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Intracranial pressure monitors

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https://www.readbyqxmd.com/read/29159065/train-of-four-stimulation-artifact-mimicking-a-seizure-during-computerized-automated-icu-eeg-monitoring
#1
Laxmi P Dhakal, William O Tatum, William D Freeman
A 54-year-old man was admitted to the intensive care unit with an aneurysmal subarachnoid hemorrhage and subsequently underwent mechanical ventilation and received neuromuscular blocking drugs to control refractory elevated intracranial pressure. During quantitative EEG monitoring, an automated alert was triggered by the train of four peripheral nerve stimulation artifacts. Real-time feedback was made possible due to remote monitoring. This case illustrates how computerized, automated artificial intelligence algorithms can be used beyond typical seizure detection in the intensive care unit for remote monitoring to benefit patient care...
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/29155778/a-detailed-protocol-for-physiological-parameters-acquisition-and-analysis-in-neurosurgical-critical-patients
#2
Xiang Wu, Guoyi Gao, Junfeng Feng, Qing Mao, Jiyao Jiang
Intracranial pressure (ICP) monitoring is now widely used in neurosurgical critical patients. Besides mean ICP value, the ICP derived parameters such as ICP waveform, amplitude of pulse (AMP), the correlation of ICP amplitude and ICP mean (RAP), pressure reactivity index (PRx), ICP and arterial blood pressure (ABP) wave amplitude correlation (IAAC), and so on, can reflect intracranial status, predict prognosis, and can also be used as guidance of proper treatment. However, most of the clinicians focus only on the mean ICP value while ignoring these parameters because of the limitations of the current devices...
October 17, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29147674/pediatric-otogenic-sigmoid-sinus-thrombosis-case-report-and-literature-reappraisal
#3
Andrea Scherer, Andrew Jea
The purpose of this study was to review our experience with a single case of mastoiditis associated with sigmoid sinus thrombosis and increased intracranial pressure, and to review the experience of others through prior publications. We reviewed a case of a 6-year-old boy with an acute otitis media and mastoiditis, with associated ipsilateral sigmoid sinus and contralateral distal transverse sinus thrombosis. Based on the literature and our own experience, we conclude that most children with dural sinus thrombosis from acute otitis media and mastoiditis, in the setting of increased intracranial pressure, attain a good neurological outcome with a conservative neurosurgical approach...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/29123886/sudden-cerebral-depression-detected-by-bispectral-index-monitoring-in-cryptococcal-meningitis-with-elevated-near-fatal-cerebrospinal-fluid-pressure
#4
Hironori Matsumoto, Suguru Annen, Kensuke Umakoshi, Jun Takeba, Satoshi Kikuchi, Yuki Nakabayashi, Naoki Moriyama, Muneaki Ohshita, Mayuki Aibiki
Case: An increase in cerebrospinal fluid pressure (CSFP) is usually prominent in cryptococcal meningitis, which has a high mortality rate, so aggressive management to control CSFP is crucial. In this case, a 40-year-old-man survived cryptococcal meningitis treated with continuous spinal drainage under bispectral index (BIS) monitoring. He unexpectedly showed hypertension, went into a coma, and even loss his light reflexes due to CSFP elevation. His BIS values had abruptly dropped before developing these symptoms, but dramatically recovered after lumbar puncture drainage, suggesting that BIS monitoring could reflect cerebral function changes due to CSFP alternations...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29118021/venous-collapse-regulates-intracranial-pressure-in-upright-body-positions
#5
Petter Holmlund, Anders Eklund, Lars-Owe D Koskinen, Elias Johansson, Nina Sundström, Jan Malm, Sara Qvarlander
Recent interest in intracranial pressure (ICP) in the upright posture has revealed that the mechanisms regulating postural changes in ICP are not fully understood. We have suggested an explanatory model where the postural changes in ICP depend on well-established hydrostatic effects in the venous system and where these effects are interrupted by collapse of the internal jugular veins (IJVs) in more upright positions. The aim of this study was to investigate this relationship by simultaneous invasive measurements of ICP, venous pressure and IJV collapse in healthy volunteers...
November 8, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29113858/differences-in-blood-pressure-by-measurement-technique-in-neurocritically-ill-patients-a-technological-assessment
#6
Abhijit V Lele, Daren Wilson, Prabhakar Chalise, Jules Nazzaro, Vijay Krishnamoorthy, Monica S Vavilala
Blood pressure data may vary by measurement technique. We performed a technological assessment of differences in blood pressure measurement between non-invasive blood pressure (NIBP) and invasive arterial blood pressure (ABP) in neurocritically ill patients. After IRB approval, a prospective observational study was performed to study differences in systolic blood pressure (SBP), mean arterial pressure (MAP), and cerebral perfusion pressure (CPP) values measured by NIBP arm, ABP at level of the phlebostatic axis (ABP heart) and ABP at level of the external auditory meatus (ABP brain) at 30 and 45-degree head of bed elevation (HOB) using repeated measure analysis of covariance and correlation coefficients...
November 4, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29101614/visual-outcome-after-endoscopic-third-ventriculostomy-for-hydrocephalus
#7
Ji-Ho Jung, Yong-Hyun Chai, Shin Jung, In-Young Kim, Woo-Youl Jang, Kyung-Sub Moon, Seul-Kee Kim, Sangjoon Chong, Seung-Ki Kim, Tae-Young Jung
PURPOSE: Hydrocephalus-related symptoms are mostly improved after successful endoscopic third ventriculostomy (ETV). However, visual symptoms can be different. This study was focused on visual symptoms. We analyzed the magnetic resonance images (MRI) of the orbit and visual outcomes. METHODS: From August 2006 to November 2016, 50 patients with hydrocephalus underwent ETV. The male-to-female ratio was 33:17, and the median age was 61 years (range, 5-74 years). There were 18 pediatric and 32 adult patients...
November 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29089921/the-neurological-wake-up-test-a-role-in-neurocritical-care-monitoring-of-traumatic-brain-injury-patients
#8
REVIEW
Niklas Marklund
The most fundamental clinical monitoring tool in traumatic brain injury (TBI) patients is the repeated clinical examination. In the severe TBI patient treated by continuous sedation in a neurocritical care (NCC) unit, sedation interruption is required to enable a clinical evaluation (named the neurological wake-up test; NWT) assessing the level of consciousness, pupillary diameter and reactivity to light, and presence of focal neurological deficits. There is a basic conflict regarding the NWT in the NCC setting; can the clinical information obtained by the NWT justify the risk of inducing a stress response in a severe TBI patient? Furthermore, in the presence of advanced multimodal monitoring and neuroimaging, is the NWT necessary to identify important clinical alterations? In studies of severe TBI patients, the NWT was consistently shown to induce a stress reaction including brief increases in intracranial pressure (ICP) and changes in cerebral perfusion pressure (CPP)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29088962/complications-of-invasive-intracranial-pressure-monitoring-devices-in-neurocritical-care
#9
Samon Tavakoli, Geoffrey Peitz, William Ares, Shaheryar Hafeez, Ramesh Grandhi
Intracranial pressure monitoring devices have become the standard of care for the management of patients with pathologies associated with intracranial hypertension. Given the importance of invasive intracranial monitoring devices in the modern neurointensive care setting, gaining a thorough understanding of the potential complications related to device placement-and misplacement-is crucial. The increased prevalence of intracranial pressure monitoring as a management tool for neurosurgical patients has led to the publication of a plethora of papers regarding their indications and complications...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29088943/the-role-of-icp-monitoring-in-meningitis
#10
Areej Tariq, Pedro Aguilar-Salinas, Ricardo A Hanel, Neeraj Naval, Mohamad Chmayssani
Intracranial pressure (ICP) monitoring has been widely accepted in the management of traumatic brain injury. However, its use in other pathologies that affect ICP has not been advocated as strongly, especially in CNS infections. Despite the most aggressive and novel antimicrobial therapies for meningitis, the mortality rate associated with this disease is far from satisfactory. Although intracranial hypertension and subsequent death have long been known to complicate meningitis, no specific guidelines targeting ICP monitoring are available...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29084196/multi-modality-neuromonitoring-in-severe-pediatric-traumatic-brain-injury-monitoring-pediatric-tbi
#11
REVIEW
Adam M H Young, Mathew R Guilfoyle, Joseph Donnelly, Peter Smielewski, Shruti Agarwal, Marek Czosnyka, Peter J Hutchinson
Each year, the annual hospitalization rates of traumatic brain injury (TBI) in children in the US are 57.7 per 100 K less than 5 years of age and 23.1 per 100 K in the 5-14 year age group. Despite this, little is known about the pathophysiology of TBI in children and how to manage it most effectively. Historically, TBI management has been guided by clinical examination. This has been assisted progressively by clinical imaging, intracranial pressure (ICP) monitoring and finally software that can calculate optimal brain physiology...
October 30, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29084012/effects-of-changes-in-arterial-carbon-dioxide-and-oxygen-partial-pressures-on-cerebral-oximeter-performance
#12
Andrew Schober, John R Feiner, Philip E Bickler, Mark D Rollins
BACKGROUND: Cerebral oximetry (cerebral oxygen saturation; ScO2) is used to noninvasively monitor cerebral oxygenation. ScO2 readings are based on the fraction of reduced and oxidized hemoglobin as an indirect estimate of brain tissue oxygenation and assume a static ratio of arterial to venous intracranial blood. Conditions that alter cerebral blood flow, such as acute changes in PaCO2, may decrease accuracy. We assessed the performance of two commercial cerebral oximeters across a range of oxygen concentrations during normocapnia and hypocapnia...
October 30, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29067632/a-national-trial-on-differences-in-cerebral-perfusion-pressure-values-by-measurement-location
#13
Molly M McNett, Mary Kay Bader, Sarah Livesay, Susan Yeager, Cristina Moran, Arianna Barnes, Kimberly R Harrison, DaiWai M Olson
BACKGROUND: Cerebral perfusion pressure (CPP) is a key parameter in management of brain injury with suspected impaired cerebral autoregulation. CPP is calculated by subtracting intracranial pressure (ICP) from mean arterial pressure (MAP). Despite consensus on importance of CPP monitoring, substantial variations exist on anatomical reference points used to measure arterial MAP when calculating CPP. This study aimed to identify differences in CPP values based on measurement location when using phlebostatic axis (PA) or tragus (Tg) as anatomical reference points...
October 24, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29060774/regression-based-noninvasive-estimation-of-intracranial-pressure
#14
Andrea Fanelli, Frederick W Vonberg, Rohan Jaishankar, Syed M Imaduddin, Robert C Tasker, Thomas Heldt
Monitoring of intracranial pressure (ICP) is indicated in patients with a variety of conditions affecting the brain and cerebrospinal fluid space. The measurement of ICP, however, is highly invasive as it requires placement of a catheter in the brain tissue or cerebral ventricular spaces. Several noninvasive techniques have been proposed to overcome this issue, and one class of approaches is based on analyzing cerebral blood flow velocity (CBFV) and arterial blood pressure (ABP) waveforms to infer ICP. Here, we analyze a physiologic model linking ICP to CBFV and ABP and present a regression-based approach to estimating ICP...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29060220/effect-of-temperature-variation-on-remote-pressure-readout-in-wirelessly-powered-intracranial-pressure-monitoring-system
#15
M Waqas A Khan, Muhammad Rizwan, Lauri Sydanheimo, Yahya Rahmat-Samii, Leena Ukkonen, Toni Bjorninen
An implantable pressure monitoring system is a compelling approach to home monitoring of intracranial pressure in the long term. In our approach, an on-body unit powers a cranially concealed system where a piezoresistive element senses the pressure. A data transmission unit built in the same platform emits a signal at a pressure dependent frequency through a miniature far field antenna. In this work, we focus on assessing the impact of variable temperature on the pressure readout at an off-body unit through in-vitro experiments...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29058090/icp-management-in-patients-suffering-from-traumatic-brain-injury-a-systematic-review-of-randomized-controlled-trials
#16
REVIEW
Peter Abraham, Robert C Rennert, Brandon C Gabel, Jayson A Sack, Navaz Karanjia, Peter Warnke, Clark C Chen
BACKGROUND: Severe traumatic brain injury (sTBI) is a major cause of morbidity and mortality. Intracranial pressure (ICP) monitoring and management form the cornerstone of treatment paradigms for sTBI in developed countries. We examine the available randomized controlled trial (RCT) data on the impact of ICP management on clinical outcomes after sTBI. METHODS: A systematic review of the literature on ICP management following sTBI was performed to identify pertinent RCT articles...
December 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29054776/icp-guided-shunt-valve-adjustments-with-the-miethke-sensor-reservoir
#17
Sebastian Antes, Axel Stadie, Simon Müller, Stefan Linsler, David Breuskin, Joachim Oertel
BACKGROUND: Telemetric intracranial pressure (ICP) monitoring seems to be a promising therapy-supporting option in shunt-treated patients. Benefits become obvious when headaches are unspecific and clinical symptoms cannot be related to possible over- or underdrainage. In this work, a new telemetric device to individually adjust shunt valves according to the ICP was evaluated. METHODS: Between December 2015 and November 2016, 25 patients with suspected suboptimal shunt valve settings underwent insertion of a telemetric ICP sensor ("Sensor Reservoir", Christoph Miethke GmbH & Co...
October 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29050524/transcranial-doppler-systolic-flow-index-and-icp-derived-cerebrovascular-reactivity-indices-in-tbi
#18
Frederick Adam Zeiler, Danilo Cardim, Joseph Donnelly, David Menon, Marek Czosnyka, Peter Smieleweski
To explore relationships between transcranial Doppler (TCD) indices of cerebrovascular reactivity and those derived from intracranial pressure (ICP). GOALS: A. Confirm previously described co-variance patterns of TCD/ICP indices, and B. Describe thresholds for Sx (correlation between systolic flow velocity (FVs) and cerebral perfusion pressure (CPP)) associated with outcome. Retrospective cohort of traumatic brain injury (TBI) patients: with TCD and ICP monitoring, we calculated various continuous indices of cerebrovascular reactivity: A...
October 19, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29043546/compensatory-reserve-weighted-intracranial-pressure-and-its-association-with-outcome-after-traumatic-brain-injury
#19
L Calviello, J Donnelly, D Cardim, C Robba, F A Zeiler, P Smielewski, M Czosnyka
OBJECTIVE: We introduced 'compensatory-reserve-weighted intracranial pressure (ICP),' named 'weightedICP' for brevity, as a variable that may better describe changes leading to mortality after traumatic brain injury (TBI) over the standard mean ICP. METHODS: ICP was monitored prospectively in over 1023 sedated and ventilated patients. The RAP coefficient (R-correlation, A-amplitude, and P-pressure) was calculated as the running correlation coefficient between slow changes in the pulse amplitude of ICP and the mean ICP...
October 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29028696/brain-oxygen-optimization-in-severe-traumatic-brain-injury-phase-ii-a-phase-ii-randomized-trial
#20
RANDOMIZED CONTROLLED TRIAL
David O Okonkwo, Lori A Shutter, Carol Moore, Nancy R Temkin, Ava M Puccio, Christopher J Madden, Norberto Andaluz, Randall M Chesnut, M Ross Bullock, Gerald A Grant, John McGregor, Michael Weaver, Jack Jallo, Peter D LeRoux, Dick Moberg, Jason Barber, Christos Lazaridis, Ramon R Diaz-Arrastia
OBJECTIVES: A relationship between reduced brain tissue oxygenation and poor outcome following severe traumatic brain injury has been reported in observational studies. We designed a Phase II trial to assess whether a neurocritical care management protocol could improve brain tissue oxygenation levels in patients with severe traumatic brain injury and the feasibility of a Phase III efficacy study. DESIGN: Randomized prospective clinical trial. SETTING: Ten ICUs in the United States...
November 2017: Critical Care Medicine
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