Predicting Post-craniectomy ICP: A Comprehensive Compartmental Model including Decompressive Craniectomy

A novel lumped-parameter model is proposed to help with establish practice criteria of decompressive craniectomy and explain post-craniectomy intracranial dynamics. Besides traditional four major parts of arterial and venous blood, cerebrospinal fluid and brain tissue, another compartment produced by secondary intracranial hypertension is included here. The elliptical deflection solution under uniformly distributed pressure is introduced to compute the craniectomy compartment volume and incorporate it into existing differential equations. Under particular pathology in this paper our model predicts the waveform of post-craniectomy intracranial pressure, which measures the clinical effectiveness of such an operation. Then a statistical model—Gaussian fitting model is used to fit our simulation data. This quantitative model provides a possible way to designate the operation criteria such as the size of decompressive craniectomy. Finally we propose the optimal interval of craniectomy size as from 100 to 300 square centimeters and that larger than 400 square centimeters would not obviously reinforce pressure reduction anymore.