Acute and Critical Care

Original Article

Neurosurgery
Deep learning-based model for detection of intracranial waveforms with poor brain compliance in southern Thailand: Thara Tunthanathip, Avika Trakulpanitkit; Acute Crit Care. 2025;40(3):473-481. Published online August 29, 2025; DOI: https://doi.org/10.4266/acc.001425

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Background
Intracranial pressure (ICP) waveform analysis provides critical insights into brain compliance and can aid in the early detection of neurological deterioration. Deep learning (DL) has recently emerged as an effective approach for analyzing complex medical signals and imaging data. The aim of the present research was to develop a DL-based model for detecting ICP waveforms indicative of poor brain compliance. Methods: A retrospective cohort study was conducted using ICP wave images collected from postoperative hydrocephalus (HCP) patients who underwent ventriculostomy. The images were categorized into normal and poor compliance waveforms. Precision, recall, mean average precision at the 0.5 intersection over union (mAP_0.5), and the area under the receiver operating characteristic curve (AUC) were used to test. Results: The dataset consisted of 2,744 ICP wave images from 21 HCP patients. The best-performing model achieved a precision of 0.97, a recall of 0.96, and a mAP_0.5 of 0.989. The confusion matrix for poor brain compliance waveform detection using the test dataset also demonstrated a high classification accuracy, with true positive and true negative rates of 48.5% and 47.8%, respectively. Additionally, the model demonstrated high accuracy, achieving a mAP_0.5 of 0.994, sensitivity of 0.956, specificity of 0.970, and an AUC of 0.96 in the detection of poor compliance waveforms. Conclusions: The DL-based model successfully detected pathological ICP waveforms, thereby enhancing clinical decision-making. As DL advances, its significance in neurocritical care will help to pave the way for more individualized and data-driven approaches to brain monitoring and management

Citations

Citations to this article as recorded by

Perioperative Anesthetic Strategies in Emergent Neurosurgery During Severe Traumatic Brain Injury
Denise Baloi, Clayton Rawson, Deondra Montgomery, Michael Karsy, Mehrdad Pahlevani
Trauma Care.2026; 6(1): 5. CrossRef

Case Report

Repeated Hypothermia for Rebound Cerebral Edema after Therapeutic Hypothermia in Malignant Cerebral Infarction: Jeong Ho Hong, Jin Heon Jeong, Jun Young Chang, Min Ju Yeo, Han Yeong Jeong, Hee Joon Bae, Moon Ku Han; Korean J Crit Care Med. 2013;28(3):221-224.; DOI: https://doi.org/10.4266/kjccm.2013.28.3.221

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Abstract PDF

Malignant cerebral infarction has a high risk of fatal brain edema and increased intracranial pressure with cerebral herniation causing death. One of the major causes of death is a rebound cerebral edema during rewarming phase. A 66-year-old male patient presented with the right hemiplegia and global aphasia due to malignant cerebral infarction in the whole territory of middle cerebral artery with the occlusion of the proximal internal carotid artery. Being refused decompressive hemicraniectomy, he received the therapeutic hypothermia for 6 days. After rewarming for 6 hours, mentality was suddenly decreased and dilated left pupil. Follow-up CT revealed that midline shifting was more aggravated. We decided on repeated hypothermia for rebound cerebral edema and successfully controlled. We report our experience with repeated hypothermia for rebound cerebral edema following therapeutic hypothermia in malignant cerebral infarction.

Citations

Citations to this article as recorded by

Dexmedetomidine Use in Patients with 33℃ Targeted Temperature Management: Focus on Bradycardia as an Adverse Effect
Hyo-yeon Seo, Byoung-joon Oh, Eun-jung Park, Young-gi Min, Sang-cheon Choi
The Korean Journal of Critical Care Medicine.2015; 30(4): 272. CrossRef
Therapeutic Hypothermia after Decompressive Craniectomy in Malignant Cerebral Infarction
Jun Young Chang, Jeong-Ho Hong, Jin-Heon Jeong, Sung-Jin Nam, Ji-Hwan Jang, Jae Seung Bang, Moon-Ku Han
Korean Journal of Critical Care Medicine.2014; 29(2): 93. CrossRef

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