scholarly journals Human ophthalmic artery as a sensor for non-invasive intracranial pressure monitoring: numerical modeling and in vivo pilot study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paulius Lucinskas ◽  
Mantas Deimantavicius ◽  
Laimonas Bartusis ◽  
Rolandas Zakelis ◽  
Edgaras Misiulis ◽  
...  
Keyword(s):  
Numerical Modeling ◽  
Clinical Study ◽  
Intracranial Pressure ◽  
Pressure Sensor ◽  
Ophthalmic Artery ◽  
Open Angle Glaucoma ◽  
Icp Monitoring ◽  
Paired Data ◽  
Non Invasive ◽  
Data Points

AbstractIntracranial pressure (ICP) monitoring is important in managing neurosurgical, neurological, and ophthalmological patients with open-angle glaucoma. Non-invasive two-depth transcranial Doppler (TCD) technique is used in a novel method for ICP snapshot measurement that has been previously investigated prospectively, and the results showed clinically acceptable accuracy and precision. The aim of this study was to investigate possibility of using the ophthalmic artery (OA) as a pressure sensor for continuous ICP monitoring. First, numerical modeling was done to investigate the possibility, and then a pilot clinical study was conducted to compare two-depth TCD-based non-invasive ICP monitoring data with readings from an invasive Codman ICP microsensor from patients with severe traumatic brain injury. The numerical modeling showed that the systematic error of non-invasive ICP monitoring was < 1.0 mmHg after eliminating the intraorbital and blood pressure gradient. In a clinical study, a total of 1928 paired data points were collected, and the extreme data points of measured differences between invasive and non-invasive ICP were − 3.94 and 4.68 mmHg (95% CI − 2.55 to 2.72). The total mean and SD were 0.086 ± 1.34 mmHg, and the correlation coefficient was 0.94. The results show that the OA can be used as a linear natural pressure sensor and that it could potentially be possible to monitor the ICP for up to 1 h without recalibration.

Validation of Noninvasive Absolute Intracranial Pressure Measurements in Traumatic Brain Injury and Intracranial Hemorrhage

2018 ◽  
Vol 16 (2) ◽  
pp. 186-196 ◽  
Author(s):  
Jenny C Kienzler ◽  
Rolandas Zakelis ◽  
Sabrina Bäbler ◽  
Elke Remonda ◽  
Arminas Ragauskas ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Pilot Study ◽  
Intracranial Pressure ◽  
Intracranial Hemorrhage ◽  
Patient Specific ◽  
Paired Data ◽  
Secondary Damage ◽  
New Instrument ◽  
Data Points

Abstract BACKGROUND Increased intracranial pressure (ICP) causes secondary damage in traumatic brain injury (TBI), and intracranial hemorrhage (ICH). Current methods of ICP monitoring require surgery and carry risks of complications. OBJECTIVE To validate a new instrument for noninvasive ICP measurement by comparing values obtained from noninvasive measurements to those from commercial implantable devices through this pilot study. METHODS The ophthalmic artery (OA) served as a natural ICP sensor. ICP measurements obtained using noninvasive, self-calibrating device utilizing Doppler ultrasound to evaluate OA flow were compared to standard implantable ICP measurement probes. RESULTS A total of 78 simultaneous, paired, invasive, and noninvasive ICP measurements were obtained in 11 ICU patients over a 17-mo period with the diagnosis of TBI, SAH, or ICH. A total of 24 paired data points were initially excluded because of questions about data independence. Analysis of variance was performed first on the 54 remaining data points and then on the entire set of 78 data points. There was no difference between the 2 groups nor was there any correlation between type of sensor and the patient (F[10, 43] = 1.516, P = .167), or the accuracy and precision of noninvasive ICP measurements (F[1, 43] = 0.511, P = .479). Accuracy was [−1.130; 0.539] mm Hg (CL = 95%). Patient-specific calibration was not needed. Standard deviation (precision) was [1.632; 2.396] mm Hg (CL = 95%). No adverse events were encountered. CONCLUSION This pilot study revealed no significant differences between invasive and noninvasive ICP measurements (P &lt; .05), suggesting that noninvasive ICP measurements obtained by this method are comparable and reliable.

scholarly journals Location of the internal carotid artery and ophthalmic artery segments for non-invasive intracranial pressure measurement by multi-depth TCD

2017 ◽  
Vol 12 (1) ◽  
pp. 1384290 ◽  
Author(s):  
Yasin Hamarat ◽  
Mantas Deimantavicius ◽  
Evaldas Kalvaitis ◽  
Lina Siaudvytyte ◽  
Ingrida Januleviciene ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Pressure Measurement ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
Non Invasive

scholarly journals Prospective Clinical Study of Non-Invasive Intracranial Pressure Measurements in Open-Angle Glaucoma Patients and Healthy Subjects

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 664
Author(s):  
Mantas Deimantavicius ◽  
Yasin Hamarat ◽  
Paulius Lucinskas ◽  
Rolandas Zakelis ◽  
Laimonas Bartusis ◽  
...  
Keyword(s):  
Clinical Study ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Healthy Subjects ◽  
Open Angle Glaucoma ◽  
Normal Tension Glaucoma ◽  
Influential Factors ◽  
Nerve Degeneration ◽  
Prospective Clinical Study ◽  
The Mean

Background and Objective: Glaucoma is a progressive optic neuropathy in which the optic nerve is damaged. The optic nerve is exposed not only to intraocular pressure (IOP) in the eye, but also to intracranial pressure (ICP), as it is surrounded by cerebrospinal fluid in the subarachnoid space. Here, we analyse ICP differences between patients with glaucoma and healthy subjects (HSs). Materials and Methods: Ninety-five patients with normal-tension glaucoma (NTG), 60 patients with high-tension glaucoma (HTG), and 62 HSs were included in the prospective clinical study, and ICP was measured non-invasively by two-depth transcranial Doppler (TCD). Results: The mean ICP of NTG patients (9.42 ± 2.83 mmHg) was significantly lower than that of HSs (10.73 ± 2.16 mmHg) (p = 0.007). The mean ICP of HTG patients (8.11 ± 2.68 mmHg) was significantly lower than that of NTG patients (9.42 ± 2.83 mmHg) (p = 0.008) and significantly lower than that of HSs (10.73 ± 2.16 mmHg) (p < 0.001). Conclusions: An abnormal ICP value could be one of the many influential factors in the optic nerve degeneration of NTG patients and should be considered as such instead of just being regarded as a “low ICP”.

scholarly journals Non-invasive intracranial pressure monitoring in idiopathic intracranial hypertension and lumbar puncture in pediatric patient: Case report

2021 ◽  
Vol 12 ◽  
pp. 493
Author(s):  
Thomas Markus Dhaese ◽  
Leonardo C. Welling ◽  
Alice Magro Kosciasnki ◽  
Gustavo Frigeri ◽  
Judy Auada ◽  
...  
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Lumbar Puncture ◽  
Idiopathic Intracranial Hypertension ◽  
Intracranial Pressure Monitoring ◽  
Invasive Technique ◽  
Icp Monitoring ◽  
Pressure Monitoring ◽  
Non Invasive

Background: Intracranial pressure (ICP) monitoring has been variously explored as a diagnostic and therapeutic modality in many pathological conditions leading neurological injury. This monitoring standardly depends on an invasive procedure such as cranial or lumbar catheterization. The gold standard for ICP monitoring is through an intraventricular catheter, but this invasive technique is associated with certain risks such as haemorrhage and infection. (1) Also, it is a high-cost procedure and consequently not available in a variety of underprivileged places and clinical situations in which intracranial hypertension is prevalent (3). An accurate non-invasive and low-priced method to measure elevated ICP would therefore be desirable. Under these circumstances, Brazilian scientists developed a non-invasive method for intracranial pressure monitoring (ICP-NI), which uses an electric resistance extensometer that measures micro deformations of the skull and transforms it into an electrical signal. In this case report, the authors describe a pediatrician patient with the diagnosis of idiopathic intracranial hypertension who was successfully submitted to a lumbar puncture under monitorization with this device. Case description: 7 year old girl with progressive symptoms that lead to the diagnosis of idiopathic intracranial hypertension. The patient was submitted to a lumbar punction with continuous non-invasive ICP monitoring. Conclusion: Estimating ICP (non-invasive) from LP monitoring (invasive) often reflect inaccurate ICP results, and affects negatively on IIH diagnosis and a non-invasive diagnostic method could reduce the requirement for invasive approaches, improving patient health outcomes.

On the feasibility of a liquid crystal polymer pressure sensor for intracranial pressure measurement

2019 ◽  
Vol 64 (5) ◽  
pp. 543-553
Author(s):  
Preedipat Sattayasoonthorn ◽  
Jackrit Suthakorn ◽  
Sorayouth Chamnanvej
Keyword(s):  
Liquid Crystal ◽  
Intracranial Pressure ◽  
Minimally Invasive ◽  
Pressure Sensor ◽  
Microelectromechanical Systems ◽  
Liquid Crystal Polymer ◽  
Monitoring Device ◽  
Icp Monitoring ◽  
Ongoing Research ◽  
Crystal Polymer

Abstract Intracranial pressure (ICP) monitoring is crucial in determining the appropriate treatment in traumatic brain injury. Minimally invasive approaches to monitor ICP are subject to ongoing research because they are expected to reduce infections and complications associated with conventional devices. This study aims to develop a wireless ICP monitoring device that is biocompatible, miniature and implantable. Liquid crystal polymer (LCP) was selected to be the main material for the device fabrication. This study considers the design, fabrication and testing of the sensing unit of the proposed wireless ICP monitoring device. A piezoresistive pressure sensor was designed to respond to 0–50 mm Hg applied pressure and fabricated on LCP by standard microelectromechanical systems (MEMS) procedures. The fabricated LCP pressure sensor was studied in a moist environment by means of a hydrostatic pressure test. The results showed a relative change in voltage and pressure from which the sensor’s sensitivity was deduced. This was a proof-of-concept study and based on the results of this study, a number of recommendations for improving the considered sensor performance were made. The limitations are discussed, and future design modifications are proposed that should lead to a complete LCP package with an improved performance for wireless, minimally invasive ICP monitoring.

scholarly journals Intracranial pressure monitoring

2015 ◽  
Vol 02 (03) ◽  
pp. 193-203 ◽  
Author(s):  
Mary Abraham ◽  
Vasudha Singhal
Keyword(s):  
Intracranial Pressure ◽  
Cost Effective ◽  
Optic Nerve Sheath Diameter ◽  
Icp Monitoring ◽  
Non Invasive ◽  
Injured Brain ◽  
Neurological Patients ◽  
Catheter Tip ◽  
Long Term Prognosis ◽  
Invasive Techniques

AbstractBrain specific monitoring enables detection and prevention of secondary cerebral insults, especially in the injured brain, thereby preventing permanent neurological damage. Intracranial pressure (ICP) monitoring is widely used in various neurological, neurosurgical and even medical conditions, both intraoperatively and in critical care, to improve patient outcome. It is especially useful in patients with traumatic brain injury, as a robust predictor of cerebral perfusion, and can help to guide therapy and assess long-term prognosis. Intraventricular catheters remain the gold standard for ICP monitoring, as they are the most reliable, accurate and cost-effective, and allow therapeutic cerebrospinal fluid drainage. Newer fibreoptic catheter tip and microchip transducer techniques have revolutionised ICP monitoring, with their ease of insertion in patients with narrow ventricles, and reduced risk of infection and haemorrhage. Furthermore, non-invasive methods of ICP monitoring, such as transcranial Doppler, optic nerve sheath diameter, etc., have emerged as promising techniques for screening patients with raised ICP in settings where invasive techniques are either not feasible (patients with severe coagulopathy) or not available (setups without access to a neurosurgeon). Therefore, ICP monitoring, as a part of multi-modality neuromonitoring, is a useful tool in the armamentarium of the neuro-intensivist in decreasing morbidity and mortality of critically ill neurological patients.

scholarly journals From head micro-motions towards CSF dynamics and non-invasive intracranial pressure monitoring

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Arnošt Mládek ◽  
Václav Gerla ◽  
Petr Šeba ◽  
Vladimír Kolář ◽  
Petr Skalický ◽  
...  
Keyword(s):  
Differential Geometry ◽  
Intracranial Pressure ◽  
Continuous Monitoring ◽  
Time Derivative ◽  
Global Perspective ◽  
Icp Monitoring ◽  
Csf Dynamics ◽  
Non Invasive ◽  
Cartan Curvature ◽  
Mechanical Sensors

AbstractContinuous monitoring of the intracranial pressure (ICP) is essential in neurocritical care. There are a variety of ICP monitoring systems currently available, with the intraventricular fluid filled catheter transducer currently representing the “gold standard”. As the placement of catheters is associated with the attendant risk of infection, hematoma formation, and seizures, there is a need for a reliable, non-invasive alternative. In the present study we suggest a unique theoretical framework based on differential geometry invariants of cranial micro-motions with the potential for continuous non-invasive ICP monitoring in conservative traumatic brain injury (TBI) treatment. As a proof of this concept, we have developed a pillow with embedded mechanical sensors and collected an extensive dataset (> 550 h on 24 TBI coma patients) of cranial micro-motions and the reference intraparenchymal ICP. From the multidimensional pulsatile curve we calculated the first Cartan curvature and constructed a ”fingerprint” image (Cartan map) associated with the cerebrospinal fluid (CSF) dynamics. The Cartan map features maxima bands corresponding to a pressure wave reflection corresponding to a detectable skull tremble. We give evidence for a statistically significant and patient-independent correlation between skull micro-motions and ICP time derivative. Our unique differential geometry-based method yields a broader and global perspective on intracranial CSF dynamics compared to rather local catheter-based measurement and has the potential for wider applications.

scholarly journals Ophthalmic Artery as a sensor for non-invasive intracranial pressure measurement electronic system

2012 ◽  
Vol 122 (6) ◽  
Author(s):  
Laimonas Bartusis ◽  
R. Zakelis ◽  
G. Daubaris ◽  
A. Ragauskas ◽  
S. Rutkauskas ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Pressure Measurement ◽  
Ophthalmic Artery ◽  
Electronic System ◽  
Non Invasive

scholarly journals Non-invasive estimation of intracranial pressure by diffuse optics − a proof-of-concept study

2020 ◽  
Author(s):  
Jonas B Fischer ◽  
Ameer Ghouse ◽  
Susanna Tagliabue ◽  
Federica Maruccia ◽  
Anna Rey-Perez ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Intracranial Pressure ◽  
Correlation Coefficient ◽  
Correlation Spectroscopy ◽  
Critical Conditions ◽  
Proof Of Concept ◽  
Icp Monitoring ◽  
Concept Study ◽  
Non Invasive

Intracranial pressure (ICP) is an important parameter to monitor in several neuropathologies. However, because current clinically accepted methods are invasive, its monitoring is limited to patients in critical conditions. On the other side, there are other less critical conditions where ICP monitoring could still be useful, thus there is a need to develop non-invasive methods. We propose a new method to estimate ICP based on the analysis of the non-invasive measurement of pulsatile, microvascular cerebral blood flow with diffuse correlation spectroscopy. This is achieved by training a recurrent neural network using only the cerebral blood flow as the input. The method is validated using a 50% split sample method using the data from a proof-of-concept study. The study involved a population of infants (n=6) with external hydrocephalus (initially diagnosed as benign enlargement of subarachnoid spaces) as well as a population of adults (n=6) suffering from traumatic brain injury. The algorithm was applied to each cohort individually to obtain a model and an ICP estimate. In both diverse cohorts, the non-invasive estimation of ICP was achieved with an accuracy less than <4 mmHg and a negligible small bias. Furthermore, we have achieved a good correlation (Pearson's correlation coefficient >0.9) and good concordance (Lin's concordance correlation coefficient >0.9) in comparison to standard clinical, invasive ICP monitoring. This preliminary work paves the way for further investigations of this tool for the non-invasive, bed-side assessment of ICP.

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