From head micro-motions towards CSF dynamics and non-invasive intracranial pressure monitoring

Abstract Continuous monitoring of the intracranial pressure (ICP) is essential in neurocritical care. There are a variety of ICP monitoring systems currently available, with the intraventricular fluid filled catheter transducer currently representing the “gold standard”. As the placement of catheter...

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Autores principales:	Arnošt Mládek, Václav Gerla, Petr Šeba, Vladimír Kolář, Petr Skalický, Helen Whitley, Lenka Lhotská, Vladimír Beneš, Ondřej Bradáč
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2a77fbd1eae4485a81c4fc2d062540a1
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spelling	oai:doaj.org-article:2a77fbd1eae4485a81c4fc2d062540a12021-12-02T16:08:07ZFrom head micro-motions towards CSF dynamics and non-invasive intracranial pressure monitoring10.1038/s41598-021-93740-52045-2322https://doaj.org/article/2a77fbd1eae4485a81c4fc2d062540a12021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93740-5https://doaj.org/toc/2045-2322Abstract Continuous monitoring of the intracranial pressure (ICP) is essential in neurocritical care. There are a variety of ICP monitoring systems currently available, with the intraventricular fluid filled catheter transducer currently representing the “gold standard”. As the placement of catheters is associated with the attendant risk of infection, hematoma formation, and seizures, there is a need for a reliable, non-invasive alternative. In the present study we suggest a unique theoretical framework based on differential geometry invariants of cranial micro-motions with the potential for continuous non-invasive ICP monitoring in conservative traumatic brain injury (TBI) treatment. As a proof of this concept, we have developed a pillow with embedded mechanical sensors and collected an extensive dataset (> 550 h on 24 TBI coma patients) of cranial micro-motions and the reference intraparenchymal ICP. From the multidimensional pulsatile curve we calculated the first Cartan curvature and constructed a ”fingerprint” image (Cartan map) associated with the cerebrospinal fluid (CSF) dynamics. The Cartan map features maxima bands corresponding to a pressure wave reflection corresponding to a detectable skull tremble. We give evidence for a statistically significant and patient-independent correlation between skull micro-motions and ICP time derivative. Our unique differential geometry-based method yields a broader and global perspective on intracranial CSF dynamics compared to rather local catheter-based measurement and has the potential for wider applications.Arnošt MládekVáclav GerlaPetr ŠebaVladimír KolářPetr SkalickýHelen WhitleyLenka LhotskáVladimír BenešOndřej BradáčNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Arnošt Mládek Václav Gerla Petr Šeba Vladimír Kolář Petr Skalický Helen Whitley Lenka Lhotská Vladimír Beneš Ondřej Bradáč From head micro-motions towards CSF dynamics and non-invasive intracranial pressure monitoring
description	Abstract Continuous monitoring of the intracranial pressure (ICP) is essential in neurocritical care. There are a variety of ICP monitoring systems currently available, with the intraventricular fluid filled catheter transducer currently representing the “gold standard”. As the placement of catheters is associated with the attendant risk of infection, hematoma formation, and seizures, there is a need for a reliable, non-invasive alternative. In the present study we suggest a unique theoretical framework based on differential geometry invariants of cranial micro-motions with the potential for continuous non-invasive ICP monitoring in conservative traumatic brain injury (TBI) treatment. As a proof of this concept, we have developed a pillow with embedded mechanical sensors and collected an extensive dataset (> 550 h on 24 TBI coma patients) of cranial micro-motions and the reference intraparenchymal ICP. From the multidimensional pulsatile curve we calculated the first Cartan curvature and constructed a ”fingerprint” image (Cartan map) associated with the cerebrospinal fluid (CSF) dynamics. The Cartan map features maxima bands corresponding to a pressure wave reflection corresponding to a detectable skull tremble. We give evidence for a statistically significant and patient-independent correlation between skull micro-motions and ICP time derivative. Our unique differential geometry-based method yields a broader and global perspective on intracranial CSF dynamics compared to rather local catheter-based measurement and has the potential for wider applications.
format	article
author	Arnošt Mládek Václav Gerla Petr Šeba Vladimír Kolář Petr Skalický Helen Whitley Lenka Lhotská Vladimír Beneš Ondřej Bradáč
author_facet	Arnošt Mládek Václav Gerla Petr Šeba Vladimír Kolář Petr Skalický Helen Whitley Lenka Lhotská Vladimír Beneš Ondřej Bradáč
author_sort	Arnošt Mládek
title	From head micro-motions towards CSF dynamics and non-invasive intracranial pressure monitoring
title_short	From head micro-motions towards CSF dynamics and non-invasive intracranial pressure monitoring
title_full	From head micro-motions towards CSF dynamics and non-invasive intracranial pressure monitoring
title_fullStr	From head micro-motions towards CSF dynamics and non-invasive intracranial pressure monitoring
title_full_unstemmed	From head micro-motions towards CSF dynamics and non-invasive intracranial pressure monitoring
title_sort	from head micro-motions towards csf dynamics and non-invasive intracranial pressure monitoring
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/2a77fbd1eae4485a81c4fc2d062540a1
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From head micro-motions towards CSF dynamics and non-invasive intracranial pressure monitoring

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