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。由于颅骨的体积是固定的，其内容物体积的增加导致颅内压（ICP）的增加。颅内压升高可通过压迫供应大脑的血管或重要大脑结构本身而导致脑损伤或死亡恶化。检测和治疗这种颅内压升高对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，需要通过颅骨直接进入探针系统。这一提议的主要假设是，它是可能的监测颅内压力的变化，通过非侵入性手段使用声学测量。这种测量方法与目前监测ICP的侵入性测量相比具有显著的优势，因为测量可以方便、快速（不到一分钟）地获得，而不会侵入颅骨，感染的概率为零。建议开发一种实用的仪器来监测ICP的变化，通过测量失真产物耳声发射（DPOAE）和中耳阻抗。仪器的初步评估和改进将涉及健康的正常听力受试者在倾斜台上。随后的评估将比较该仪器与传统的侵入性方法监测ICP患者在一家大医院的神经重症监护病房。大范围的毁灭性脑损伤会导致脑肿胀或出血。由于颅骨的体积是固定的，其内容物体积的增加导致颅内压（ICP）的增加。颅内压升高可通过压迫供应大脑的血管或重要大脑结构本身而导致脑损伤或死亡恶化。检测和治疗这种颅内压升高对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，需要通过颅骨直接进入探针系统。这一提议的主要假设是，它是可能的监测颅内压力的变化，通过非侵入性手段使用声学测量。这种测量方法与目前监测ICP的侵入性测量相比具有显著的优势，因为测量可以方便、快速（不到一分钟）地获得，而不会侵入颅骨，感染的概率为零。

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.