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Intracranial pressure monitors

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https://www.readbyqxmd.com/read/28726590/a-method-of-managing-severe-traumatic-brain-injury-in-the-absence-of-intracranial-pressure-monitoring-the-ice-protocol
#1
Randall Chesnut, Nancy Temkin, Sureyya Dikmen, Carlos Rondina, Walter Videtta, Gustavo Petroni, Silvia Lujan, Victor Alanis, Antonio Luis Eiras Falcao, Gustavo La Fuente, Luis Gonzalez, Manuel Jibaja, Arturo Lavendez, Freddy Sandi Lora, Roberto Merida, Ricardo Romero, James Pridgeon, Jason Barber, Joan Machamer, Kelley Chaddock
Purpose - The imaging- and clinical-examination (ICE) algorithm used in the BEST TRIP ICP randomized controlled trial is the only prospectively investigated clinical protocol for TBI management without ICP monitoring. As the default literature standard, it warrants careful evaluation. Methods - We present the ICE protocol in detail and analyse the demographics, outcome, treatment intensity, frequency of intervention usage, and related adverse events in the ICE-protocol cohort. Results - The 167 ICE protocol patients were young (median 29 years) with a median Glasgow Coma Scale motor score of 4 but with anisocoria or abnormal pupillary reactivity in 40%...
July 20, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28712906/a-comparison-of-pharmacologic-therapeutic-agents-used-for-the-reduction-of-intracranial-pressure-following-traumatic-brain-injury
#2
REVIEW
Ahmed M Alnemari, Brianna M Krafcik, Tarek R Mansour, Daniel Gaudin
OBJECTIVE: In neurotrauma care, a better understanding of treatments following traumatic brain injury (TBI) has led to a significant decrease in morbidity and mortality in this population. TBI represents a significant medical problem, and complications following TBI are associated with the initial injury and post-event intracranial processes such as elevated intracranial pressure (ICP) and brain edema. Consequently, appropriate therapeutic interventions are required to reduce brain tissue damage and improve cerebral perfusion...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28712896/prospective-evaluation-of-the-non-invasive-headsense-icp-monitor-in-tbi-patients-undergoing-invasive-icp-monitoring
#3
Martin W Herklots, Walid Moudrous, Annemarie Oldenbeuving, Gerwin Roks, Stylianos Mourtzoukos, Guus G Schoonman, Oliver Ganslandt
BACKGROUND: Currently intracranial pressure (ICP) is measured by invasive methods with a significant risk of infectious and hemorrhagic complications. Because of these high risks, there is need for a noninvasive ICP (nICP) monitor with an accuracy similar to that of an invasive ICP monitor. OBJECTIVE: To assess prospectively the accuracy and precision of a nICP monitor compared with invasive intracranial pressure (iICP) measurement in severe TBI patients. METHODS: Participants were ICP-monitored patients who had sustained TBI...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710082/accuracy-and-precision-of-venous-pressure-measurements-of-endovascular-microcatheters-in-the-setting-of-dural-venous-sinus-stenosis
#4
Michael B Avery, Sheryl Sambrano, Javed Khader Eliyas, Muneer Eesa, Alim P Mitha
INTRODUCTION: Dural venous sinus stenosis (DVSS) may lead to increased intracranial pressure, sometimes requiring a stent if a high pressure gradient exists. Many neuroendovascular physicians use microcatheters to measure gradients, yet there are no studies comparing the accuracies and precisions of modern day microcatheters. We examined pressure recordings from five commonly used microcatheters in an experimental DVSS model. METHODS: Using a programmable pump, dynamic flow was established in a closed circuit mimicking the venous sinus waveform...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28693567/protocol-based-invasive-intracranial-pressure-monitoring-in-acute-liver-failure-feasibility-safety-and-impact-on-management
#5
Venkatakrishna Rajajee, Robert J Fontana, Anthony J Courey, Parag G Patil
BACKGROUND: Acute liver failure (ALF) may result in elevated intracranial pressure (ICP). While invasive ICP monitoring (IICPM) may have a role in ALF management, these patients are typically coagulopathic and at risk for intracranial hemorrhage (ICH). Contemporary ICP monitoring techniques and coagulopathy reversal strategies may be associated with a lower risk of hemorrhage. Our objective was to evaluate the safety, feasibility, impact on clinical management and outcomes associated with protocol-directed use of IICPM in ALF...
July 11, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28674514/aspects-on-the-physiological-and-biochemical-foundations-of-neurocritical-care
#6
REVIEW
Carl-Henrik Nordström, Lars-Owe Koskinen, Magnus Olivecrona
Neurocritical care (NCC) is a branch of intensive care medicine characterized by specific physiological and biochemical monitoring techniques necessary for identifying cerebral adverse events and for evaluating specific therapies. Information is primarily obtained from physiological variables related to intracranial pressure (ICP) and cerebral blood flow (CBF) and from physiological and biochemical variables related to cerebral energy metabolism. Non-surgical therapies developed for treating increased ICP are based on knowledge regarding transport of water across the intact and injured blood-brain barrier (BBB) and the regulation of CBF...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28665250/prognostic-value-of-changes-in-brain-tissue-oxygen-pressure-before-and-after-decompressive-craniectomy-following-severe-traumatic-brain-injury
#7
Santiago T Lubillo, Dácil M Parrilla, José Blanco, Jesús Morera, Jaime Dominguez, Felipe Belmonte, Patricia López, Ismael Molina, Candelaria Ruiz, Francisco J Clemente, Daniel A Godoy
OBJECTIVE In severe traumatic brain injury (TBI), the effects of decompressive craniectomy (DC) on brain tissue oxygen pressure (PbtO2) and outcome are unclear. The authors aimed to investigate whether changes in PbtO2 after DC could be used as an independent prognostic factor. METHODS The authors conducted a retrospective, observational study at 2 university hospital ICUs. The study included 42 patients who were admitted with isolated moderate or severe TBI and underwent intracranial pressure (ICP) and PbtO2 monitoring before and after DC...
June 30, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28664392/validation-of-near-infrared-spectroscopy-for-monitoring-cerebral-autoregulation-in-comatose-patients
#8
Lucia Rivera-Lara, Romergryko Geocadin, Andres Zorrilla-Vaca, Ryan Healy, Batya R Radzik, Caitlin Palmisano, Marek Mirski, Wendy C Ziai, Charles Hogue
BACKGROUND: Transcranial Doppler (TCD) noninvasively measures cerebral blood flow (CBF) velocity and is a well-studied method to monitor cerebral autoregulation (CA). Near-infrared spectroscopy (NIRS) has emerged as a promising noninvasive method to determine CA continuously by using regional cerebral oxygen saturation (rSO2) as a surrogate for CBF. Little is known about its accuracy to determine CA in patients with intracranial lesions. The purpose of this study was to assess the accuracy of rSO2-based CA monitoring with TCD methods in comatose patients with acute neurological injury...
June 29, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28661946/correlations-between-hourly-pupillometer-readings-and-intracranial-pressure-values
#9
Molly McNett, Cristina Moran, Clare Janki, Anastasia Gianakis
INTRODUCTION: Automated pupillometry is emerging as a mainstay in neurocritical care primarily because it overcomes limitations of manual pupillary examinations. Although several recent studies show improved assessment accuracy with a pupillometer, few investigate clinical use, specifically how well parameters correlate with multimodality monitoring and outcomes. The primary aim of this study was to examine correlations between serial pupillometer readings and intracranial pressure (ICP) values among neurocritically ill patients...
August 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28661942/nursing-management-of-lumbar-drainage-in-cryptococcal-meningitis-a-case-report
#10
Ling Ling, Lu Guo, Jingjuan Wang, Lili Zhang, Jie Zhu, Zhiyu Huang
Raised intracranial pressure is a hallmark of cryptococcal meningitis and is associated with increased mortality. Continuous drainage of lumbar cerebrospinal fluid is suggested to control intracranial pressure. The complications induced by this treatment have been described. However, nursing care associated with identification and management of complications is less well known. We encountered a patient with human immunodeficiency virus-negative cryptococcal meningitis who developed increasing cerebrospinal fluid pressure, hearing impairment, and limb weakness...
August 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28645586/venous-sinus-stenting-in-the-management-of-patients-with-intracranial-hypertension-manifesting-with-skull-base-cerebrospinal-fluid-leaks
#11
Rajiv R Iyer, David Solomon, Abhay Moghekar, C Rory Goodwin, Charles M Stewart, Masaru Ishii, Philippe Gailloud, Gary L Gallia
BACKGROUND: A subset of patients with skull base cerebrospinal fluid (CSF) leaks are found to have elevated intracranial pressure (ICP). In these patients, elevated ICP is thought to contribute to both the pathophysiology of the leak as well as postoperative leak recurrences. Current strategies for post-operative ICP control include medical therapy and shunting procedures. The aim of this study is to report the use of venous sinus stenting (VSS) in the management of patients with skull base CSF leaks due to elevated ICP...
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28644064/frequent-vomiting-attacks-in-a-patient-with-lhermitte-duclos-disease-a-rare-pathophysiology-of-cerebellar-lesions
#12
Chika Somagawa, Tomonori Ono, Ryoko Honda, Hiroshi Baba, Takeshi Hiu, Ryujiro Ushijima, Keisuke Toda, Kei Sato, Masahiro Ito, Keisuke Tsutsumi
Lhermitte-Duclos disease (LDD) is a neurological disease caused by a hamartomatous lesion in the cerebellum. Clinically, LDD is commonly associated with progressive space-occupying lesion effects in the posterior fossa, increasing intracranial pressure, occlusive hydrocephalus, and focal neurological deficits of adjacent structures. The authors report the case of a 10-year-old boy with LDD who had been suffering from vomiting attacks (VAs). These VAs had been brief in duration but extremely frequent, and they had been resistant to antiemetic drugs since the early postnatal period...
June 23, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28643998/survey-in-expert-clinicians-on-validity-of-automated-calculation-of-optimal-cerebral-perfusion-pressure
#13
Romy Steijn, Roy Stewart, Marek Czosnyka, Joseph Donnelly, Ari Ercole, Antony Absalom, Jan W Elting, Christina Haubrich, Peter Smielewski, Marcel Aries
BACKGROUND: Optimal cerebral perfusion pressure (CPPopt) targeting in traumatic brain injury (TBI) patients constitutes an active and controversial area of research. It has been suggested that an autoregulation guided CPP therapy may improve TBI outcome. Prerequisites of a CPPopt intervention study would be objective criteria for the CPPopt detection.. This study compared the agreement between automated and visual CPPopt detection. METHODS: Twenty-five clinicians from 18 centres worldwide, familiar with brain monitoring and using dedicated software, reviewed ten 4-hour CPPopt screenshots at 48 hrs after ictus in selected TBI patients...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28627088/astrogliosis-and-impaired-aquaporin-4-and-dystrophin-systems-in-idiopathic-normal-pressure-hydrocephalus
#14
Per Kristian Eide, Hans-Arne Hansson
AIMS: Idiopathic normal pressure hydrocephalus (iNPH) is one subtype of dementia that may improve following drainage of cerebrospinal fluid (CSF). This prospective observational study explored whether expression of the water channel aquaporin-4 (AQP4) and the anchoring molecule dystrophin 71 (Dp71) are altered at astrocytic perivascular endfeet and in adjacent neuropil of iNPH patient. Observations were related to measurements of pulsatile and static intracranial pressure (ICP). METHODS: The study included iNPH patients undergoing overnight monitoring of the pulsatile/static ICP, in whom a biopsy was taken from the frontal cerebral cortex during placement of the ICP sensor...
June 19, 2017: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/28625587/a-rabbit-model-of-aneurysmal-subarachnoid-hemorrhage-by-ear-central-artery-suprasellar-cistern-shunt
#15
Jing Lu, Fuxiang Chen, Bing Cai, Fan Chen, Dezhi Kang
Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening hemorrhagic cerebrovascular disease. The concept of early brain injury (EBI), induced by sharply increased intracranial pressure (ICP) and low cerebral perfusion pressure (CPP) with cerebral global ischemia following aneurysm rupture, has been increasingly accepted. However, EBI has not been well studied partly due to lack of an ideal animal model. The purpose of this study was to establish a new aSAH model which can mimic the pathophysiological damage of EBI...
June 15, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28624560/intracranial-hypotension-following-traumatic-brain-injury-a-diagnostic-and-therapeutic-challenge
#16
Jacob Chen Ming Low, Anan Shtaya, Samantha Hettige
BACKGROUND: Intracranial hypotension (IH) is a recognized cause of coma; however, the diagnosis is often challenging, especially in patients with superimposed traumatic brain injury. CASE DESCRIPTION: A 67-year-old woman became comatose following evacuation of bilateral acute subdural hematomas with concurrent respiratory failure. Imaging and intraparenchymal intracranial pressure monitoring confirmed secondary IH. She was managed with an epidural blood patch and a 72-hour period in the Trendelenburg position guided by intracranial pressure monitoring and clinical assessment...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28623520/prediction-of-intracranial-hypertension-through-noninvasive-intracranial-pressure-waveform-analysis-in-pediatric-hydrocephalus
#17
Matheus Fernando Manzolli Ballestero, Gustavo Frigieri, Brenno Caetano Troca Cabella, Sergio Mascarenhas de Oliveira, Ricardo Santos de Oliveira
PURPOSE: The purpose of this study is to evaluate a noninvasive device to assess intracranial pressure wave form in children with hydrocephalus. METHODS: A prospective and non-experimental descriptive-analytic study was performed. Fifty-six patients were enrolled in this study. They were divided in four groups: group A, children with clinically compensated hydrocephalus; B, surgically treated hydrocephalus; C, patients with acute intracranial hypertension due to hydrocephalus; and D, children without neurological disease (control)...
June 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28623468/-intracranial-pressure-monitoring-in-polytrauma-patients-with-traumatic-brain-injury
#18
REVIEW
T Neubauer, W Buchinger, E Höflinger, J Brand
BACKGROUND: The monitoring of intracranial pressure (ICP) represents a cornerstone in the intensive care of patients with traumatic brain injury (TBI) and the industry provides various technical solutions to this end. Decompressive craniectomy can be an option if conservative measures fail to reduce excessive ICP. OBJECTIVE: To examine the pathophysiology of ICP in trauma, the management of polytrauma involving TBI, and the indications for decompressive craniectomy; and to compare the different monitoring systems and their complications...
June 16, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28614970/effect-of-cerebrospinal-fluid-drainage-on-brain-tissue-oxygenation-in-traumatic-brain-injury
#19
Omar S Akbik, Mark Krasberg, Edwin M Nemoto, Howard Yonas
The effectiveness of cerebrospinal fluid (CSF) drainage in lowering high intracranial pressure (ICP) is well established in severe traumatic brain injury (TBI). However, recently the use of external ventricular drains and intracranial pressure monitors in traumatic brain injury has come under question. The aim of this retrospective study was to investigate the effect of CSF drainage on brain tissue oxygenation (PbtO2). Using a multimodality monitoring system, we continuously monitored brain tissue oxygenation (PbtO2) and parenchymal ICP during CSF drainage events via a ventriculostomy in 40 patients with severe traumatic brain injury (TBI)...
June 14, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28584914/optical-coherence-tomography-for-the-diagnosis-and-monitoring-of-idiopathic-intracranial-hypertension
#20
Philipp Albrecht, Christine Blasberg, Marius Ringelstein, Ann-Kristin Müller, David Finis, Rainer Guthoff, Ella-Maria Kadas, Wolf Lagreze, Orhan Aktas, Hans-Peter Hartung, Friedemann Paul, Alexander U Brandt, Axel Methner
The objectives of the study were to investigate the value of optical coherence tomography in detecting papilledema in patients with idiopathic intracranial hypertension (IIH), a disease which is difficult to monitor and which can lead to permanent visual deficits; to analyze retinal changes over time. In this non-interventional case-control study, spectral-domain optical coherence tomography (SD-OCT) was used to analyze the retinal and optic nerve head (ONH) morphology of 21 patients with IIH and 27 age- and sex-matched healthy controls over time...
July 2017: Journal of Neurology
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