Hydrocephalus is a neurological disease that manifests itself in an elevated fluid pressure within the brain, and if left untreated, may be fatal. It is currently treated using shunt implants, which consist of a mechanical valve and tubes that regulate the pressure of cerebrospinal fluid (CSF) by draining excess fluid into the abdomen. Hydrocephalus shunting systems are no longer expected simply to regulate the intracranial pressure (ICP), but also to offer the option of regaining independence of the shunt. Additionally, they could offer personalised valve management which is one of the main limitations of current shunts. This paper describes the design of a multi-agent system for an intelligent and personalised CSF management system. Patient feedback and intracranial pressure readings will play important roles in the process of CSF regulation and weaning, introduces an element of personalisation to the treatment. The new shunting system would deliver both reactive and goal-driven solutions for the treatment, at the same time the intelligent part of the system will be monitoring how well the shunt is performing. These tasks can be achieved by implementing an agent approach in designing this system. Such system would help us to understand more about the dynamics of hydrocephalus.
Hydrocephalus is caused by blockage or reabsorption difficulty that upsets the natural balance of production and absorption of cerebrospinal fluid in the brain, resulting in a build-up of the fluid in the ventricles of the brain. One of the recent advances in the treatment of hydrocephalus is the invention of a mechatronic valve. The desirability of such valve lies in the potential of having shunt that not only control hydrocephalus but also seeks to treat it. In contrast to current valves, such a valve is regulated based on a time based schedule not on the differential pressure across the valve. Thus the effectiveness of such valve is highly dependant on selecting an appropriate valve schedule that delivers personal dynamic treatment for every individual patient. Providing such a schedule is likely to be one of the obstacles facing the implementation of the mechatronic valve. In this paper, an algorithm is proposed to help in developing such a schedule that dynamically change based on the patients' own intracranial pressure data and a novel figure of merit, thus providing the physician with an easy tool that facilitate the use of the mechatronic valve. The algorithm was implemented in M ATLAB and Simulink. Real ICP data for three hydrocephalus patients (before shunting) were used to test this algorithm and the resulted schedules along with the resulted intracranial pressure data have illustrated the effectiveness of the algorithm in providing schedule that maintain ICP within the normal limits.
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