Analysis of the intracranial pressure waveform in hydrocephalus patients using a non-invasive device
Raphael Bertani 1, Caio Perret2, Stefan Koester3, Paulo Santa Maria2, Savio Batista4, Tamires Guimarães Cavalcante Carlos de Carvalho5, Nicolas Rabelo1, Ruy Monteiro2
1Department of Neurosurgery, University of São Paulo, São Paulo, SP, 01246-000, Brazil; 2Department of Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, RJ, 22430-160, Brazil; 3School of Medicine, Vanderbilt University, Nashville, TN, 37240, USA; 4Medical school, Universidade Federal do Rio de Janeiro (UFRJ), RJ, 20210-030, Brazil; 5Medical school, Universidade Nove de Julho (UNINOVE), São Paulo, SP, 01525-000, Brazil.
Correspondence: Raphael Bertani (email@example.com)
Fluids and Barriers of the CNS 2022, 19(1)
Introduction: Non-invasive devices that reliably monitor brain compliance can reduce patients’ exposure to potentially harmful or costly imaging modalities. The aim of this study is to assess this situation with a new non-invasive headband device developed by brain4care®.
Methods: Patients were submitted to either surgical or valve adjustment procedures and monitored before and after the procedure by the brain4care® headband device. Sixteen symptomatic patients with a previous radiological diagnosis of hydrocephalus, in need of intervention, between the ages of 26 and 73 were analyzed.
Results: Out of these patients, 5 were submitted to external ventricular drainages (EVD), 9 to ventriculoperitoneal shunting (VPS), and 2 to valve adjustment. All patients had an abnormal cerebral complacency wave, with P2 > P1 before the procedure, and after, 75% of the patients changed to a normal pattern with P1 > P2. All patients self-reported feeling comfortable with the device.
Conclusions: By providing practitioners the Intracranial Pressure (ICP) waveform and values of the P2 / P1 ratio, without quantification of ICP values, this non-invasive device can decrease costs, the time needed to diagnose whether changes or revision of the shunt, and complications of invasive methods for ICP monitoring. Moreover, it can be used in scenarios where invasive ICP monitoring is not indicated, yet would still be insightful.