Non-Invasive Instrument for Monitoring Changes in Intracranial Pressure

描述（由申请人提供）：广泛的破坏性脑损伤导致脑肿胀或出血。由于颅骨体积固定，其内容物体积的增加导致颅内压（ICP）升高。颅内压升高可通过压迫供应大脑的血管或重要的大脑结构本身而导致脑损伤恶化或死亡。检测和治疗ICP的这种增加对于保护受伤的大脑至关重要。目前，监测ICP的唯一方法是侵入性的，并且需要探针系统通过颅骨直接进入。该建议的主要假设是，可以通过使用声学测量的非侵入性手段来监测颅内压的变化。这种测量方法相对于当前监测ICP的侵入性测量具有显著的优点，因为可以方便且快速地（在不到一分钟内）获得测量，而不侵入颅骨并且感染的可能性为零。提出了一种利用畸变产物耳声发射（DPOAE）和中耳阻抗测量来监测ICP变化的实用仪器。仪器的初始评估和改进将涉及倾斜台上的健康正常听力受试者。随后的评估将比较仪器与传统的侵入性方法监测颅内压与患者在神经重症监护病房的一家大医院。广泛的破坏性脑损伤会导致脑肿胀或出血。由于头骨的体积是固定的，因此其内容物体积的增加会导致颅内压（ICP）升高。颅内压升高可通过压迫供应大脑的血管或重要的大脑结构本身而导致脑损伤恶化或死亡。检测和治疗ICP的这种增加对于保护受伤的大脑至关重要。目前，监测ICP的唯一方法是侵入性的，并且需要探针系统通过颅骨直接进入。该建议的主要假设是，可以通过使用声学测量的非侵入性手段来监测颅内压的变化。这种测量方法相对于当前监测ICP的侵入性测量具有显著的优点，因为可以方便且快速地（在不到一分钟内）获得测量，而不侵入颅骨并且感染的可能性为零。

DESCRIPTION (provided by applicant): A wide range of devastating brain injuries cause brain swelling or bleeding. Because the skull is fixed in volume, increases in the volume of its contents result in increases in intracranial pressure (ICP). Elevations of ICP can lead to worsening brain injury or death by compressing either blood vessels supplying the brain or vital brain structures themselves. Detecting and treating such increases in ICP is crucial to protecting the injured brain. Currently, the only methods to monitor ICP are invasive and require direct entry of a probe system through the skull. The major hypothesis of this proposal is that it is possible to monitor changes in intracranial pressure by non-invasive means using acoustic measurements. This method of measurement has significant advantages over current invasive measurements of monitoring ICP in that the measurements can be obtained conveniently and rapidly (in less than a minute) without invading the skull and with zero probability of infection. It is proposed to develop a practical instrument for monitoring changes in ICP using measurements of distortion product otoacoustic emissions (DPOAE) and middle ear impedance. Initial evaluation and refinement of the instrument will involve healthy normal hearing subjects on a tilt table. Subsequent evaluations will compare the instrument with the conventional invasive method of monitoring ICP with patients in the neurological intensive care unit of a major hospital. A wide range of devastating brain injuries cause brain swelling or bleeding. Because the skull is fixed in volume, increases in the volume of its contents result in increases in intracranial pressure (ICP). Elevations of ICP can lead to worsening brain injury or death by compressing either blood vessels supplying the brain or vital brain structures themselves. Detecting and treating such increases in ICP is crucial to protecting the injured brain. Currently, the only methods to monitor ICP are invasive and require direct entry of a probe system through the skull. The major hypothesis of this proposal is that it is possible to monitor changes in intracranial pressure by non-invasive means using acoustic measurements. This method of measurement has significant advantages over current invasive measurements of monitoring ICP in that the measurements can be obtained conveniently and rapidly (in less than a minute) without invading the skull and with zero probability of infection.