Journal
NEUROPHOTONICS
Volume 9, Issue 4, Pages -Publisher
SPIE-SOC PHOTO-OPTICAL INSTRUMENTATION ENGINEERS
DOI: 10.1117/1.NPh.9.4.045005
Keywords
benign enlargement of subarachnoid spaces; hydrocephalus; intracranial pressure monitoring; optical techniques; pathophysiology
Categories
Funding
- Department of Cirugia and Ciencias Morfologicas of the Universitat Autonoma de Barcelona
- European Union's Horizon 2020 Research and Innovation Program under the Marie Sklodowska-Curie [675332]
- European Union's Horizon 2020 Research and Innovation Program [101017113, 101016087]
- Fondo de Investigacion Sanitaria (Instituto de Salud Carlos III) [PI18/00468]
- Fundacio CELLEX Barcelona
- Fundacio Mir Puig
- Agencia Estatal de Investigacion (PHOTOMETABO) [PID2019106481RBC31]
- Severo Ochoa Program for Centers of Excelence in RD [CEX2019-000910-S]
- Obra social La Caixa Foundation (LlumMedBcn)
- Generalitat de Catalunya (CERCA) [AGAUR-2017SGR-1380, RIS3CAT-001-P-001682 CECH]
- FEDER EC
- LASERLAB EUROPE V (EC H2020) [871124]
- KidsBrainIT (ERANET NEURON)
- Fundacio La Marato de TV3 [201724.31, 201709.31]
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This study aimed to evaluate whether there were cerebral hemodynamic changes associated with intracranial pressure (ICP) B-waves that could be evaluated with noninvasive neuromonitoring.
Significance: Benign external hydrocephalus (BEH) is considered a self-limiting pathology with a good prognosis. However, some children present a pathological intracranial pressure (ICP) characterized by quantitative and qualitative alterations (the so-called B-waves) that can lead to neurological sequelae. Aim: Our purpose was to evaluate whether there were cerebral hemodynamic changes associated with ICP B-waves that could be evaluated with noninvasive neuromonitoring. Approach: We recruited eleven patients (median age 16 months, range 7 to 55 months) with BEH and an unfavorable evolution requiring ICP monitoring. Bedside, nocturnal monitoring using near-infrared time-resolved and diffuse correlation spectroscopies synchronized to the clinical monitoring was performed. Results: By focusing on the timing of different ICP patterns that were identified manually by clinicians, we detected significant tissue oxygen saturation (StO(2)) changes (p = 0.002) and blood flow index (BFI) variability (p = 0.005) between regular and high-amplitude B-wave patterns. A blinded analysis looking for analogs of ICP patterns in BFI time traces achieved 90% sensitivity in identifying B-waves and 76% specificity in detecting the regular patterns. Conclusions: We revealed the presence of StO2 and BFI variations-detectable with optical techniques-during ICP B-waves in BEH children. Finally, the feasibility of detecting ICP B-waves in hemodynamic time traces obtained noninvasively was shown. (c) The Authors. Published by SPIE under a Creative Commons Attribution 4.0 International License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.
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