Dr Peter Smielewski

University position
Senior Research Associate
Dr Peter Smielewski is pleased to consider applications from prospective PhD students.
Departments
Department of Clinical Neurosciences
Institutes
Home page
http://www.neurosurg.cam.ac.uk
Research Theme
Interests
In an established environment of Clinical Neuroscience Dept large quantities of data can be captured from bed-side monitors. Using that data, continuous assessment of changing cerebrovascular haemodynamics and oxygenation is possible but requires sophisticated signal analysis. My primary research involves development of ICM+ software which encapsulates 20 years of our experience in brain monitoring gained in multiple neurosurgical and intensive care centres. It collects data from bedside monitors and produces on-line trends of parameters defined using highly configurable signal processing formulae. Using a variety of statistical charts complex information coming off the bedside monitors can be summarized in a concise fashion and presented to medical staff in a simple way that alerts them to the development of various pathological processes. The software is now installed in a number of academic centres around the world providing basis for multi-centre collaborations in brain monitoring.

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Research Focus
Keywordsbrain monitoring biomedical signal analysis cerebral haemodynamics cerebrospinal fluid dynamics cerebral autoregulation testing |
Clinical conditionsHydrocephalus Stroke Traumatic brain injury |
Equipment
Brain tissue oxygenation
Computational modelling
Haemodynamic monitoring
Near-infrared Spectroscopy
Positron Emission Tomography (PET)
Transcranial Doppler Ultrasound
Collaborators
Cambridge | United KingdomKristian Aquilina Web: http://www.nbt.nhs.uk/ InternationalPhillip Bijlenga Web: http://www.hug-ge.ch/ Ken Brady Web: http://www.hopkinshospital.org/index.html Matthias Jaeger Web: http://www.uniklinik-leipzig.de/ Andrea Lavinio Web: http://www.spedalicivili.brescia.it Phillip Lewis Web: http://www.alfred.org.au/ Stephan Ng Web: http://www.nni.com.sg/ Martin Schumann Web: http://www.mh-hannover.de/index.p... Luzius Steiner Web: http://www.kantonsspital-basel.ch/ |
Key publications
Bijlenga P, Czosnyka M, Budohoski KP, Soehle M, Pickard JD, Kirkpatrick PJ, Smielewski P (2010), “"Optimal cerebral perfusion pressure" in poor grade patients after subarachnoid hemorrhage.” Neurocrit Care 13(1):17-23 Details
Zweifel C, Castellani G, Czosnyka M, Carrera E, Brady KM, Kirkpatrick PJ, Pickard JD, Smielewski P (2010), “Continuous assessment of cerebral autoregulation with near-infrared spectroscopy in adults after subarachnoid hemorrhage.” Stroke 41(9):1963-8 Details
Smielewski P, Lavinio A, Timofeev I, Radolovich D, Perkes I, Pickard JD, Czosnyka M (2008), “ICM+, a flexible platform for investigations of cerebrospinal dynamics in clinical practice.” Acta Neurochir Suppl 102:145-51 Details
Zweifel C, Lavinio A, Steiner LA, Radolovich D, Smielewski P, Timofeev I, Hiler M, Balestreri M, Kirkpatrick PJ, Pickard JD, Hutchinson P, Czosnyka M (2008), “Continuous monitoring of cerebrovascular pressure reactivity in patients with head injury.” Neurosurg Focus 25(4):E2 Details
Czosnyka M, Smielewski P, Lavinio A, Czosnyka Z, Pickard JD (2007), “A synopsis of brain pressures: which? when? are they all useful?” Neurol Res 29(7):672-9 Details
Lavinio A, Schmidt EA, Haubrich C, Smielewski P, Pickard JD, Czosnyka M (2007), “Noninvasive evaluation of dynamic cerebrovascular autoregulation using Finapres plethysmograph and transcranial Doppler” Stroke 38(2):402-404 Details
Smielewski P, Czosnyka M, Steiner L, Belestri M, Piechnik S, Pickard JD (2005), “ICM+: software for on-line analysis of bedside monitoring data after severe head trauma” Acta Neurochir Suppl 95:43-49 Details
Smielewski P, Coles JP, Fryer TD, Minhas PS, Menon DK, Pickard JD (2002), “Integrated image analysis solutions for PET datasets in damaged brain” J Clin Monit Comput 17(7-8):427-440
Publications
2011
Budohoski KP, Reinhard M, Aries MJ, Czosnyka Z, Smielewski P, Pickard JD, Kirkpatrick PJ, Czosnyka M (2011), “Monitoring cerebral autoregulation after head injury. Which component of transcranial Doppler flow velocity is optimal?” Neurocrit Care Details
Carrera E, Kim DJ, Castellani G, Zweifel C, Smielewski P, Pickard JD, Czosnyka M (2011), “Effect of hyper- and hypocapnia on cerebral arterial compliance in normal subjects.” J Neuroimaging 21(2):121-5 Details
Carrera E, Kim DJ, Castellani G, Zweifel C, Smielewski P, Pickard JD, Kirkpatrick PJ, Czosnyka M (2011), “Cerebral arterial compliance in patients with internal carotid artery disease.” Eur J Neurol 18(5):711-8 Details
Carrera E, Steiner LA, Castellani G, Smielewski P, Zweifel C, Haubrich C, Pickard JD, Menon DK, Czosnyka M (2011), “Changes in Cerebral Compartmental Compliances during Mild Hypocapnia in Patients with Traumatic Brain Injury.” J Neurotrauma 28(6):889-96 Details
Haubrich C, Steiner L, Kasprowicz M, Diedler J, Carrera E, Diehl RR, Smielewski P, Czosnyka M (2011), “Short-Term Moderate Hypocapnia Augments Detection of Optimal Cerebral Perfusion Pressure.” J Neurotrauma Details
Lee JK, Brady KM, Mytar JO, Kibler KK, Carter EL, Hirsch KG, Hogue CW, Easley RB, Jordan LC, Smielewski P, Czosnyka M, Shaffner DH, Koehler RC (2011), “Cerebral blood flow and cerebrovascular autoregulation in a swine model of pediatric cardiac arrest and hypothermia.” Crit Care Med Details
Sorrentino E, Budohoski KP, Kasprowicz M, Smielewski P, Matta B, Pickard JD, Czosnyka M (2011), “Critical thresholds for transcranial Doppler indices of cerebral autoregulation in traumatic brain injury.” Neurocrit Care 14(2):188-93 Details
Timofeev I, Carpenter KL, Nortje J, Al-Rawi PG, O'Connell MT, Czosnyka M, Smielewski P, Pickard JD, Menon DK, Kirkpatrick PJ, Gupta AK, Hutchinson PJ (2011), “Cerebral extracellular chemistry and outcome following traumatic brain injury: a microdialysis study of 223 patients.” Brain 134(Pt 2):484-94 Details
2010
Brady K, Joshi B, Zweifel C, Smielewski P, Czosnyka M, Easley RB, Hogue CW Jr (2010), “Real-time continuous monitoring of cerebral blood flow autoregulation using near-infrared spectroscopy in patients undergoing cardiopulmonary bypass.” Stroke 41(9):1951-6 Details
Brady KM, Mytar JO, Kibler KK, Hogue CW Jr, Lee JK, Czosnyka M, Smielewski P, Easley RB (2010), “Noninvasive autoregulation monitoring with and without intracranial pressure in the naive piglet brain.” Anesth Analg 111(1):191-5 Details
Carrera E, Kim DJ, Castellani G, Zweifel C, Czosnyka Z, Kasparowicz M, Smielewski P, Pickard JD, Czosnyka M (2010), “What shapes pulse amplitude of intracranial pressure?” J Neurotrauma 27(2):317-24 Details
Joshi B, Brady K, Lee J, Easley B, Panigrahi R, Smielewski P, Czosnyka M, Hogue CW Jr (2010), “Impaired autoregulation of cerebral blood flow during rewarming from hypothermic cardiopulmonary bypass and its potential association with stroke.” Anesth Analg 110(2):321-8 Details
Kasprowicz M, Schmidt E, Kim DJ, Haubrich C, Czosnyka Z, Smielewski P, Czosnyka M (2010), “Evaluation of the cerebrovascular pressure reactivity index using non-invasive finapres arterial blood pressure.” Physiol Meas 31(9):1217-28 Details
Kim DJ, Carrera E, Czosnyka M, Keong N, Smielewski P, Balédent O, Sutcliffe MP, Pickard JD, Czosnyka Z (2010), “Cerebrospinal compensation of pulsating cerebral blood volume in hydrocephalus.” Neurol Res 32(6):587-92 Details
Radolovich DK, Czosnyka M, Timofeev I, Lavinio A, Kim DJ, Jaeger M, Hutchinson P, Gupta A, Pickard JD, Smielewski P (2010), “Transient changes in brain tissue oxygen in response to modifications of cerebral perfusion pressure: an observational study.” Anesth Analg 110(1):165-73 Details
Weerakkody RA, Czosnyka M, Zweifel C, Castellani G, Smielewski P, Keong N, Haubrich C, Pickard J, Czosnyka Z (2010), “Slow vasogenic fluctuations of intracranial pressure and cerebral near infrared spectroscopy--an observational study.” Acta Neurochir (Wien) 152(10):1763-9 Details
Zweifel C, Castellani G, Czosnyka M, Helmy A, Manktelow A, Carrera E, Brady KM, Hutchinson PJ, Menon DK, Pickard JD, Smielewski P (2010), “Noninvasive monitoring of cerebrovascular reactivity with near infrared spectroscopy in head-injured patients.” J Neurotrauma 27(11):1951-8 Details
Zweifel C, Czosnyka M, Lavinio A, Castellani G, Kim DJ, Carrera E, Pickard JD, Kirkpatrick PJ, Smielewski P (2010), “A comparison study of cerebral autoregulation assessed with transcranial Doppler and cortical laser Doppler flowmetry.” Neurol Res 32(4):425-8 Details
2009
Brady KM, Lee JK, Kibler KK, Easley RB, Koehler RC, Czosnyka M, Smielewski P, Shaffner DH (2009), “The lower limit of cerebral blood flow autoregulation is increased with elevated intracranial pressure.” Anesth Analg 108(4):1278-83 Details
Brady KM, Shaffner DH, Lee JK, Easley RB, Smielewski P, Czosnyka M, Jallo GI, Guerguerian AM (2009), “Continuous monitoring of cerebrovascular pressure reactivity after traumatic brain injury in children.” Pediatrics 124(6):e1205-12 Details
Castellani G, Zweifel C, Kim DJ, Carrera E, Radolovich DK, Smielewski P, Hutchinson PJ, Pickard JD, Czosnyka M (2009), “Plateau waves in head injured patients requiring neurocritical care.” Neurocrit Care 11(2):143-50 Details
Czosnyka M, Brady K, Reinhard M, Smielewski P, Steiner LA (2009), “Monitoring of cerebrovascular autoregulation: facts, myths, and missing links.” Neurocrit Care 10(3):373-86 Details
Kim DJ, Czosnyka Z, Keong N, Radolovich DK, Smielewski P, Sutcliffe MP, Pickard JD, Czosnyka M (2009), “Index of cerebrospinal compensatory reserve in hydrocephalus.” Neurosurgery 64(3):494-501; discussion 501-2 Details
Kim DJ, Kasprowicz M, Carrera E, Castellani G, Zweifel C, Lavinio A, Smielewski P, Sutcliffe MP, Pickard JD, Czosnyka M (2009), “The monitoring of relative changes in compartmental compliances of brain.” Physiol Meas 30(7):647-59 Details
Lee JK, Kibler KK, Benni PB, Easley RB, Czosnyka M, Smielewski P, Koehler RC, Shaffner DH, Brady KM (2009), “Cerebrovascular reactivity measured by near-infrared spectroscopy.” Stroke 40(5):1820-6 Details
López-Magaña JA, Richards HK, Radolovich DK, Kim DJ, Smielewski P, Kirkpatrick PJ, Pickard JD, Czosnyka M (2009), “Critical closing pressure: comparison of three methods.” J Cereb Blood Flow Metab 29(5):987-93 Details
Petrella G, Czosnyka M, Smielewski P, Allin D, Guazzo EP, Pickard JD, Czosnyka ZH (2009), “In vivo assessment of hydrocephalus shunt.” Acta Neurol Scand 120(5):317-23 Details
Radolovich DK, Czosnyka M, Timofeev I, Lavinio A, Hutchinson P, Gupta A, Pickard JD, Smielewski P (2009), “Reactivity of brain tissue oxygen to change in cerebral perfusion pressure in head injured patients.” Neurocrit Care 10(3):274-9 Details
Santarius T, Kirkpatrick PJ, Ganesan D, Chia HL, Jalloh I, Smielewski P, Richards HK, Marcus H, Parker RA, Price SJ, Kirollos RW, Pickard JD, Hutchinson PJ (2009), “Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomised controlled trial.” Lancet 374(9695):1067-73 Details
Steiner LA, Pfister D, Strebel SP, Radolovich D, Smielewski P, Czosnyka M (2009), “Near-infrared spectroscopy can monitor dynamic cerebral autoregulation in adults.” Neurocrit Care 10(1):122-8 Details
2008
Abate MG, Trivedi M, Fryer TD, Smielewski P, Chatfield DA, Williams GB, Aigbirhio F, Carpenter TA, Pickard JD, Menon DK, Coles JP (2008), “Early derangements in oxygen and glucose metabolism following head injury: the ischemic penumbra and pathophysiological heterogeneity.” Neurocrit Care 9(3):319-25 Details
Czosnyka M, Radolovich D, Balestreri M, Lavinio A, Hutchinson P, Timofeev I, Smielewski P, Pickard JD (2008), “Gender-related differences in intracranial hypertension and outcome after traumatic brain injury.” Acta Neurochir Suppl 102:25-8 Details
Czosnyka M, Smielewski P, Lavinio A, Pickard JD, Panerai R (2008), “An assessment of dynamic autoregulation from spontaneous fluctuations of cerebral blood flow velocity: a comparison of two models, index of autoregulation and mean flow index.” Anesth Analg 106(1):234-9, table of contents Details
Czosnyka Z, Keong N, Kim DJ, Radolovich D, Smielewski P, Lavinio A, Schmidt EA, Momjian S, Owler B, Pickard JD, Czosnyka M (2008), “Pulse amplitude of intracranial pressure waveform in hydrocephalus.” Acta Neurochir Suppl 102:137-40 Details
Lavinio A, Ene-Iordache B, Nodari I, Girardini A, Cagnazzi E, Rasulo F, Smielewski P, Czosnyka M, Latronico N (2008), “Cerebrovascular reactivity and autonomic drive following traumatic brain injury.” Acta Neurochir Suppl 102:3-7 Details
Lavinio A, Harding S, Van Der Boogaard F, Czosnyka M, Smielewski P, Richards HK, Pickard JD, Czosnyka ZH (2008), “Magnetic field interactions in adjustable hydrocephalus shunts.” J Neurosurg Pediatr 2(3):222-8 Details
Nortje J, Coles JP, Timofeev I, Fryer TD, Aigbirhio FI, Smielewski P, Outtrim JG, Chatfield DA, Pickard JD, Hutchinson PJ, Gupta AK, Menon DK (2008), “Effect of hyperoxia on regional oxygenation and metabolism after severe traumatic brain injury: preliminary findings.” Crit Care Med 36(1):273-81 Details
Pfister D, Schmidt B, Smielewski P, Siegemund M, Strebel SP, Rüegg S, Marsch SC, Pargger H, Steiner LA (2008), “Intracranial pressure in patients with sepsis.” Acta Neurochir Suppl 102:71-5 Details
Pfister D, Siegemund M, Dell-Kuster S, Smielewski P, Rüegg S, Strebel SP, Marsch SC, Pargger H, Steiner LA (2008), “Cerebral perfusion in sepsis-associated delirium.” Crit Care 12(3):R63 Details
Timofeev I, Czosnyka M, Nortje J, Smielewski P, Kirkpatrick P, Gupta A, Hutchinson P (2008), “Effect of decompressive craniectomy on intracranial pressure and cerebrospinal compensation following traumatic brain injury.” J Neurosurg 108(1):66-73 Details
2007
Brady KM, Lee JK, Kibler KK, Smielewski P, Czosnyka M, Easley RB, Koehler RC, Shaffner DH (2007), “Continuous time-domain analysis of cerebrovascular autoregulation using near-infrared spectroscopy.” Stroke 38(10):2818-25 Details
Coles JP, Fryer TD, Coleman MR, Smielewski P, Gupta AK, Minhas PS, Aigbirhio F, Chatfield DA, Williams GB, Boniface S, Carpenter TA, Clark JC, Pickard JD, Menon DK (2007), “Hyperventilation following head injury: effect on ischemic burden and cerebral oxidative metabolism.” Crit Care Med 35(2):568-78 Details
Czosnyka M, Czosnyka Z, Keong N, Lavinio A, Smielewski P, Momjian S, Schmidt EA, Petrella G, Owler B, Pickard JD (2007), “Pulse pressure waveform in hydrocephalus: what it is and what it isn't.” Neurosurg Focus 22(4):E2 Details
Czosnyka M, Smielewski P, Timofeev I, Lavinio A, Guazzo E, Hutchinson P, Pickard JD (2007), “Intracranial pressure: more than a number.” Neurosurg Focus 22(5):E10 Details
Eide PK, Czosnyka M, Sorteberg W, Pickard JD, Smielewski P (2007), “Association between intracranial, arterial pulse pressure amplitudes and cerebral autoregulation in head injury patients.” Neurol Res 29(6):578-82 Details
Eklund A, Smielewski P, Chambers I, Alperin N, Malm J, Czosnyka M, Marmarou A (2007), “Assessment of cerebrospinal fluid outflow resistance.” Med Biol Eng Comput 45(8):719-35 Details
Haubrich C, Czosnyka Z, Lavinio A, Smielewski P, Diehl RR, Pickard JD, Czosnyka M (2007), “Is there a direct link between cerebrovascular activity and cerebrospinal fluid pressure-volume compensation?” Stroke 38(10):2677-80 Details
Lavinio A, Timofeev I, Nortje J, Outtrim J, Smielewski P, Gupta A, Hutchinson PJ, Matta BF, Pickard JD, Menon D, Czosnyka M (2007), “Cerebrovascular reactivity during hypothermia and rewarming.” Br J Anaesth 99(2):237-44 Details
Lewis PM, Smielewski P, Pickard JD, Czosnyka M (2007), “Slow oscillations in middle cerebral artery cerebral blood flow velocity and aging.” Neurol Res 29(3):260-3 Details
Lewis PM, Smielewski P, Pickard JD, Czosnyka M (2007), “Dynamic cerebral autoregulation: should intracranial pressure be taken into account?” Acta Neurochir (Wien) 149(6):549-55; discussion 555 Details
Newcombe VF, Williams GB, Nortje J, Bradley PG, Harding SG, Smielewski P, Coles JP, Maiya B, Gillard JH, Hutchinson PJ, Pickard JD, Carpenter TA, Menon DK (2007), “Analysis of acute traumatic axonal injury using diffusion tensor imaging.” Br J Neurosurg 21(4):340-8 Details
2006
Balestreri M, Czosnyka M, Hutchinson P, Steiner LA, Hiler M, Smielewski P, Pickard JD (2006), “Impact of intracranial pressure and cerebral perfusion pressure on severe disability and mortality after head injury.” Neurocrit Care 4(1):8-13 Details
Coles JP, Fryer TD, Bradley PG, Nortje J, Smielewski P, Rice K, Clark JC, Pickard JD, Menon DK (2006), “Intersubject variability and reproducibility of 15O PET studies.” J Cereb Blood Flow Metab 26(1):48-57 Details
Czosnyka M, Hutchinson PJ, Balestreri M, Hiler M, Smielewski P, Pickard JD (2006), “Monitoring and interpretation of intracranial pressure after head injury.” Acta Neurochir Suppl 96:114-8 Details
Guendling K, Smielewski P, Czosnyka M, Lewis P, Nortje J, Timofeev I, Hutchinson PJ, Pickard JD (2006), “Use of ICM+ software for on-line analysis of intracranial and arterial pressures in head-injured patients.” Acta Neurochir Suppl 96:108-13 Details
Hiler M, Czosnyka M, Hutchinson P, Balestreri M, Smielewski P, Matta B, Pickard JD (2006), “Predictive value of initial computerized tomography scan, intracranial pressure, and state of autoregulation in patients with traumatic brain injury.” J Neurosurg 104(5):731-7 Details
2005
Cunningham AS, Salvador R, Coles JP, Chatfield DA, Bradley PG, Johnston AJ, Steiner LA, Fryer TD, Aigbirhio FI, Smielewski P, Williams GB, Carpenter TA, Gillard JH, Pickard JD, Menon DK (2005), “Physiological thresholds for irreversible tissue damage in contusional regions following traumatic brain injury.” Brain 128(Pt 8):1931-42 Details
Czosnyka M, Balestreri M, Steiner L, Smielewski P, Hutchinson PJ, Matta B, Pickard JD (2005), “Age, intracranial pressure, autoregulation, and outcome after brain trauma.” J Neurosurg 102(3):450-4 Details
Czosnyka M, Steiner L, Balestreri M, Schmidt E, Smielewski P, Hutchinson PJ, Pickard JD (2005), “Concept of "true ICP" in monitoring and prognostication in head trauma.” Acta Neurochir Suppl 95:341-4 Details
Czosnyka Z, Czosnyka M, Owler B, Momjian S, Kasprowicz M, Schmidt EA, Smielewski P, Pickard JD (2005), “Clinical testing of CSF circulation in hydrocephalus.” Acta Neurochir Suppl 95:247-51 Details
Johnston AJ, Steiner LA, Coles JP, Chatfield DA, Fryer TD, Smielewski P, Hutchinson PJ, O'Connell MT, Al-Rawi PG, Aigbirihio FI, Clark JC, Pickard JD, Gupta AK, Menon DK (2005), “Effect of cerebral perfusion pressure augmentation on regional oxygenation and metabolism after head injury.” Crit Care Med 33(1):189-95; discussion 255-7 Details
Kumar A, Schmidt EA, Hiler M, Smielewski P, Pickard JD, Czosnyka M (2005), “Asymmetry of critical closing pressure following head injury.” J Neurol Neurosurg Psychiatry 76(11):1570-3 Details
Pickard JD, Hutchinson PJ, Coles JP, Steiner LA, Johnston AJ, Fryer TD, Coleman MR, Smielewski P, Chatfield DA, Aigbirhio F, Williams GB, Rice K, Clark JC, Salmond CH, Sahakian BJ, Bradley PG, Carpenter TA, Salvador R, Pena A, Gillard JH, Cunningham AS, Piechnik S, Czosnyka M, Menon DK (2005), “Imaging of cerebral blood flow and metabolism in brain injury in the ICU.” Acta Neurochir Suppl 95:459-64 Details
Steiner LA, Balestreri M, Johnston AJ, Coles JP, Smielewski P, Pickard JD, Menon DK, Czosnyka M (2005), “Predicting the response of intracranial pressure to moderate hyperventilation.” Acta Neurochir (Wien) 147(5):477-83; discussion 483 Details
2004
Balestreri M, Czosnyka M, Chatfield DA, Steiner LA, Schmidt EA, Smielewski P, Matta B, Pickard JD (2004), “Predictive value of Glasgow Coma Scale after brain trauma: change in trend over the past ten years.” J Neurol Neurosurg Psychiatry 75(1):161-2 Details
Balestreri M, Czosnyka M, Steiner LA, Schmidt E, Smielewski P, Matta B, Pickard JD (2004), “Intracranial hypertension: what additional information can be derived from ICP waveform after head injury?” Acta Neurochir (Wien) 146(2):131-41 Details
Chen SF, Richards HK, Smielewski P, Johnström P, Salvador R, Pickard JD, Harris NG (2004), “Relationship between flow-metabolism uncoupling and evolving axonal injury after experimental traumatic brain injury.” J Cereb Blood Flow Metab 24(9):1025-36 Details
Coles JP, Fryer TD, Smielewski P, Chatfield DA, Steiner LA, Johnston AJ, Downey SP, Williams GB, Aigbirhio F, Hutchinson PJ, Rice K, Carpenter TA, Clark JC, Pickard JD, Menon DK (2004), “Incidence and mechanisms of cerebral ischemia in early clinical head injury.” J Cereb Blood Flow Metab 24(2):202-11 Details
Coles JP, Fryer TD, Smielewski P, Rice K, Clark JC, Pickard JD, Menon DK (2004), “Defining ischemic burden after traumatic brain injury using 15O PET imaging of cerebral physiology.” J Cereb Blood Flow Metab 24(2):191-201 Details
Guadagno JV, Warburton EA, Aigbirhio FI, Smielewski P, Fryer TD, Harding S, Price CJ, Gillard JH, Carpenter TA, Baron JC (2004), “Does the acute diffusion-weighted imaging lesion represent penumbra as well as core? A combined quantitative PET/MRI voxel-based study.” J Cereb Blood Flow Metab 24(11):1249-54 Details
Menon DK, Coles JP, Gupta AK, Fryer TD, Smielewski P, Chatfield DA, Aigbirhio F, Skepper JN, Minhas PS, Hutchinson PJ, Carpenter TA, Clark JC, Pickard JD (2004), “Diffusion limited oxygen delivery following head injury.” Crit Care Med 32(6):1384-90 Details
Minhas PS, Smielewski P, Kirkpatrick PJ, Pickard JD, Czosnyka M (2004), “Pressure autoregulation and positron emission tomography-derived cerebral blood flow acetazolamide reactivity in patients with carotid artery stenosis.” Neurosurgery 55(1):63-7; discussion 67-8 Details
Owler BK, Momjian S, Czosnyka Z, Czosnyka M, Péna A, Harris NG, Smielewski P, Fryer T, Donovan T, Coles J, Carpenter A, Pickard JD (2004), “Normal pressure hydrocephalus and cerebral blood flow: a PET study of baseline values.” J Cereb Blood Flow Metab 24(1):17-23 Details
Owler BK, Pena A, Momjian S, Czosnyka Z, Czosnyka M, Harris NG, Smielewski P, Fryer T, Donvan T, Carpenter A, Pickard JD (2004), “Changes in cerebral blood flow during cerebrospinal fluid pressure manipulation in patients with normal pressure hydrocephalus: a methodological study.” J Cereb Blood Flow Metab 24(5):579-87 Details
Steiner LA, Balestreri M, Johnston AJ, Czosnyka M, Coles JP, Chatfield DA, Smielewski P, Pickard JD, Menon DK (2004), “Sustained moderate reductions in arterial CO2 after brain trauma time-course of cerebral blood flow velocity and intracranial pressure.” Intensive Care Med 30(12):2180-7 Details
2003
Czosnyka M, Smielewski P, Czosnyka Z, Piechnik S, Steiner LA, Schmidt E, Gooskens I, Soehle M, Lang EW, Matta BF, Pickard JD (2003), “Continuous assessment of cerebral autoregulation: clinical and laboratory experience.” Acta Neurochir Suppl 86:581-5 Details
Gooskens I, Schmidt EA, Czosnyka M, Piechnik SK, Smielewski P, Kirkpatrick PJ, Pickard JD (2003), “Pressure-autoregulation, CO2 reactivity and asymmetry of haemodynamic parameters in patients with carotid artery stenotic disease. A clinical appraisal.” Acta Neurochir (Wien) 145(7):527-32; discussion 532 Details
Kasprowicz M, Czosnyka M, Czosnyka Z, Momjian S, Smielewski P, Juniewicz H, Pickard JD (2003), “Hysteresis of the cerebrospinal pressure-volume curve in hydrocephalus.” Acta Neurochir Suppl 86:529-32 Details
Minhas PS, Menon DK, Smielewski P, Czosnyka M, Kirkpatrick PJ, Clark JC, Pickard JD (2003), “Positron emission tomographic cerebral perfusion disturbances and transcranial Doppler findings among patients with neurological deterioration after subarachnoid hemorrhage.” Neurosurgery 52(5):1017-22; discussion 1022-4 Details
Nestor PJ, Fryer TD, Smielewski P, Hodges JR (2003), “Limbic hypometabolism in Alzheimer's disease and mild cognitive impairment.” Ann Neurol 54(3):343-51 Details
Schmidt EA, Czosnyka M, Steiner LA, Balestreri M, Smielewski P, Piechnik SK, Matta BF, Pickard JD (2003), “Asymmetry of pressure autoregulation after traumatic brain injury.” J Neurosurg 99(6):991-8 Details
Schmidt EA, Piechnik SK, Smielewski P, Raabe A, Matta BF, Czosnyka M (2003), “Symmetry of cerebral hemodynamic indices derived from bilateral transcranial Doppler.” J Neuroimaging 13(3):248-54 Details
Steiner LA, Coles JP, Czosnyka M, Minhas PS, Fryer TD, Aigbirhio FI, Clark JC, Smielewski P, Chatfield DA, Donovan T, Pickard JD, Menon DK (2003), “Cerebrovascular pressure reactivity is related to global cerebral oxygen metabolism after head injury.” J Neurol Neurosurg Psychiatry 74(6):765-70 Details
Steiner LA, Coles JP, Johnston AJ, Chatfield DA, Smielewski P, Fryer TD, Aigbirhio FI, Clark JC, Pickard JD, Menon DK, Czosnyka M (2003), “Assessment of cerebrovascular autoregulation in head-injured patients: a validation study.” Stroke 34(10):2404-9 Details
Steiner LA, Coles JP, Johnston AJ, Czosnyka M, Fryer TD, Smielewski P, Chatfield DA, Salvador R, Aigbirhio FI, Clark JC, Menon DK, Pickard JD (2003), “Responses of posttraumatic pericontusional cerebral blood flow and blood volume to an increase in cerebral perfusion pressure.” J Cereb Blood Flow Metab 23(11):1371-7 Details
2002
Coles JP, Minhas PS, Fryer TD, Smielewski P, Aigbirihio F, Donovan T, Downey SP, Williams G, Chatfield D, Matthews JC, Gupta AK, Carpenter TA, Clark JC, Pickard JD, Menon DK (2002), “Effect of hyperventilation on cerebral blood flow in traumatic head injury: clinical relevance and monitoring correlates.” Crit Care Med 30(9):1950-9 Details
Czosnyka M, Smielewski P, Piechnik S, Pickard JD (2002), “Clinical significance of cerebral autoregulation.” Acta Neurochir Suppl 81:117-9 Details
Schmidt EA, Czosnyka M, Smielewski P, Piechnik SK, Pickard JD (2002), “Asymmetry of cerebral autoregulation following head injury.” Acta Neurochir Suppl 81:133-4 Details
Smielewski P, Coles JP, Fryer TD, Minhas PS, Menon DK, Pickard JD (2002), “Integrated image analysis solutions for PET datasets in damaged brain.” J Clin Monit Comput 17(7-8):427-40 Details
Steiner LA, Czosnyka M, Piechnik SK, Smielewski P, Chatfield D, Menon DK, Pickard JD (2002), “Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury.” Crit Care Med 30(4):733-8 Details
2001
Al-Rawi PG, Smielewski P, Kirkpatrick PJ (2001), “Evaluation of a near-infrared spectrometer (NIRO 300) for the detection of intracranial oxygenation changes in the adult head.” Stroke 32(11):2492-500 Details
Czosnyka M, Smielewski P, Piechnik S, Steiner LA, Pickard JD (2001), “Cerebral autoregulation following head injury.” J Neurosurg 95(5):756-63 Details
Turner CL, Tebbs S, Smielewski P, Kirkpatrick PJ (2001), “The influence of hemodynamic stress factors on intracranial aneurysm formation.” J Neurosurg 95(5):764-70 Details
2000
Czosnyka M, Smielewski P, Piechnik S, Schmidt EA, Seeley H, al-Rawi P, Matta BF, Kirkpatrick PJ, Pickard JD (2000), “Continuous assessment of cerebral autoregulation--clinical verification of the method in head injured patients.” Acta Neurochir Suppl 76:483-4 Details
Laing RJ, Smielewski P, Czosnyka M, Quaranta N, Moffat DA (2000), “A study of perioperative lumbar cerebrospinal fluid pressure in patients undergoing acoustic neuroma surgery.” Skull Base Surg 10(4):179-85 Details
Lam JM, Smielewski P, al-Rawi P, Griffiths P, Yu AL, Pickard JD, Kirkpatrick PJ (2000), “Prediction of cerebral ischaemia during carotid endarterectomy with preoperative CO2-reactivity studies and angiography.” Br J Neurosurg 14(5):441-8 Details
Lam JM, Smielewski P, Czosnyka M, Pickard JD, Kirkpatrick PJ (2000), “Predicting delayed ischemic deficits after aneurysmal subarachnoid hemorrhage using a transient hyperemic response test of cerebral autoregulation.” Neurosurgery 47(4):819-25; discussions 825-6 Details
1999
Czosnyka M, Smielewski P, Piechnik S, Al-Rawi PG, Kirkpatrick PJ, Matta BF, Pickard JD (1999), “Critical closing pressure in cerebrovascular circulation.” J Neurol Neurosurg Psychiatry 66(5):606-11 Details
Czosnyka M, Smielewski P, Piechnik S, Schmidt EA, Al-Rawi PG, Kirkpatrick PJ, Pickard JD (1999), “Hemodynamic characterization of intracranial pressure plateau waves in head-injury patients.” J Neurosurg 91(1):11-9 Details
Piechnik SK, Yang X, Czosnyka M, Smielewski P, Fletcher SH, Jones AL, Pickard JD (1999), “The continuous assessment of cerebrovascular reactivity: a validation of the method in healthy volunteers.” Anesth Analg 89(4):944-9 Details
1998
al-Rawi PG, Smielewski P, Kirkpatrick PJ (1998), “Preliminary evaluation of a prototype spatially resolved spectrometer.” Acta Neurochir Suppl 71:255-7 Details
Czosnyka M, Matta BF, Smielewski P, Kirkpatrick PJ, Pickard JD (1998), “Cerebral perfusion pressure in head-injured patients: a noninvasive assessment using transcranial Doppler ultrasonography.” J Neurosurg 88(5):802-8 Details
Czosnyka M, Smielewski P, Kirkpatrick P, Piechnik S, Laing R, Pickard JD (1998), “Continuous monitoring of cerebrovascular pressure-reactivity in head injury.” Acta Neurochir Suppl 71:74-7 Details
Kirkpatrick PJ, Lam J, Al-Rawi P, Smielewski P, Czosnyka M (1998), “Defining thresholds for critical ischemia by using near-infrared spectroscopy in the adult brain.” J Neurosurg 89(3):389-94 Details
Kirkpatrick PJ, Smielewski P, Al-Rawi P, Czosnyka M (1998), “Resolving extra- and intracranial signal changes during adult near infrared spectroscopy.” Neurol Res 20 Suppl 1:S19-22 Details
Minhas PS, Smielewski P, Czosnyka M, Kirkpatrick PJ (1998), “Preoperative carbon dioxide reactivity studies do not predict the hemodynamic changes seen during carotid endarterectomy after internal carotid artery clamping.” J Stroke Cerebrovasc Dis 7(1):44-51 Details
Piechnik S, Czosnyka M, Smielewski P, Pickard JD (1998), “Indices for decreased cerebral blood flow control--a modelling study.” Acta Neurochir Suppl 71:269-71 Details
Smielewski P, Czosnyka M, Pickard JD, Kirkpatrick P (1998), “Assessment of cerebrovascular reactivity in patients with carotid artery disease using near-infrared spectroscopy.” Acta Neurochir Suppl 71:263-5 Details
1997
Czosnyka M, Piechnik S, Richards HK, Kirkpatrick P, Smielewski P, Pickard JD (1997), “Contribution of mathematical modelling to the interpretation of bedside tests of cerebrovascular autoregulation.” J Neurol Neurosurg Psychiatry 63(6):721-31 Details
Czosnyka M, Smielewski P, Kirkpatrick P, Laing RJ, Menon D, Pickard JD (1997), “Continuous assessment of the cerebral vasomotor reactivity in head injury.” Neurosurgery 41(1):11-7; discussion 17-9 Details
Gupta AK, Menon DK, Czosnyka M, Smielewski P, Jones JG (1997), “Thresholds for hypoxic cerebral vasodilation in volunteers.” Anesth Analg 85(4):817-20 Details
Gupta AK, Menon DK, Czosnyka M, Smielewski P, Kirkpatrick PJ, Jones JG (1997), “Non-invasive measurement of cerebral blood volume in volunteers.” Br J Anaesth 78(1):39-43 Details
Lam JM, Smielewski P, al-Rawi P, Griffiths P, Pickard JD, Kirkpatrick PJ (1997), “Internal and external carotid contributions to near-infrared spectroscopy during carotid endarterectomy.” Stroke 28(5):906-11 Details
Smielewski P, Czosnyka M, Kirkpatrick P, Pickard JD (1997), “Evaluation of the transient hyperemic response test in head-injured patients.” J Neurosurg 86(5):773-8 Details
Smielewski P, Czosnyka M, Pickard JD, Kirkpatrick P (1997), “Clinical evaluation of near-infrared spectroscopy for testing cerebrovascular reactivity in patients with carotid artery disease.” Stroke 28(2):331-8 Details
Smielewski P, Czosnyka M, Zabolotny W, Kirkpatrick P, Richards H, Pickard JD (1997), “A computing system for the clinical and experimental investigation of cerebrovascular reactivity.” Int J Clin Monit Comput 14(3):185-98 Details
1996
Czosnyka M, Guazzo E, Whitehouse M, Smielewski P, Czosnyka Z, Kirkpatrick P, Piechnik S, Pickard JD (1996), “Significance of intracranial pressure waveform analysis after head injury.” Acta Neurochir (Wien) 138(5):531-41; discussion 541-2 Details
Czosnyka M, Smielewski P, Kirkpatrick P, Menon DK, Pickard JD (1996), “Monitoring of cerebral autoregulation in head-injured patients.” Stroke 27(10):1829-34 Details
Czosnyka M, Whitehouse H, Smielewski P, Simac S, Pickard JD (1996), “Testing of cerebrospinal compensatory reserve in shunted and non-shunted patients: a guide to interpretation based on an observational study.” J Neurol Neurosurg Psychiatry 60(5):549-58 Details
Kirkpatrick PJ, Smielewski P, Piechnik S, Pickard JD, Czosnyka M (1996), “Early effects of mannitol in patients with head injuries assessed using bedside multimodality monitoring.” Neurosurgery 39(4):714-20; discussion 720-1 Details
Smielewski P, Czosnyka M, Kirkpatrick P, McEroy H, Rutkowska H, Pickard JD (1996), “Assessment of cerebral autoregulation using carotid artery compression.” Stroke 27(12):2197-203 Details
Smielewski P, Kirkpatrick PJ, Richards H, Pickard JD, Czosnyka M (1996), “A feedback-controlled pump produces stable hypotension in anaesthetised rabbits.” J Cereb Blood Flow Metab 16(3):532-6 Details
Whitfield PC, Moss H, O'Hare D, Smielewski P, Pickard JD, Kirkpatrick PJ (1996), “An audit of aneurysmal subarachnoid haemorrhage: earlier resuscitation and surgery reduces inpatient stay and deaths from rebleeding.” J Neurol Neurosurg Psychiatry 60(3):301-6 Details
1995
Kirkpatrick PJ, Smielewski P, Czosnyka M, Menon DK, Pickard JD (1995), “Near-infrared spectroscopy use in patients with head injury.” J Neurosurg 83(6):963-70 Details
Kirkpatrick PJ, Smielewski P, Whitfield PC, Czosnyka M, Menon D, Pickard JD (1995), “An observational study of near-infrared spectroscopy during carotid endarterectomy.” J Neurosurg 82(5):756-63 Details
Smielewski P, Czosnyka M, Iyer V, Piechnik S, Whitehouse H, Pickard J (1995), “Computerised transient hyperaemic response test--a method for the assessment of cerebral autoregulation.” Ultrasound Med Biol 21(5):599-611 Details
Smielewski P, Czosnyka M, Roszkowski M, Walencik A (1995), “Identification of the cerebrospinal compensatory mechanisms via computer-controlled drainage of the cerebrospinal fluid.” Childs Nerv Syst 11(5):297-300 Details
Smielewski P, Kirkpatrick P, Minhas P, Pickard JD, Czosnyka M (1995), “Can cerebrovascular reactivity be measured with near-infrared spectroscopy?” Stroke 26(12):2285-92 Details
1994
Czosnyka M, Guazzo E, Iyer V, Kirkpatrick P, Smielewski P, Whitehouse H, Pickard JD (1994), “Testing of cerebral autoregulation in head injury by waveform analysis of blood flow velocity and cerebral perfusion pressure.” Acta Neurochir Suppl (Wien) 60:468-71 Details
Czosnyka M, Whitehouse H, Smielewski P, Kirkpatrick P, Guazzo EP, Pickard JD (1994), “Computer supported multimodal bed-side monitoring for neuro intensive care.” Int J Clin Monit Comput 11(4):223-32 Details
Kirkpatrick PJ, Meyer T, Sarkies N, Pickard JD, Whitehouse H, Smielewski P (1994), “Papilloedema and visual failure in a patient with nocturnal hypoventilation.” J Neurol Neurosurg Psychiatry 57(12):1546-7 Details
Kirkpatrick PJ, Smielewski P, Czosnyka M, Pickard JD (1994), “Continuous monitoring of cortical perfusion by laser Doppler flowmetry in ventilated patients with head injury.” J Neurol Neurosurg Psychiatry 57(11):1382-8 Details


