Dr Zofia Czosnyka University positionSenior Research Associate Dr Zofia Czosnyka is pleased to consider applications from prospective PhD students. DepartmentsDepartment of Clinical Neurosciences InstitutesHome pagehttp://www.neurosurg.cam.ac.uk Research ThemesInterestsDisturbance in cerebrospinal fluid circulation is one, but probably not the only reason for developing hydrocephalus. Physical models of CSF compensation may be identified in clinical practice. I provide a clinical service for the Hydrocephalus Clinic, consisting of CSF infusion studies and ICP monitoring. Infusion study is a unique clinical protocol where ICP is changed in a controllable manner. This produces the ideal opportunity to collect data regarding brain physiology. Past and ongoing projects include: 1. Signal processing for identification of cerebrospinal compensation 2. Analysis of cerebral autoregulation in hydrocephalus using transcarnial Doppler 3. Differences between Middle and Posterior Arteries autoregulation during mild intracranial hypertension 4. Stability of sinus pressure during infusion test in idiopathic intracranial hypertension 5. Identification of shunt functioning and overdrainage 6. Brain hysterezis 7. Distribution of PET-CBF in white matter in NPH  Infusion study with recording of arterial blood pressure, ICP and blood flow velocity in the MCA (left and right) Click image to view full-size Research Focus
EquipmentComputational modelling CSF infusion study ICP monitoring Collaborators
Associated News ItemsKey publicationsCzosnyka M, Czosnyka Z, Momjian S, Pickard JD (2004), “Cerebrospinal fluid dynamics” Physiol Meas 25(5):R51-76 Details Momjian S, Owler BK, Czosnyka Z, Czosnyka M, Pena A, Pickard JD (2004), “Pattern of white matter regional cerebral blood flow and autoregulation in normal pressure hydrocephalus” Brain 127(Pt 5):965-72 Details Czosnyka ZH, Czosnyka M, Whitfield PC, Donovan T, Pickard JD (2002), “Cerebral autoregulation among patients with symptoms of hydrocephalus” Neurosurgery 50(3):526-32 Publications2014Capel C, Kasprowicz M, Czosnyka M, Baledent O, Smielewski P, Pickard JD, Czosnyka Z (2014), “Cerebrovascular time constant in patients suffering from hydrocephalus.” Neurol Res 36(3):255-61 Details Chari A, Czosnyka M, Richards HK, Pickard JD, Czosnyka ZH (2014), “Hydrocephalus shunt technology: 20 years of experience from the Cambridge Shunt Evaluation Laboratory.” J Neurosurg Details Hart MG, Czosnyka M, Czosnyka ZH, Fernandes HM (2014), “Combined Intracranial Pressure Monitoring and Cerebrospinal Fluid Infusion Study to Guide Management of Slit Ventricle Syndrome.” Pediatr Neurosurg Details Werndle MC, Saadoun S, Phang I, Czosnyka M, Varsos GV, Czosnyka ZH, Smielewski P, Jamous A, Bell BA, Zoumprouli A, Papadopoulos MC (2014), “Monitoring of spinal cord perfusion pressure in acute spinal cord injury: initial findings of the injured spinal cord pressure evaluation study*.” Crit Care Med 42(3):646-55 Details 2013Czosnyka Z, Pickard JD, Czosnyka M (2013), “Hydrodynamic properties of the Certas hydrocephalus shunt.” J Neurosurg Pediatr 11(2):198-204 Details 2012Bouzerar R, Czosnyka M, Czosnyka Z, Balédent O (2012), “Physical phantom of craniospinal hydrodynamics.” Acta Neurochir Suppl 113:65-9 Details Budohoski KP, Reinhard M, Aries MJ, Czosnyka Z, Smielewski P, Pickard JD, Kirkpatrick PJ, Czosnyka M (2012), “Monitoring cerebral autoregulation after head injury. Which component of transcranial Doppler flow velocity is optimal?” Neurocrit Care 17(2):211-8 Details Czosnyka M, Czosnyka Z, Agarwal-Harding KJ, Pickard JD (2012), “Modeling of CSF dynamics: legacy of Professor Anthony Marmarou.” Acta Neurochir Suppl 113:9-14 Details Czosnyka M, Czosnyka Z, Pickard JD (2012), “Programmable Shunt Assistant tested in Cambridge shunt evaluation laboratory.” Acta Neurochir Suppl 113:71-6 Details Kim DJ, Czosnyka Z, Kasprowicz M, Smieleweski P, Baledent O, Guerguerian AM, Pickard JD, Czosnyka M (2012), “Continuous monitoring of the Monro-Kellie doctrine: is it possible?” J Neurotrauma 29(7):1354-63 Details Smielewski P, Czosnyka Z, Kasprowicz M, Pickard JD, Czosnyka M (2012), “ICM+: a versatile software for assessment of CSF dynamics.” Acta Neurochir Suppl 114:75-9 Details Weerakkody RA, Czosnyka M, Zweifel C, Castellani G, Smielewski P, Brady K, Pickard JD, Czosnyka Z (2012), “Near infrared spectroscopy as possible non-invasive monitor of slow vasogenic ICP waves.” Acta Neurochir Suppl 114:181-5 Details 2011Czosnyka Z, Owler B, Keong N, Santarius T, Baledent O, Pickard JD, Czosnyka M (2011), “Impact of duration of symptoms on CSF dynamics in idiopathic normal pressure hydrocephalus.” Acta Neurol Scand 123(6):414-8 Details Weerakkody RA, Czosnyka M, Schuhmann MU, Schmidt E, Keong N, Santarius T, Pickard JD, Czosnyka Z (2011), “Clinical assessment of cerebrospinal fluid dynamics in hydrocephalus. Guide to interpretation based on observational study.” Acta Neurol Scand 124(2):85-98 Details 2010Carrera 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 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 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 2009Kim 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 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 2008Allin D, Czosnyka M, Czosnyka Z (2008), “Laboratory testing of the Pressio intracranial pressure monitor.” Neurosurgery 62(5):1158-61; discussion 1161 Details Allin DM, Czosnyka M, Richards HK, Pickard JD, Czosnyka ZH (2008), “Investigation of the hydrodynamic properties of a new MRI-resistant programmable hydrocephalus shunt.” Cerebrospinal Fluid Res 5:8 Details Czosnyka Z, Czosnyka M, Lavinio A, Keong N, Pickard JD (2008), “Clinical testing of CSF circulation.” Eur J Anaesthesiol Suppl 42:142-5 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, Czosnyka Z, Czosnyka M (2008), “Cerebrospinal fluid dynamics: disturbances and diagnostics.” Eur J Anaesthesiol Suppl 42:137-41 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 Petrella G, Czosnyka M, Keong N, Pickard JD, Czosnyka Z (2008), “How does CSF dynamics change after shunting?” Acta Neurol Scand 118(3):182-8 Details Pickard JD, Czosnyka Z, Czosnyka M, Owler B, Higgins JN (2008), “Coupling of sagittal sinus pressure and cerebrospinal fluid pressure in idiopathic intracranial hypertension--a preliminary report.” Acta Neurochir Suppl 102:283-5 Details Schuhmann MU, Sood S, McAllister JP, Jaeger M, Ham SD, Czosnyka Z, Czosnyka M (2008), “Value of overnight monitoring of intracranial pressure in hydrocephalic children.” Pediatr Neurosurg 44(4):269-79 Details 2007Bromby A, Czosnyka Z, Allin D, Richards HK, Pickard JD, Czosnyka M (2007), “Laboratory study on "intracranial hypotension" created by pumping the chamber of a hydrocephalus shunt.” Cerebrospinal Fluid Res 4:2 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, 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 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 2006Allin DM, Czosnyka ZH, Czosnyka M, Richards HK, Pickard JD (2006), “In vitro hydrodynamic properties of the Miethke ProGAV hydrocephalus shunt.” Cerebrospinal Fluid Res 3:9 Details 2005Czosnyka 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 Czosnyka Z, Czosnyka M, Pickard JD (2005), “CSF pulse pressure and B waves.” J Neurosurg 103(4):767-8; author reply 768 Details Czosnyka Z, van den Boogaard F, Czosnyka M, Momjian S, Gelling L, Pickard JD (2005), “The relationship between CSF circulation and cerebrovascular pressure-reactivity in normal pressure hydrocephalus.” Acta Neurochir Suppl 95:207-11 Details Czosnyka ZH, Cieslicki K, Czosnyka M, Pickard JD (2005), “Hydrocephalus shunts and waves of intracranial pressure.” Med Biol Eng Comput 43(1):71-7 Details Czosnyka ZH, Czosnyka M, Richards HK, Pickard JD (2005), “Evaluation of three new models of hydrocephalus shunts.” Acta Neurochir Suppl 95:223-7 Details Juniewicz H, Kasprowicz M, Czosnyka M, Czosnyka Z, Gizewski S, Dzik M, Pickard JD (2005), “Analysis of intracranial pressure during and after the infusion test in patients with communicating hydrocephalus.” Physiol Meas 26(6):1039-48 Details Schmidt EA, Czosnyka Z, Momjian S, Czosnyka M, Bech RA, Pickard JD (2005), “Intracranial baroreflex yielding an early cushing response in human.” Acta Neurochir Suppl 95:253-6 Details 2004Czosnyka M, Richards HK, Czosnyka Z, Pickard JD (2004), “Normal-pressure hydrocephalus.” J Neurosurg 101(6):1083-4; author reply 1084 Details Kasprowicz M, Czosnyka Z, Czosnyka M, Momjian S, Juniewicz H, Pickard JD (2004), “Slight elevation of baseline intracranial pressure after fluid infusion into CSF space in patients with hydrocephalus.” Neurol Res 26(6):628-31 Details Momjian S, Czosnyka Z, Czosnyka M, Pickard JD (2004), “Link between vasogenic waves of intracranial pressure and cerebrospinal fluid outflow resistance in normal pressure hydrocephalus.” Br J Neurosurg 18(1):56-61 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 2003Czosnyka M, Czosnyka Z, Momjian S, Schmidt E (2003), “Calculation of the resistance to CSF outflow.” J Neurol Neurosurg Psychiatry 74(9):1354; author reply 1354-5 Details Czosnyka M, Czosnyka Z, Schmidt EA, Momjian S (2003), “Cerebrospinal fluid production.” J Neurosurg 99(1):206-7; author reply 207 Details Czosnyka M, Czosnyka ZH, Richards HK, Pickard JD (2003), “Hydrodynamic properties of extraventricular drainage systems.” Neurosurgery 52(3):619-23; discussion 623 Details 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 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 2002Czosnyka Z, Czosnyka M, Richards HK, Pickard JD (2002), “Laboratory testing of hydrocephalus shunts -- conclusion of the U.K. Shunt evaluation programme.” Acta Neurochir (Wien) 144(6):525-38; discussion 538 Details Czosnyka ZH, Czosnyka M, Pickard JD (2002), “Shunt testing in-vivo: a method based on the data from the UK shunt evaluation laboratory.” Acta Neurochir Suppl 81:27-30 Details Czosnyka ZH, Czosnyka M, Whitfield PC, Donovan T, Pickard JD (2002), “Cerebral autoregulation among patients with symptoms of hydrocephalus.” Neurosurgery 50(3):526-32; discussion 532-3 Details Taylor R, Czosnyka Z, Czosnyka M, Pickard JD (2002), “Factors determining mean ICP in hydrocephalic patients with Hakim-programmable valve: implications of the parallel arrangement of the CSF outflow resistance and shunt.” Acta Neurochir Suppl 81:23-6 Details Taylor R, Czosnyka Z, Czosnyka M, Pickard JD (2002), “A laboratory model of testing shunt performance after implantation.” Br J Neurosurg 16(1):30-5 Details 2001Czosnyka M, Czosnyka ZH, Whitfield PC, Donovan T, Pickard JD (2001), “Age dependence of cerebrospinal pressure-volume compensation in patients with hydrocephalus.” J Neurosurg 94(3):482-6 Details Czosnyka ZH, Czosnyka M, Richards HK, Pickard JD (2001), “Laboratory evaluation of the phoenix CRx diamond valve.” Neurosurgery 48(3):689-93; discussion 693-4 Details Owler BK, Fong KC, Czosnyka Z (2001), “Importance of ICP monitoring in the investigation of CSF circulation disorders.” Br J Neurosurg 15(5):439-40 Details 2000Czosnyka M, Copeman J, Czosnyka Z, McConnell R, Dickinson C, Pickard JD (2000), “Post-traumatic hydrocephalus: influence of craniectomy on the CSF circulation.” J Neurol Neurosurg Psychiatry 68(2):246-8 Details Czosnyka Z, Czosnyka M, Copeman J, Pickard JD (2000), “A randomized, controlled study of a programmable shunt valve versus a conventional valve for patients with hydrocephalus.” Neurosurgery 47(5):1250-1 Details 1999Czosnyka M, Richards HK, Czosnyka Z, Piechnik S, Pickard JD, Chir M (1999), “Vascular components of cerebrospinal fluid compensation.” J Neurosurg 90(4):752-9 Details Czosnyka Z, Czosnyka M, Pickard JD (1999), “Hydrodynamic performance of a new siphon preventing device: the SiphonGuard.” J Neurol Neurosurg Psychiatry 66(3):408-9 Details 1998Czosnyka Z, Czosnyka M, Richards H, Pickard JD (1998), “Hydrodynamic properties of hydrocephalus shunts.” Acta Neurochir Suppl 71:334-9 Details Czosnyka Z, Czosnyka M, Richards H, Pickard JD (1998), “Chhabra hydrocephalus shunt: lessons for gravitational valves.” J Neurol Neurosurg Psychiatry 65(3):406-7 Details Czosnyka Z, Czosnyka M, Richards HK, Pickard JD (1998), “Posture-related overdrainage: comparison of the performance of 10 hydrocephalus shunts in vitro.” Neurosurgery 42(2):327-33; discussion 333-4 Details 1997Czosnyka M, Czosnyka Z, Pickard JD (1997), “Laboratory testing of the Spiegelberg brain pressure monitor: a technical report.” J Neurol Neurosurg Psychiatry 63(6):732-5 Details Czosnyka M, Czosnyka Z, Whitehouse H, Pickard JD (1997), “Hydrodynamic properties of hydrocephalus shunts: United Kingdom Shunt Evaluation Laboratory.” J Neurol Neurosurg Psychiatry 62(1):43-50 Details 1996Czosnyka M, Czosnyka Z, Pickard JD (1996), “Laboratory testing of three intracranial pressure microtransducers: technical report.” Neurosurgery 38(1):219-24 Details 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, Harland S, Piechnik S, Kirkpatrick P, Czosnyka Z, Menon D (1996), “Systematic overestimation of intracranial pressure measured using a Camino pressure monitor.” J Neurol Neurosurg Psychiatry 61(4):427-8 Details 1990Czosnyka M, Maksymowicz W, Batorski L, Koszewski W, Czosnyka Z (1990), “Comparison between classic-differential and automatic shunt functioning on the basis of infusion tests.” Acta Neurochir (Wien) 106(1-2):1-8 Details |