Non-Invasive Instrument for Monitoring Changes in Intracranial Pressure

描述(申请人提供)：广泛的破坏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会导致颅内压(ICP)的增加。颅内压升高可通过压迫供应大脑的血管或重要的脑结构本身而导致更严重的脑损伤或死亡。检测和治疗这种颅内压的增加对于保护受损的大脑至关重要。目前，监测颅内压的唯一方法是有创的，需要通过头骨直接进入探头系统。这一建议的主要假设是，有可能通过使用声学测量的非侵入性手段来监测颅内压的变化。这种测量方法与目前监测颅内压的侵入性测量方法相比具有显著的优势，因为可以方便、快速(不到一分钟)获得测量结果，而不会侵犯颅骨，感染的可能性为零。建议开发一种实用的仪器，通过测量失真产物耳声发射(DPOAE)和中耳阻抗来监测颅内压的变化。该仪器的初步评估和改进将让健康的正常听力受试者坐在斜台上。随后的评估将把该仪器与传统的侵入性方法监测颅内压与一家大医院神经重症监护病房的患者进行比较。大范围的破坏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会导致颅内压(ICP)的增加。颅内压升高可通过压迫供应大脑的血管或重要的脑结构本身而导致更严重的脑损伤或死亡。检测和治疗这种颅内压的增加对于保护受损的大脑至关重要。目前，监测颅内压的唯一方法是有创的，需要通过头骨直接进入探头系统。这一建议的主要假设是，有可能通过使用声学测量的非侵入性手段来监测颅内压的变化。这种测量方法与目前监测颅内压的侵入性测量方法相比具有显著的优势，因为可以方便、快速(不到一分钟)获得测量结果，而不会侵犯颅骨，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.