Raised intra-cranial pressure (ICP) is a common occurrence in people with traumatic brain injuries and primary brain bleeds. In these patients the best way to monitor ICP is through the usage of an extraventricular drain (EVD), which can show the exact ICP measurement. EVDs run a high risk of causing severe infections when used in a non-sterile environment or handled with unclean hands. Additionally, EVDs are fairly resource intensive and the better EVDs (ones that are fiberoptic, and ones that electronically give the measurement) are cost-prohibitive in low-resource settings. Non-invasive techniques have been identified that can be used to measure ICP, such as pupillometry and ultrasound measurements of the optic nerves. These two techniques have been shown to identify patients with raised ICP. This makes them great candidates to be used in a low resource setting as a screening tool. Taking these tools a step further would allow these non-invasive techniques to replace EVDs to monitor responses to treatment for those with raised ICP. Our current study seeks to prove that these non-invasive techniques can be used as a treatment monitoring tool and not solely as screening tools.
PIs: Michael Haglund, MD, PhD and Carmen Graffagnino, MD