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Continuous monitoring of cerebral blood flow (CBF) and oxygenation may enable early detection and inform clinical management. We hypothesized that non-invasive, bedside optical spectroscopy measurements of CBF and oxygenation are sensitive to abrupt increases in ICP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A hybrid optical system combining broadband near-infrared spectroscopy (bNIRS) and diffuse correlation spectroscopy (DCS) was used to monitor cerebral oxygenation and blood flow in 7 newborn piglets. ICP was gradually increased through saline infusion into the ventricles, and changes in CBF, oxygen saturation (StO\n                      <jats:sub>2<\/jats:sub>\n                      ), oxyhemoglobin (HbO\u2082), deoxyhemoglobin (Hb), and the oxidation state of cytochrome-c-oxidase (oxCCO) were continuously monitored with the hybrid optical device.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Elevated ICP was associated with decreased StO\n                      <jats:sub>2<\/jats:sub>\n                      and CBF, while oxCCO remained stable, indicating unchanged cerebral oxygen metabolism. Across all parameters, segmented linear regression revealed a breakpoint at which ICP alterations led to steeper slopes and in turn, larger hemodynamic changes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates that bNIRS\/DCS can effectively detect ICP-induced changes in cerebral hemodynamics and shows promise as a non-invasive neuromonitoring tool for neonatal critical care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Tissue optical spectroscopy can detect the hemodynamic effects of elevated ICP and could be used to guide interventions aimed at mitigating these effects.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Breakpoints identified in hemodynamics highlight a compensatory mechanism, after which ICP changes lead to a larger impact on cerebral hemodynamics.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Elevated ICP leads to distinct hemodynamic changes that may precede injury.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>This study supports the use of tissue optical spectroscopy for non-invasive neonatal neuromonitoring.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-025-04446-7","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T17:18:29Z","timestamp":1760203109000},"page":"2019-2026","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neonatal cerebral hemodynamics under elevated intracranial pressure: a near-infrared spectroscopy study in piglets"],"prefix":"10.1038","volume":"99","author":[{"given":"Sule","family":"Karagulleoglu-Kunduraci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah","family":"Kamar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasa","family":"Eskandari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed","family":"Samaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamadou","family":"Diop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,11]]},"reference":[{"key":"4446_CR1","unstructured":"Hospitalization and Childbirth Quick Stats Metadata."},{"key":"4446_CR2","doi-asserted-by":"publisher","first-page":"2588","DOI":"10.1364\/BOE.9.002588","volume":"9","author":"A Rajaram","year":"2018","unstructured":"Rajaram, A. et al. 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