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病例报告:使用新型无创颅内压波形管理的脑室腹腔分流患儿的难治性头痛

Case Report: Untreatable Headache in a Child With Ventriculoperitoneal Shunt Managed by Use of New Non-invasive Intracranial Pressure Waveform.

作者信息

Paraguassu Geraldo, Khilnani Mark, Rabelo Nicollas Nunes, Cobos Luiza D'Ottaviano, Frigieri Gustavo

机构信息

Hospital Estadual Alberto Torres, Rio de Janeiro, Brazil.

Bio Technology Consulting Services, Atlanta, GA, United States.

出版信息

Front Neurosci. 2021 Feb 10;15:601945. doi: 10.3389/fnins.2021.601945. eCollection 2021.

Abstract

brain4care, a new Food and Drug Administration (FDA)-cleared non-invasive sensor that monitors intracranial pressure waveforms, was used in a 13-year-old girl who presented with untreatable headaches. The patient had a history of craniopharyngioma resection and a ventriculoperitoneal shunt placement 7 years prior to the use of the device. Secondary obstructive hydrocephalus was also a present factor in the case. The hypothesis was that due to the hydrocephalus, the child presented chronic headaches and needed constant readjustment into the ventriculoperitoneal shunt to regulate the cerebrospinal fluid inside her ventricles in order to control the patient's intracranial pressure (ICP). The device was chosen considering the risks to submit a patient into the regular invasive method to measure ICP. It was identified that the device could also indicate altered intracranial compliance due to the ratio between the P1 and P2 amplitudes (P2/P1 ratio > 1).

摘要

brain4care是一种新的经美国食品药品监督管理局(FDA)批准的非侵入性传感器,用于监测颅内压波形,该传感器被用于一名患有无法治愈的头痛的13岁女孩身上。该患者有颅咽管瘤切除术病史,在使用该设备7年前进行了脑室腹腔分流术。继发性梗阻性脑积水也是该病例中的一个现存因素。假设是由于脑积水,该儿童出现慢性头痛,需要不断调整脑室腹腔分流术以调节脑室内的脑脊液,从而控制患者的颅内压(ICP)。考虑到让患者接受常规有创方法测量ICP的风险,选择了该设备。经确定,该设备还可根据P1和P2振幅之比(P2/P1比率>1)指示颅内顺应性改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1667/7928322/68086807d189/fnins-15-601945-g0001.jpg

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