Skip to main content
Top
Published in: Child's Nervous System 1/2024

26-07-2023 | Craniosynostosis | Original Article

Analysis of intracranial pressure waveform using a non-invasive method in individuals with craniosynostosis

Authors: Michele Madeira Brandao, Cristiano Tonello, Isabella Parizotto, Luciano Brandao Machado, Nivaldo Alonso

Published in: Child's Nervous System | Issue 1/2024

Login to get access

Abstract

Purpose

Craniosynostosis can lead to symptoms resulting from cranial compliance (CC) changes and intracranial hypertension (ICH), which may cause cognitive and visual impairment. Non-invasive methods have emerged, including a new device that captures and processes the intracranial pressure waveform (ICPw) by the skull’s oscillation. The present study evaluates ICPw obtained non-invasively (NIICPw) in patients with craniosynostosis.

Methods

This prospective, cross-sectional, and descriptive study was conducted at a single center. Patients diagnosed with craniosynostosis and who provided informed consent were included. A US Food and Drug Administration–approved mechanical extensometer device (Brain4Care Corp.) was used to obtain a NIICPw. An ophthalmologist did a point-of-care retinography to check the optic nerve papilla. The P2/P1 ratio and the morphology of the NIICPw were analyzed, as well as the retinography.

Results

Thirty-five patients were evaluated, and 42 registers were obtained because seven were assessed before and after the surgery. The two patients who presented papilledema had low CC (NIICPw shape Class 3 or 4). There was a significant association between NIICPw and papilledema.

Conclusion

The ratio P2/P1 and the NIICPw morphology provided by a non-invasive monitor are related to CC changes before papilledema occurs. This is especially useful in patients with craniosynostosis because invasive ICP monitoring is not always feasible. Further studies are warranted to establish the clinical utility of NIICPw in patients with craniosynostosis.
Literature
6.
go back to reference Swanson J, Bender L, Mitchell B et al (2015) Optical coherence tomography: an objective modality for detecting papilledema in craniosynostosis patients with suspected intracranial hypertension. Cleft Palate-Craniofac J 52:e139 Swanson J, Bender L, Mitchell B et al (2015) Optical coherence tomography: an objective modality for detecting papilledema in craniosynostosis patients with suspected intracranial hypertension. Cleft Palate-Craniofac J 52:e139
8.
go back to reference Lang S-S, Kalmar C, Heuer G et al (2020) Optical coherence tomography can detect elevated intracranial pressure in craniosynostosis. J Neursurg Pediatr 25:2–3 Lang S-S, Kalmar C, Heuer G et al (2020) Optical coherence tomography can detect elevated intracranial pressure in craniosynostosis. J Neursurg Pediatr 25:2–3
14.
go back to reference Hayward R, Gonsalez S (2005) How low can you go? Intracranial pressure, cerebral perfusion pressure, and respiratory obstruction in children with complex craniosynostosis. J Neurosurg 102:16–22PubMed Hayward R, Gonsalez S (2005) How low can you go? Intracranial pressure, cerebral perfusion pressure, and respiratory obstruction in children with complex craniosynostosis. J Neurosurg 102:16–22PubMed
20.
go back to reference Rubiano AM, Figaji A, Hawryluk GW (2022) Intracranial pressure management: moving beyond guidelines. Curr Opin Crit Care 28:101–110CrossRefPubMed Rubiano AM, Figaji A, Hawryluk GW (2022) Intracranial pressure management: moving beyond guidelines. Curr Opin Crit Care 28:101–110CrossRefPubMed
24.
go back to reference April F, Monro A (1783) Observations on the structure and functions of the nervous system, illustrated with tables. Lond Med J 4(2):113–135. PMCID: PMC5545466 April F, Monro A (1783) Observations on the structure and functions of the nervous system, illustrated with tables. Lond Med J 4(2):113–135. PMCID: PMC5545466
25.
go back to reference Raksin PB, Alperin N, Sivaramakrishnan A et al (2003) Noninvasive intracranial compliance and pressure based on dynamic magnetic resonance imaging of blood flow and cerebrospinal fluid flow: review of principles, implementation, and other noninvasive approaches. Neurosurgical focus FOC 14:1–8. https://doi.org/10.3171/foc.2003.14.4.4CrossRef Raksin PB, Alperin N, Sivaramakrishnan A et al (2003) Noninvasive intracranial compliance and pressure based on dynamic magnetic resonance imaging of blood flow and cerebrospinal fluid flow: review of principles, implementation, and other noninvasive approaches. Neurosurgical focus FOC 14:1–8. https://​doi.​org/​10.​3171/​foc.​2003.​14.​4.​4CrossRef
26.
go back to reference Alperin N (2020) Does the brain have mechanical compliance? Magn Reson Mater Phys, Biol Med 33:753–756CrossRef Alperin N (2020) Does the brain have mechanical compliance? Magn Reson Mater Phys, Biol Med 33:753–756CrossRef
27.
go back to reference Ueno T, Ballard RE, Shuer LM et al (1998) Noninvasive measurement of pulsatile intracranial pressure using ultrasound. ActaNeurochir 71(Suppl]):66–69 Ueno T, Ballard RE, Shuer LM et al (1998) Noninvasive measurement of pulsatile intracranial pressure using ultrasound. ActaNeurochir 71(Suppl]):66–69
31.
go back to reference Mataczy C, Kazimierska A, Uryga A et al (2022) End-to-end automatic morphological classification of intracranial pressure pulse waveforms using deep learning index terms-deep neural networks, intracranial pressure, intensive care unit. IEEE J Biomed Health Inform 26. https://doi.org/10.1109/JBHI.2021.3088629 Mataczy C, Kazimierska A, Uryga A et al (2022) End-to-end automatic morphological classification of intracranial pressure pulse waveforms using deep learning index terms-deep neural networks, intracranial pressure, intensive care unit. IEEE J Biomed Health Inform 26. https://​doi.​org/​10.​1109/​JBHI.​2021.​3088629
Metadata
Title
Analysis of intracranial pressure waveform using a non-invasive method in individuals with craniosynostosis
Authors
Michele Madeira Brandao
Cristiano Tonello
Isabella Parizotto
Luciano Brandao Machado
Nivaldo Alonso
Publication date
26-07-2023
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 1/2024
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-023-06092-y

Other articles of this Issue 1/2024

Child's Nervous System 1/2024 Go to the issue