Noninvasive Intracranial Pressure Estimation Using Subspace System Identification and Bespoke Machine Learning Algorithms: A Learning-to-Rank Approach

Anni Zhao; Ayca Ermis; Jeffrey Robert Vitt; Sergio Brasil; Wellingson Paiva; Magdalena Kasprowicz; Malgorzata Burzynska; Robert Hamilton; Runze Yan; Ofer Sadan; J. Claude Hemphill; Lieven Vandenberghe; Xiao Hu

arXiv · 2601.20916

Noninvasive Intracranial Pressure Estimation Using Subspace System Identification and Bespoke Machine Learning Algorithms: A Learning-to-Rank Approach

Anni Zhao·Ayca Ermis·Jeffrey Robert Vitt·Sergio Brasil·Wellingson Paiva·Magdalena Kasprowicz·Malgorzata Burzynska·Robert Hamilton·Runze Yan·Ofer Sadan·J. Claude Hemphill·Lieven Vandenberghe·Xiao Hu

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Abstract

Accurate noninvasive estimation of intracranial pressure (ICP) remains a major challenge in critical care. We developed a bespoke machine learning algorithm that integrates system identification and ranking-constrained optimization to estimate mean ICP from noninvasive signals. A machine learning framework was proposed to obtain accurate mean ICP values using arbitrary noninvasive signals. The subspace system identification algorithm is employed to identify cerebral hemodynamics models for ICP simulation using arterial blood pressure (ABP), cerebral blood velocity (CBv), and R-wave to R-wave interval (R-R interval) signals in a comprehensive database. A mapping function to describe the relationship between the features of noninvasive signals and the estimation errors is learned using innovative ranking constraints through convex optimization. Patients across multiple clinical settings were randomly split into testing and training datasets for performance evaluation of the mapping function. The results indicate that about 31.88% of testing entries achieved estimation errors within 2 mmHg and 34.07% of testing entries between 2 mmHg and 6 mmHg from the nonlinear mapping with constraints. Our results demonstrate the feasibility of the proposed noninvasive ICP estimation approach. Further validation and technical refinement are required before clinical deployment, but this work lays the foundation for safe and broadly accessible ICP monitoring in patients with acute brain injury and related conditions.

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Anni Zhao, Ayca Ermis, Jeffrey Robert Vitt, Sergio Brasil, Wellingson Paiva, Magdalena Kasprowicz, Malgorzata Burzynska, Robert Hamilton, Runze Yan, Ofer Sadan, J. Claude Hemphill, Lieven Vandenberghe, Xiao Hu. 2026-01-28. Noninvasive Intracranial Pressure Estimation Using Subspace System Identification and Bespoke Machine Learning Algorithms: A Learning-to-Rank Approach. https://arxiv.org/abs/2601.20916

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