing cerebral blood flow. The increase in cerebral venous pressure may be achieved using an occluding catheter in the superior vena cava or the internal jugular veins, using external compression of the cervical veins, or any other suitable mechanism. The occlusion may be controlled precisely during treatment, possibly as a function of cerebral blood flow, and after treatment the patient may experience a persistent effect because the cerebral vasculature is no longer collapsed.

Venous modulation of collateral perfusion of cerebral ischemia

A system for detecting and measuring increased global or local intracranial pressure includes various devices for performing controlled occlusion of jugular cranial blood outflow and generating occlusion data related to said controlled occlusion, a cranial blood outflow pressure measurement device and a processor for processing jugular cranial blood outflow occlusion data and cranial blood outflow data to identify and/or measure a functional relationship between the jugular controlled occlusion and the jugular cranial blood outflow pressure. A device communicates the functional relationship a display device and/or a patient monitoring system. The processor also detects a state of equilibrium between the jugular cranial blood outflow pressure and the jugular occlusion pressure at occlusion. In yet another embodiment, intracranial and extracranial vessel compliance is measured by NIRS system, the equilibrated using external compression bladder, and equilibrium bladder pressure is displayed as local intracranial pressure.

Noninvasive method to measure intracranial and effective cerebral outflow pressure

A method to measure effective cerebral outflow pressure or intracranial pressure is disclosed. The craniospinal venous system has multiple anastomoses between the jugular veins and vertebral venous plexus. Jugular veins collapse with cervical compression or head elevation, when extrinsic pressure exceeds venous pressure. The vertebral venous plexus is exposed to intracranial pressure and collapses when intracranial pressure exceeds venous pressure. Vertebral venous plexus is not compressed with head elevation or cervical compression, because enclosure in the spinal canal protects veins from the direct effects of atmospheric pressure and cervical compression. Using cervical compression and/or head elevation blood outflow is redistributed between jugular veins and vertebral venous plexus, while the degree of cervical compression or head elevation indicates effective cerebral outflow pressure or ICP.

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Los Angeles, CA, United States of America

David S Liebeskind