Validation of Non-Invasive Intracranial Pressure (ICP) Monitoring Device

Author(s):  
Author(s):  
V. Vijaywargi ◽  
R. Proffitt ◽  
P. Mane ◽  
K. Mossi ◽  
K. Ward ◽  
...  

The brain is surrounded by cerebrospinal fluid, and when a brain tumor or a traumatic brain injury has occurred, intracranial pressure, ICP, is developed. Monitoring ICP non-invasively is a challenge. Currently, a probe is inserted through the skull, running the risk of infection, bleeding, and damage to the brain tissue with residual neurologic effects. A novel method to measure ICP using actuators and sensors has been proposed where the skull is vibrated at high frequencies and the receiving signal is measured at the surface eyelid. A design of experiments approach is used to develop the sensor part of the ICP monitoring device so that gain can be maximized using factors such as area, thickness, electrode, and applied pressure. In addition, sensor packaging is optimized to minimize dampening of the signal and ensure durability, reliability, and repeatability of the measurements. Results of this study showed that for a range of areas and thicknesses with Cu-Ni electrodes packaged with super strength durable tape are the optimum factors for the ICP sensor. These parameters are then incorporated into a design that allows ease of application and consistency of the measurements.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paulius Lucinskas ◽  
Mantas Deimantavicius ◽  
Laimonas Bartusis ◽  
Rolandas Zakelis ◽  
Edgaras Misiulis ◽  
...  

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.


2021 ◽  
Vol 12 ◽  
pp. 493
Author(s):  
Thomas Markus Dhaese ◽  
Leonardo C. Welling ◽  
Alice Magro Kosciasnki ◽  
Gustavo Frigeri ◽  
Judy Auada ◽  
...  

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.


2019 ◽  
Vol 64 (5) ◽  
pp. 543-553
Author(s):  
Preedipat Sattayasoonthorn ◽  
Jackrit Suthakorn ◽  
Sorayouth Chamnanvej

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.


2015 ◽  
Vol 02 (03) ◽  
pp. 193-203 ◽  
Author(s):  
Mary Abraham ◽  
Vasudha Singhal

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.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Arnošt Mládek ◽  
Václav Gerla ◽  
Petr Šeba ◽  
Vladimír Kolář ◽  
Petr Skalický ◽  
...  

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.


2018 ◽  
Vol 128 (3) ◽  
pp. 828-833 ◽  
Author(s):  
Alberto Aiolfi ◽  
Desmond Khor ◽  
Jayun Cho ◽  
Elizabeth Benjamin ◽  
Kenji Inaba ◽  
...  

OBJECTIVEIntracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma.METHODSThis retrospective observational study was based on the American College of Surgeons Trauma Quality Improvement Program database, which was searched for all patients with isolated severe blunt head injury who had an ICP monitor placed in the 2-year period from 2013 to 2014. Extracted variables included demographics, comorbidities, mechanisms of injury, head injury specifics (epidural, subdural, subarachnoid, intracranial hemorrhage, and diffuse axonal injury), Abbreviated Injury Scale (AIS) score for each body area, Injury Severity Score (ISS), vital signs in the emergency department, and craniectomy. Outcomes included 30-day mortality, complications, number of ventilation days, intensive care unit and hospital lengths of stay, and functional independence.RESULTSDuring the study period, 105,721 patients had isolated severe traumatic brain injury (head AIS score ≥ 3). Overall, an ICP monitoring device was placed in 2562 patients (2.4%): 1358 (53%) had an IVD and 1204 (47%) had an IPD. The severity of the head AIS score did not affect the type of ICP monitoring selected. There was no difference in the median ISS; ISS > 15; head AIS Score 3, 4, or 5; or the need for craniectomy between the 2 device groups. Unadjusted 30-day mortality was significantly higher in the group with IVDs (29% vs 25.5%, p = 0.046); however, stepwise logistic regression analysis showed that the type of ICP monitoring was not an independent risk factor for death, complications, or functional outcome at discharge.CONCLUSIONSThis study demonstrated that compliance with the Brain Trauma Foundation guidelines for ICP monitoring is poor. In isolated severe blunt head injuries, the type of ICP monitoring device does not have any effect on survival, systemic complications, or functional outcome.


2020 ◽  
Author(s):  
Jonas B Fischer ◽  
Ameer Ghouse ◽  
Susanna Tagliabue ◽  
Federica Maruccia ◽  
Anna Rey-Perez ◽  
...  

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.


2016 ◽  
Vol 03 (01) ◽  
pp. 009-014 ◽  
Author(s):  
Shalini Nair

AbstractIntracranial pressure (ICP) measurement plays a vital role in decision making in neurological emergencies. Invasive methods of ICP monitoring have been the gold standard. Advent of various non-invasive techniques has widened the option of ICP measurement in medical cases as well. We illustrate two cases where optic nerve sheath measurements helped in managing raised ICP and time the need for surgical intervention and review the literature on non-invasive ICP measurement.


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