Repository logo

Brain blood flow pulse analysis may help to recognize individuals who suffer from hydrocephalus.

Published version

Repository DOI

Change log


Ziółkowski, Arkadiusz  ORCID logo
Kasprowicz, Magdalena  ORCID logo
Czosnyka, Zofia 


BACKGROUND: Normal pressure hydrocephalus (NPH) is often associated with altered cerebral blood flow. Recent research with the use of the ultrasonic method suggests specific changes in the shape of cardiac-related cerebral arterial blood volume (CaBV) pulses in NPH patients. Our study aims to provide a quantitative analysis of the shape of CaBV pulses, estimated based on transcranial Doppler ultrasonography (TCD) in NPH patients and healthy individuals. METHODS: The CaBV pulses were estimated using TCD cerebral blood flow velocity signals recorded from probable NPH adults and age-matched healthy individuals at rest. The shape of the CaBV pulses was compared to a triangular shape with 27 similarity parameters calculated for every reliable CaBV pulse and compared between patients and volunteers. The diagnostic accuracy of the most prominent parameter for NPH classification was evaluated using the area under the receiver operating characteristic curve (AUC). RESULTS: The similarity parameters were calculated for 31 probable NPH patients (age: 59 years (IQR: 47, 67 years), 14 females) and 23 healthy volunteers (age: 54 years (IQR: 43, 61 years), 18 females). Eighteen of 27 parameters were different between healthy individuals and NPH patients (p < 0.05). The most prominent differences were found for the ascending slope of the CaBV pulse with the AUC equal to 0.87 (95% confidence interval: 0.77, 0.97, p < 0.001). CONCLUSIONS: The findings suggest that in NPH, the ascending slope of the CaBV pulse had a slower rise, was more like a straight line, and generally was less convex than in volunteers. Prospective research is required to verify the clinical utility of these findings.


Funder: National Institute for Health and Care Research, Cambridge Centre and Med-Tec MIC cooperative


Brain blood circulation, Cerebral blood flow velocity, Infusion test, Morphological analysis, Pulse shape analysis, Transcranial Doppler, Adult, Female, Humans, Middle Aged, Prospective Studies, Hydrocephalus, Hydrocephalus, Normal Pressure, Heart Rate, Cerebrovascular Circulation, Arteries, Ultrasonography, Doppler, Transcranial, Blood Flow Velocity

Journal Title

Acta Neurochir (Wien)

Conference Name

Journal ISSN


Volume Title



Springer Science and Business Media LLC
Narodowe Centrum Nauki (UMO-2019/35/B/ST7/00500, UMO-2019/35/B/ST7/00500)
Interreg (The Reversible Dementia Project (REVERT), The Reversible Dementia Project (REVERT))