Non-invasive ICP monitoring and ischemia detection via transcranial and ocular ultrasound

Le résumé fourni par la source

Hydrocephalus causes elevated intracranial pressure (ICP) that can lead to permanent neurologic disability. While current diagnosis relies on invasive monitoring with risks of infection and hemorrhage, the critical goal is not only measuring ICP but identifying which ICP triggers ischemia. Our research indicates that microvessels are highly sensitive to pressure and can serve as biomarkers for ICP and ischemia. We hypothesize that quantifying microvascular changes in the brain and eye could provide crucial insights into ICP and brain health in the neonatal porcine hydrocephalus model. In a neonatal porcine model, ICP was incrementally increased (10–50 mmHg) while performing contrast enhanced ultrasound via transcranial and ocular windows. Using Particle Tracking Velocimetry (PTV), we derived two biomarkers: Cerebral Microcirculation (CMC) and Retinal Microcirculation (RMC), defined as time-averaged velocity in microvessels. Our findings reveal that while macrovascular flow often persists under stress, CMC and RMC show a highly predictable linear decrease as ICP rises (R2 = 0.91 and R2 = 0.84, respectively). Moreover, drastic reduction in flow correlated with the onset of ischemia as measured via microdialysis based lactate to pyruvate levels. As such, our study suggests the potential utility of advanced ultrasound imaging of the brain and ocular microvessels to infer important physiologic information in neonatal hydrocephalus.

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