Elsawaf Yasmeen, Jaklitsch Erik, Belyea Madison, Rodriguez Levon, Silverman Alexandra, Valley Halyn, Koleilat Issam, Yaghi Nasser K, Jaeggli Michael
Department of Neurological Surgery, Oregon Health & Science University, Portland, OR 97201, USA.
Department of Biomedical Engineering, Northeastern University, Boston, MA 02115, USA.
J Pers Med. 2023 Aug 28;13(9):1318. doi: 10.3390/jpm13091318.
Hydrocephalus is a clinical disorder caused by excessive cerebrospinal fluid (CSF) buildup in the ventricles of the brain, often requiring permanent CSF diversion via an implanted shunt system. Such shunts are prone to failure over time; an ambulatory intracranial pressure (ICP) monitoring device may assist in the detection of shunt failure without an invasive diagnostic workup. Additionally, high resolution, noninvasive intracranial pressure monitoring will help in the study of diseases such as normal pressure hydrocephalus (NPH) and idiopathic intracranial hypertension (IIH). We propose an implantable, continuous, rechargeable ICP monitoring device that communicates via Bluetooth with mobile applications. The design requirements were met at the lower ICP ranges; the obtained error fell within the idealized ±2 mmHg margin when obtaining pressure values at or below 20 mmHg. The error was slightly above the specified range at higher ICPs (±10% from 20-100 mmHg). The system successfully simulates occlusions and disconnections of the proximal and distal catheters, valve failure, and simulation of A and B ICP waves. The mobile application accurately detects the ICP fluctuations that occur in these physiologic states. The presented macro-scale prototype is an ex-vivo model of an implantable, rechargeable ICP monitoring system that has the potential to measure clinically relevant ICPs and wirelessly provide accessible and continuous data to aid in the workup of shunt failure.
脑积水是一种临床病症，由脑脊液（CSF）在脑室中过度积聚引起，通常需要通过植入分流系统进行永久性脑脊液引流。随着时间的推移，这种分流装置容易出现故障；一种可移动的颅内压（ICP）监测设备可以在无需侵入性诊断检查的情况下协助检测分流故障。此外，高分辨率、非侵入性颅内压监测将有助于研究诸如正常压力脑积水（NPH）和特发性颅内高压（IIH）等疾病。我们提出了一种可植入、连续、可充电的ICP监测设备，该设备通过蓝牙与移动应用程序进行通信。在较低的颅内压范围内满足了设计要求；当获取20 mmHg及以下的压力值时，所获得的误差落在理想的±2 mmHg范围内。在较高的颅内压（20 - 100 mmHg范围内误差±10%）时，误差略高于规定范围。该系统成功模拟了近端和远端导管的堵塞和断开、阀门故障以及A波和B波颅内压波形的模拟。移动应用程序能够准确检测这些生理状态下发生的颅内压波动。所展示的宏观原型是一种可植入、可充电的ICP监测系统的体外模型，它有潜力测量临床相关的颅内压，并以无线方式提供可获取的连续数据，以协助分流故障的检查。
