The anticipation of intracranial hypertension using noninvasive measurements of intracranial pressure

✓ Transcranial Doppler ultrasonography was used to monitor 71 patients suffering from intracranial hypertension with subsequent brain death. Among these, 29 patients were also assessed for systemic arterial pressure and epidural intracranial pressure, so that a correlation between cerebral perfusion pressure and the Doppler ultrasonography waveforms could be established. Four-vessel angiography was also performed in 33 patients after clinical brain death. With increasing intracranial pressure, the transcranial Doppler ultrasonography waveforms exhibited different characteristic high-resistance profiles with first low, then zero, and then reversed diastolic flow velocities, depending on the relationship between intracranial pressure and blood pressure (that is, cerebral perfusion pressure). This study shows that transcranial. Doppler ultrasonography may be used to assess the degree of intracranial hypertension. This technique further provides a practicable, noninvasive bedside monitor of therapeutic measures.

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Faculty Opinions recommendation of Using optical coherence tomography as a surrogate of measurements of intracranial pressure in idiopathic intracranial hypertension.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.738879987.793579989 ◽

2020 ◽

Author(s):

Prem Subramanian

Keyword(s):

Optical Coherence Tomography ◽

Intracranial Pressure ◽

Intracranial Hypertension ◽

Idiopathic Intracranial Hypertension ◽

Optical Coherence

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Evaluation of cerebrovascular hemodynamics in patients with idiopathic intracranial hypertension using transcranial Doppler

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00250-8 ◽

2020 ◽

Vol 56 (1) ◽

Author(s):

Mahmoud M. Allam ◽

Hatem A. Almasry ◽

Sandra M. Ahmed ◽

Youssuf G. Taha ◽

Mohammed I. Oraby

Keyword(s):

Intracranial Pressure ◽

Intracranial Hypertension ◽

Lumbar Puncture ◽

Transcranial Doppler ◽

Idiopathic Intracranial Hypertension ◽

Pulsatility Index ◽

Research Work ◽

Increased Intracranial Pressure ◽

Significant Relation ◽

Before And After

Abstract Background Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure without a clear cause and can have serious visual effects. Previous research work suggests that transcranial Doppler measurements of pulsatility index correlate accurately with elevated intracranial pressure. Objective To assess the cerebrovascular hemodynamic changes in patients with IIH using transcranial Doppler before and after lumbar puncture and CSF withdrawal. Methods An interventional study conducted on 40 patients (31 females and 9 males) fulfilling the modified Dandy criteria for diagnosis of idiopathic intracranial hypertension, MRI brain, and MRV was done to the patients. Lumbar puncture was done for all included patients to measure intracranial pressure and CSF withdrawal. Transcranial Doppler was performed for all included before and after lumbar puncture and CSF withdrawal and the following parameters were measured: peak systolic velocity (PSV), end diastolic velocity (EDV), resistivity index (RI), and pulsatility index (PI). Results Significant relation was found between grades of papilledema and PSV, RI, and PI (p value 0.012, 0.025, 0.016) but no significant relation was found between grades of papilledema and EDV (0.102). Significant changes occurred in parameters of TCD pre- and post-CSF withdrawal including PSV, EDV, and PI (p value 0.001, 0.015, 0.019) denoting a significant change in cerebral hemodynamics after CSF withdrawal which denotes a decrease in intracranial pressure. Conclusion Increased intracranial pressure significantly affects cerebral blood flow. A normalization of transcranial Doppler parameters occurs following lowering of intracranial pressure through lumbar puncture and CSF withdrawal.

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Intracranial Pressure Monitoring and Management of Intracranial Hypertension

Critical Care Clinics ◽

10.1016/j.ccc.2014.06.005 ◽

2014 ◽

Vol 30 (4) ◽

pp. 735-750 ◽

Cited By ~ 15

Author(s):

Jon Perez-Barcena ◽

Juan Antonio Llompart-Pou ◽

Kristine H. O'Phelan

Keyword(s):

Intracranial Pressure ◽

Intracranial Hypertension ◽

Intracranial Pressure Monitoring ◽

Pressure Monitoring

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Intracranial pressure, behavioral and electrophysiological observations in experimental intracranial hypertension

Journal of Surgical Research ◽

10.1016/0022-4804(75)90107-9 ◽

1975 ◽

Vol 18 (4) ◽

pp. 447-450

Author(s):

L.F. Marshall ◽

F. Durity ◽

F. Welsh ◽

H.E. James ◽

T.W. Langfitt

Keyword(s):

Intracranial Pressure ◽

Intracranial Hypertension

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Intracranial hypertension and papilloedema as a complication to low antiretroviral therapy adherence in a man living with chronic HIV

BMJ Case Reports ◽

10.1136/bcr-2020-237504 ◽

2021 ◽

Vol 14 (3) ◽

pp. e237504

Author(s):

Rosa Maja Møhring Gynthersen ◽

Helene Mens ◽

Marianne Wegener ◽

Neval Ete Wareham

Keyword(s):

Antiretroviral Therapy ◽

Intracranial Pressure ◽

Intracranial Hypertension ◽

Idiopathic Intracranial Hypertension ◽

Ventricular Volume ◽

Art Adherence ◽

Hiv Viral Load ◽

Blurred Vision ◽

Antiretroviral Therapy Adherence ◽

Acute Retroviral Syndrome

We describe a 61-year-old man living with HIV on antiretroviral therapy (ART), who presented with headache, dizziness and blurred vision. Latest CD4+ cell count 3 months prior to admission was 570×106 cells/mL and HIV viral load <20 copies/mL. The patient was diagnosed with cerebrospinal fluid (CSF) lymphocytic pleocytosis, raised intracranial pressure and papilloedema. Neuroimaging showed normal ventricular volume and no mass lesions, suggesting (1) neuroinfection (2) idiopathic intracranial hypertension or (3) retroviral rebound syndrome (RRS) as possible causes. Neuroinfection was ruled out and idiopathic intracranial hypertension seemed unlikely. Elevated plasma HIV RNA level was detected consistent with reduced ART adherence prior to admission. RRS is a virological rebound after ART interruption, which can mimic the acute retroviral syndrome of acute primary infection. To the best of our knowledge, we describe the second case of RRS presenting as CSF lymphocytic pleocytosis and elevated intracranial pressure after low ART adherence.

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The Potentially Modifiable Risk Factor in Idiopathic Intracranial Hypertension: Body Weight

Neurology Clinical Practice ◽

10.1212/cpj.0000000000001063 ◽

2021 ◽

pp. 10.1212/CPJ.0000000000001063

Author(s):

Susan P Mollan ◽

Abd A Tahrani ◽

Alexandra J Sinclair

Keyword(s):

Weight Loss ◽

Body Weight ◽

Risk Factor ◽

Intracranial Pressure ◽

Intracranial Hypertension ◽

Treatment Strategy ◽

Idiopathic Intracranial Hypertension ◽

Potential Treatment ◽

Distal Small Intestine

AbstractPurpose of review:Idiopathic intracranial hypertension (IIH) prevalence increased in conjunction with rising obesity rates. Here, we highlight the importance of weigh management in IIH, and introduce glucagon-like peptide 1 (GLP-1) receptor agonists (RA) as potential treatment strategy for IIH.Recent findings:Weight gain is a risk factor for IIH; and weight loss (via any treatment strategy) plays a key role in IIH management. GLP-1 is an incretin secreted by the distal small intestine in response to a meal. GLP-1 RA have been shown to improve glycaemic control (no. hypoglycaemia) and lower body weight in patients with and without type 2 diabetes. The choroid plexus has been found to express GLP-1 receptors and treatment with a GLP-1 RA significantly reduces cerebrospinal fluid secretion in vitro and intracranial pressure in rodents.Summary:New research evaluating the pathophysiology of IIH supports GLP-1 RA as a potential treatment for IIH via weight loss dependant and independent mechanism to directly reduce intracranial pressure.

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Experimental model of intracranial hypertension with continuous multiparametric monitoring in swine

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130126 ◽

2013 ◽

Vol 71 (10) ◽

pp. 802-806 ◽

Cited By ~ 4

Author(s):

Almir Ferreira de Andrade ◽

Matheus Schmidt Soares ◽

Gustavo Cartaxo Patriota ◽

Alessandro Rodrigo Belon ◽

Wellingson Silva Paiva ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Animal Model ◽

Brain Injury ◽

Intracranial Pressure ◽

Intracranial Hypertension ◽

Severe Traumatic Brain Injury ◽

Transcranial Doppler ◽

Porcine Model ◽

Cerebral Oximetry ◽

Suitable Animal Model

Objective Intracranial hypertension (IH) develops in approximately 50% of all patients with severe traumatic brain injury (TBI). Therefore, it is very important to identify a suitable animal model to study and understand the pathophysiology of refractory IH to develop effective treatments. Methods We describe a new experimental porcine model designed to simulate expansive brain hematoma causing IH. Under anesthesia, IH was simulated with a balloon insufflation. The IH variables were measured with intracranial pressure (ICP) parenchymal monitoring, epidural, cerebral oximetry, and transcranial Doppler (TCD). Results None of the animals died during the experiment. The ICP epidural showed a slower rise compared with parenchymal ICP. We found a correlation between ICP and cerebral oximetry. Conclusion The model described here seems useful to understand some of the pathophysiological characteristics of acute IH.

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