Noninvasive Intracranial Pressure Monitoring in Chronic Stroke Patients with Sedentary Behavior: A Pilot Study

Ocamoto, Gabriela Nagai; Junior, Deusdedit Lineu Spavieri; Ribeiro, Jean Alex Matos; Vilela, Gustavo Henrique Frigieri; Catai, Aparecida Maria; Russo, Thiago Luiz

doi:10.1007/978-3-030-59436-7_12

Cited by 8 publications

(7 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Likewise, in recent years the knowledge on the ICP pulse waveform (ICPW) has advanced, as well as its clinical application. ICPW is an early marker of ICC impairment [3,[7][8][9] and is mainly represented by three distinct peaks: P1 (percussion wave), P2 (tidal wave) and P3 (dicrotic wave) [10]. Under physiologic conditions, P1 produced by arterial contraction is the highest peak observed, with P2 reflecting both vascular and ventricular repercussion of pressure pulse spread.…”

Section: Introductionmentioning

confidence: 99%

Intracranial Compliance Assessed by Intracranial Pressure Pulse Waveform

et al. 2021

View full text Add to dashboard Cite

Background: Morphological alterations in intracranial pressure (ICP) pulse waveform (ICPW) secondary to intracranial hypertension (ICP >20 mmHg) and a reduction in intracranial compliance (ICC) are well known indicators of neurological severity. The exclusive exploration of modifications in ICPW after either the loss of skull integrity or surgical procedures for intracranial hypertension resolution is not a common approach studied. The present study aimed to assess the morphological alterations in ICPW among neurocritical care patients with skull defects and decompressive craniectomy (DC) by comparing the variations in ICPW features according to elevations in mean ICP values. Methods: Patients requiring ICP monitoring because of acute brain injury were included. A continuous record of 10 min-length for the beat-by-beat analysis of ICPW was performed, with ICP elevation produced by means of ultrasound-guided manual internal jugular vein compression at the end of the record. ICPW features (peak amplitude ratio (P2/P1), time interval to pulse peak (TTP) and pulse amplitude) were counterweighed between baseline and compression periods. Results were distributed for three groups: intact skull (exclusive burr hole for ICP monitoring), craniotomy/large fractures (group 2) or DC (group 3). Results: 57 patients were analyzed. A total of 21 (36%) presented no skull defects, 21 (36%) belonged to group 2, whereas 15 (26%) had DC. ICP was not significantly different between groups: ±15.11 for intact, 15.33 for group 2 and ±20.81 mmHg for group 3, with ICP-induced elevation also similar between groups (p = 0.56). Significant elevation was observed for the P2/P1 ratio for groups 1 and 2, whereas a reduction was observed in group 3 (elevation of ±0.09 for groups 1 and 2, but a reduction of 0.03 for group 3, p = 0.01), and no significant results were obtained for TTP and pulse amplitudes. Conclusion: In the present study, intracranial pressure pulse waveform analysis indicated that intracranial compliance was significantly more impaired among decompressive craniectomy patients, although ICPW indicated DC to be protective for further influences of ICP elevations over the brain. The analysis of ICPW seems to be an alternative to real-time ICC assessment.

show abstract

Section: Introductionmentioning

confidence: 99%

Intracranial Compliance Assessed by Intracranial Pressure Pulse Waveform

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Apart from experimental and non-original papers, most of these articles were piloting the use of the device in patients with various neurological and non-neurological conditions. These included cryptococcal meningitis [ 5 ], renovascular hypertension [ 26 ], pediatric hydrocephalus [ 2 ], obesity [ 8 ], critical COVID-19 [ 10 ], end-stage renal disease [ 41 ], pregnancy [ 19 ], patients sedated for gastrointestinal endoscopy [ 24 ], sedentary chronic stroke patients [ 40 ], hemodialysis patients [ 42 ], prostatectomy surgery patients [ 45 ], fibromyalgia [ 33 ], cardiovascular surgery patients [ 1 ], diabetes and chronic kidney disease [ 35 ], and migraine [ 14 ]. To the best of our knowledge, this is the first prospective study to compare the Brain4Care noninvasive method with the invasive gold standard in TBI.…”

Section: Discussionmentioning

confidence: 99%

“…Since 2013, many articles have been published on the use of the Brain4Care® system in various diseases with variable results [2,5,8,10,19,27,[40][41][42][43][44]. The system uses a strain gauge sensor on the scalp, enabling noninvasive monitoring of ICP (nICP).…”

Section: Introductionmentioning

confidence: 99%

Can a new noninvasive method for assessment of intracranial pressure predict intracranial hypertension and prognosis?

et al. 2023

View full text Add to dashboard Cite

Purpose Individuals with TBI are at risk of intracranial hypertension (ICH), and monitoring of intracranial pressure (ICP) is usually indicated. However, despite many new noninvasive devices, none is sufficiently accurate and effective for application in clinical practice, particularly in the management of TBIs. This study aimed to compare the noninvasive Brain4Care system (nICP) with invasive ICP (iICP) curve parameters in their ability to predict ICH and functional prognosis in severe TBI. Methods Observational, descriptive-analytical, and prospective study of 22 patients between 2018 and 2021, simultaneously monitored with nICP and iICP. The independent variables evaluated were the presence of ICH and functional prognoses. The dependent variables were the P2/P1 pressure ratio metrics, time to peak (TTP), and TTP × P2/P1. Results We found a good nonlinear correlation between iICP and nICP waveforms, despite a moderate Pearson’s linear correlation. The noninvasive parameters of P2/P1, P2/P1 × TTP, and TTP were not associated with outcomes or ICH. The nICP P2/P1 ratio showed sensitivity/specificity/accuracy (%) of 100/0/56.3, respectively for 1-month outcomes and 77.8/22.2/50 for 6-month outcomes. The nICP TTP ratio had values of 100/0/56.3 for 1-month and 99.9/42.9/72.2 for 6-month outcomes. The nICP P2/P1 × TTP values were 100/0/56.3 for 1-month outcomes and 81.8/28.6/61.1 for 6-month outcomes. Conclusion Brain4Care’s noninvasive method showed low specificity and accuracy and cannot be used as the sole means of monitoring ICP in patients with severe TBI. Future studies with a larger sample of patients with P2 > P1 and new nICP curve parameters are warranted. Supplementary Information The online version contains supplementary material available at 10.1007/s00701-023-05580-z.

show abstract

“…It has also been studied in cases of chronic kidney disease on dialysis (Rickli et al, 2021(Rickli et al, ). al., 2021, patients with chronic stroke (Ocamoto, et al, 2021), and inumerous ICU conditions (Brasil, et al, 2021). It also have been reports in sedation situations (Bueno, et al, 2021) idiopathic intracranial hypertension (Dhaese, et al, 2021).…”

Section: Considerations About the Casesmentioning

confidence: 93%

Noninvasive intracranial pressure in patients with traumatic brain injury

Link

Botelho

Dhaese

et al. 2022

RSD

View full text Add to dashboard Cite

Monitoring and treatment of intracranial pressure are extremely important procedures in the management of patients with traumatic brain injury. The monitoring methods currently marketed are invasive and are not suitable for all patients. In addition to the risks offered, they are not available on all services. This study aims to describe the cases of five patients with traumatic brain injury of different severity who underwent noninvasive monitoring of intracranial pressure in the acute phase of the injury, relating the changes identified with the clinical picture presented. Patients showed important changes in intracranial pressure wave morphology, possibly related to the lesions, clinical presentation and therapeutic interventions used.

show abstract

Noninvasive Intracranial Pressure Monitoring in Chronic Stroke Patients with Sedentary Behavior: A Pilot Study

Cited by 8 publications

References 16 publications

Intracranial Compliance Assessed by Intracranial Pressure Pulse Waveform

Intracranial Compliance Assessed by Intracranial Pressure Pulse Waveform

Can a new noninvasive method for assessment of intracranial pressure predict intracranial hypertension and prognosis?

Noninvasive intracranial pressure in patients with traumatic brain injury

Contact Info

Product

Resources

About