Non-invasive intracranial pressure monitoring in traumatic brain injury

PI: Jana Kainerstorfer
Co-PI(s): Pulkit Grover
University: Carnegie Mellon University

There is a critical clinical need for non-invasive intracranial pressure (ICP) monitoring. Current methods are invasive and are only applicable to severe traumatic brain injury. Changes in cerebral autoregulation, which is the brain’s mechanism to maintain blood flow despite pressure changes, after brain injury may contribute to cerebral ischemia, elevated ICP, and/or cerebral hyperemia, and may worsen patient outcome. In order to quantify autoregulation and manage patient’s health based on autoregulation and perfusion, ICP needs to be measured.

Using a combination of optical methods, such as near-infrared spectroscopy (NIRS) and diffuse correlation spectroscopy (DCS), in acute measurements of increased ICP in non-human primates, we found that hemodynamic changes (as measured with NIRS and DCS) can be used to monitor ICP as well as autoregulation non-invasively. The test studies have been funded by AHA as well as NIH and are ongoing. Preliminary results demonstrated that cerebral hemodynamic changes as measured with NIRS in combination with a transfer function analysis approach can yield ICP traces and therefore feedback about the autoregulatory state of the brain. Translation of the methods into a clinical setting at the Children’s Hospital in Pittsburgh was proposed in our CMLH submission, which is used as matching funding and is the core of the proposed work. The PITA proposal expands the proposed study by developing a combined NIRS/DCS system, which is an important step towards ease-of-use in the clinic.