Skip to main content
Erschienen in: Child's Nervous System 9/2017

16.06.2017 | Original Paper

Prediction of intracranial hypertension through noninvasive intracranial pressure waveform analysis in pediatric hydrocephalus

verfasst von: Matheus Fernando Manzolli Ballestero, Gustavo Frigieri, Brenno Caetano Troca Cabella, Sergio Mascarenhas de Oliveira, Ricardo Santos de Oliveira

Erschienen in: Child's Nervous System | Ausgabe 9/2017

Einloggen, um Zugang zu erhalten

Abstract

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). Data were collected through the installation of an extracranial deformation sensor, coupled to the children’s scalp, which allowed registration of noninvasive intracranial pressure curves. Parameters obtained were analyzed: P2/P1 ratio, “classification P1 and P2 and P1 slope.

Results

P2/P1 index and “classification of P1 and P2” had a sensitivity of 80% and specificity of 100% for predicting intracranial hypertension. “P1 slope” presented no statistical difference.

Conclusion

This study showed a useful and noninvasive method for monitoring intracranial pressure, which was able to indicate the intracranial hypertension in children with hydrocephalus and, thus, should be further investigated for clinical applications.
Literatur
1.
Zurück zum Zitat Adams JP, Bell D, McKinlay J (2010) Neurocritical care: a guide to practical management. Springer, LondonCrossRef Adams JP, Bell D, McKinlay J (2010) Neurocritical care: a guide to practical management. Springer, LondonCrossRef
2.
Zurück zum Zitat Ballestero MFM (2016 ) Evaluation of a non-invasive method to monitoring intracranial pressure in children and adolescents with hydrocephalus. Master’s dissertation, Universidade de Sao Paulo, Ribeirao Preto Ballestero MFM (2016 ) Evaluation of a non-invasive method to monitoring intracranial pressure in children and adolescents with hydrocephalus. Master’s dissertation, Universidade de Sao Paulo, Ribeirao Preto
3.
Zurück zum Zitat Cabella B, Vilela GHF, Mascarenhas S, Czosnyka M, Smielewski P, Dias C, Cardim DA, Wang CC, Mascarenhas P, Andrade R (2016) Validation of a new noninvasive intracranial pressure monitoring method by direct comparison with an invasive technique. In: intracranial pressure and brain monitoring XV, vol 122. 2016/05/12 edn. Springer, pp 93–96. doi:10.1007/978-3-319-22533-3_18 Cabella B, Vilela GHF, Mascarenhas S, Czosnyka M, Smielewski P, Dias C, Cardim DA, Wang CC, Mascarenhas P, Andrade R (2016) Validation of a new noninvasive intracranial pressure monitoring method by direct comparison with an invasive technique. In: intracranial pressure and brain monitoring XV, vol 122. 2016/05/12 edn. Springer, pp 93–96. doi:10.​1007/​978-3-319-22533-3_​18
4.
Zurück zum Zitat Cardoso ER, Piatek D (1989) Intracranial and venous pressures part I: intracranial pulse wave changes during hemodynamic maneuvers in humans. In: Intracranial Pressure VII. Springer, pp 203–205 Cardoso ER, Piatek D (1989) Intracranial and venous pressures part I: intracranial pulse wave changes during hemodynamic maneuvers in humans. In: Intracranial Pressure VII. Springer, pp 203–205
6.
Zurück zum Zitat Chambers IR, Daubaris G, Jarzemskas E, Fountas K, Kvascevicius R, Ragauskas A, Rocka S, Robinson JS, Sitkauskas A (2005) The clinical application of non-invasive intracranial blood volume pulse wave monitoring. Physiol Meas 26:1019–1032. doi:10.1088/0967-3334/26/6/011 CrossRefPubMed Chambers IR, Daubaris G, Jarzemskas E, Fountas K, Kvascevicius R, Ragauskas A, Rocka S, Robinson JS, Sitkauskas A (2005) The clinical application of non-invasive intracranial blood volume pulse wave monitoring. Physiol Meas 26:1019–1032. doi:10.​1088/​0967-3334/​26/​6/​011 CrossRefPubMed
7.
Zurück zum Zitat Contant CF Jr, Robertson CS, Crouch J, Gopinath SP, Narayan RK, Grossman RG (1995) Intracranial pressure waveform indices in transient and refractory intracranial hypertension. J Neurosci Methods 57:15–25CrossRefPubMed Contant CF Jr, Robertson CS, Crouch J, Gopinath SP, Narayan RK, Grossman RG (1995) Intracranial pressure waveform indices in transient and refractory intracranial hypertension. J Neurosci Methods 57:15–25CrossRefPubMed
9.
Zurück zum Zitat Czosnyka M, Smielewski P, Timofeev I, Lavinio A, Guazzo E, Hutchinson P, Pickard JD (2007) Intracranial pressure: more than a number. Neurosurg Focus 22:E10PubMed Czosnyka M, Smielewski P, Timofeev I, Lavinio A, Guazzo E, Hutchinson P, Pickard JD (2007) Intracranial pressure: more than a number. Neurosurg Focus 22:E10PubMed
10.
Zurück zum Zitat Czosnyka Z, Keong N, Kim DJ, Radolovich D, Smielewski P, Lavinio A, Schmidt EA, Momjian S, Owler B, Pickard JD, Czosnyka M (2008) Pulse amplitude of intracranial pressure waveform in hydrocephalus. Acta Neurochir Suppl 102:137–140. doi:10.1007/978-3-211-85578-2_28 CrossRefPubMed Czosnyka Z, Keong N, Kim DJ, Radolovich D, Smielewski P, Lavinio A, Schmidt EA, Momjian S, Owler B, Pickard JD, Czosnyka M (2008) Pulse amplitude of intracranial pressure waveform in hydrocephalus. Acta Neurochir Suppl 102:137–140. doi:10.​1007/​978-3-211-85578-2_​28 CrossRefPubMed
11.
Zurück zum Zitat Czosnyka ZH, Czosnyka M, Whitfield PC, Donovan T, Pickard JD (2002) Cerebral autoregulation among patients with symptoms of hydrocephalus. Neurosurgery 50:526–532 discussion 532-523PubMed Czosnyka ZH, Czosnyka M, Whitfield PC, Donovan T, Pickard JD (2002) Cerebral autoregulation among patients with symptoms of hydrocephalus. Neurosurgery 50:526–532 discussion 532-523PubMed
12.
Zurück zum Zitat de Oliveira RS, Machado HR (2003) Transcranial color-coded Doppler ultrasonography for evaluation of children with hydrocephalus. Neurosurg Focus 15:1–7CrossRef de Oliveira RS, Machado HR (2003) Transcranial color-coded Doppler ultrasonography for evaluation of children with hydrocephalus. Neurosurg Focus 15:1–7CrossRef
13.
14.
Zurück zum Zitat Fan JY, Kirkness C, Vicini P, Burr R, Mitchell P (2008) Intracranial pressure waveform morphology and intracranial adaptive capacity. Am J Crit Care 17:545–554PubMed Fan JY, Kirkness C, Vicini P, Burr R, Mitchell P (2008) Intracranial pressure waveform morphology and intracranial adaptive capacity. Am J Crit Care 17:545–554PubMed
15.
Zurück zum Zitat Gallagher ER, Hing AV, Cunningham ML (2013) Evaluating fontanels in the newborn skull. Gallagher ER, Hing AV, Cunningham ML (2013) Evaluating fontanels in the newborn skull.
17.
Zurück zum Zitat Hashimoto M, Higashi S, Tokuda K, Yamamoto Y, Yamashita J (1993) Changes of intracranial pressure and pulse wave form induced by various mechanical stresses upon intracranial hemodynamics. In: Intracranial Pressure VIII. Springer, pp 367–371 Hashimoto M, Higashi S, Tokuda K, Yamamoto Y, Yamashita J (1993) Changes of intracranial pressure and pulse wave form induced by various mechanical stresses upon intracranial hemodynamics. In: Intracranial Pressure VIII. Springer, pp 367–371
18.
Zurück zum Zitat Huang X, Lin J, Demner-Fushman D (2006) PICO as a Knowledge Representation for Clinical Questions. In: AMIA 2006 Symposium Proceedings. pp 359–363 Huang X, Lin J, Demner-Fushman D (2006) PICO as a Knowledge Representation for Clinical Questions. In: AMIA 2006 Symposium Proceedings. pp 359–363
20.
Zurück zum Zitat Kirkness CJ, Mitchell PH, Burr RL, March KS, Newell DW (2000) Intracranial pressure waveform analysis: clinical and research implications. J Neurosci Nurs J Am Assoc Neurosci Nurs 32:271–277CrossRef Kirkness CJ, Mitchell PH, Burr RL, March KS, Newell DW (2000) Intracranial pressure waveform analysis: clinical and research implications. J Neurosci Nurs J Am Assoc Neurosci Nurs 32:271–277CrossRef
21.
Zurück zum Zitat Levine DN (2008) Intracranial pressure and ventricular expansion in hydrocephalus: have we been asking the wrong question? J Neurol Sci 269:1–11CrossRefPubMed Levine DN (2008) Intracranial pressure and ventricular expansion in hydrocephalus: have we been asking the wrong question? J Neurol Sci 269:1–11CrossRefPubMed
22.
Zurück zum Zitat Marmarou A, Beaumont A (2011) Physiology of the cerebrospinal fluid and intracranial pressure. In: Elsevier (ed) Youmans neurological surgery. Winn,. H, Filadélfia, pp 169–182 Marmarou A, Beaumont A (2011) Physiology of the cerebrospinal fluid and intracranial pressure. In: Elsevier (ed) Youmans neurological surgery. Winn,. H, Filadélfia, pp 169–182
23.
Zurück zum Zitat Mascarenhas S, Vilela GH, Carlotti C, Damiano LE, Seluque W, Colli B, Tanaka K, Wang CC, Nonaka KO (2012) The new ICP minimally invasive method shows that the Monro-Kellie doctrine is not valid. Acta Neurochir Suppl 114:117–120. doi:10.1007/978-3-7091-0956-4_21 CrossRefPubMed Mascarenhas S, Vilela GH, Carlotti C, Damiano LE, Seluque W, Colli B, Tanaka K, Wang CC, Nonaka KO (2012) The new ICP minimally invasive method shows that the Monro-Kellie doctrine is not valid. Acta Neurochir Suppl 114:117–120. doi:10.​1007/​978-3-7091-0956-4_​21 CrossRefPubMed
26.
Zurück zum Zitat Patwardhan RV, Nanda A (2005) Implanted ventricular shunts in the United States: the billion-dollar-a-year cost of hydrocephalus treatment. Neurosurgery 56:139–144 discussion 144–135CrossRefPubMed Patwardhan RV, Nanda A (2005) Implanted ventricular shunts in the United States: the billion-dollar-a-year cost of hydrocephalus treatment. Neurosurgery 56:139–144 discussion 144–135CrossRefPubMed
27.
Zurück zum Zitat Pople IK, Muhlbauer MS, Sanford RA, Kirk E (1995) Results and complications of intracranial pressure monitoring in 303 children. Pediatr Neurosurg 23:64–67CrossRefPubMed Pople IK, Muhlbauer MS, Sanford RA, Kirk E (1995) Results and complications of intracranial pressure monitoring in 303 children. Pediatr Neurosurg 23:64–67CrossRefPubMed
29.
Zurück zum Zitat Rauch ME, Mitchell PH, Tyler ML (1990) Validation of risk factors for the nursing diagnosis decreased intracranial adaptive capacity. J Neurosci Nurs 22:173–178CrossRefPubMed Rauch ME, Mitchell PH, Tyler ML (1990) Validation of risk factors for the nursing diagnosis decreased intracranial adaptive capacity. J Neurosci Nurs 22:173–178CrossRefPubMed
30.
Zurück zum Zitat Schardt C, Adams MB, Owens T, Keitz S, Fontelo P (2007) Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inf Decis Mak 7:16CrossRef Schardt C, Adams MB, Owens T, Keitz S, Fontelo P (2007) Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inf Decis Mak 7:16CrossRef
31.
Zurück zum Zitat Vilela GH, Cabella B, Mascarenhas S, Czosnyka M, Smielewski P, Dias C, Cardim DA, Mascarenhas YM, Wang CC, Andrade R, Tanaka K, Lopes LS, Colli BO (2016) Validation of a new minimally invasive intracranial pressure monitoring method by direct comparison with an invasive technique. Acta Neurochir Suppl 122:97–100. doi:10.1007/978-3-319-22533-3_19 CrossRefPubMed Vilela GH, Cabella B, Mascarenhas S, Czosnyka M, Smielewski P, Dias C, Cardim DA, Mascarenhas YM, Wang CC, Andrade R, Tanaka K, Lopes LS, Colli BO (2016) Validation of a new minimally invasive intracranial pressure monitoring method by direct comparison with an invasive technique. Acta Neurochir Suppl 122:97–100. doi:10.​1007/​978-3-319-22533-3_​19 CrossRefPubMed
Metadaten
Titel
Prediction of intracranial hypertension through noninvasive intracranial pressure waveform analysis in pediatric hydrocephalus
verfasst von
Matheus Fernando Manzolli Ballestero
Gustavo Frigieri
Brenno Caetano Troca Cabella
Sergio Mascarenhas de Oliveira
Ricardo Santos de Oliveira
Publikationsdatum
16.06.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 9/2017
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-017-3475-1

Weitere Artikel der Ausgabe 9/2017

Child's Nervous System 9/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.