Systems and methods for determining intracranial pressure non-invasively and acoustic transducer assemblies for use in such systems

a technology of intracranial pressure and acoustic transducer, which is applied in the field of systems and methods for determining intracranial pressure non-invasively and acoustic transducer assemblies for use in such systems, can solve the problems of brain mechanical compression, herniation, and elevated intracranial pressure, and achieve accurate assessment and monitoring.

Inactive Publication Date: 2009-06-11
PHYSIOSONICS +1
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

Under some conditions, elevated intracranial pressures may cause the brain to be mechanically compressed, and to herniate.
The most common cause of elevated intracranial pressure is head trauma.
Changes in intracranial pressure, particularly elevated intracranial pressure, are very serious and may be life threatening.
All of these methods and systems are invasive.
The subarachnoid bolt / screw technique requires minimal penetration of the brain, it has a relatively low risk of infection, and it provides a direct pressure measurement, but it does require penetration of an intact skull and it poorly drains CSF.
The ventriculostomy catheter technique provides CSF drainage and sampling and it provides a direct measurement of intracranial pressure, but the risks of infection, intracerebral bleeding and edema along the cannula track are significant, and it requires transducer repositioning with head movement.
All of these conventional techniques require invasive procedures and none is well suited to long term monitoring of intracranial pressure on a regular basis.
Moreover, these procedures can only be performed in hospitals staffed by qualified neurosurgeons.
The hypothesis that ICP is altered in microgravity environments is difficult to test, however, as a result of the invasive nature of conventional ICP measurement techniques.
The model of Schmidt et al. was able to realistically simulate ICP curves in a subset of patients, although not to a clinically useful degree.
While this mode of measurement is simple and inexpensive to perform, it does not provide the most accurate measure of ABP, and it is susceptible to artifacts resulting from the condition of arterial wall, the size of the patient, the hemodynamic status of the patient, and autonomic tone of the vascular smooth muscle.
Additionally, repeated cuff measurements of ABP result in falsely elevated readings of ABP, due to vasoconstriction of the arterial wall.
While such catheters are very reliable and provide the most accurate measure of ABP, they require placement by trained medical personnel, usually physicians, and they require bulky, sophisticated, fragile, sterile instrumentation.
Additionally, there is a risk of permanent arterial injury causing ischemic events when these catheters are placed.
As a result, these invasive monitors are only used in hospital settings and for patients who are critically ill or are undergoing operative procedures.

Method used

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  • Systems and methods for determining intracranial pressure non-invasively and acoustic transducer assemblies for use in such systems
  • Systems and methods for determining intracranial pressure non-invasively and acoustic transducer assemblies for use in such systems
  • Systems and methods for determining intracranial pressure non-invasively and acoustic transducer assemblies for use in such systems

Examples

Experimental program
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Effect test

example 1

ICP Prediction Results Based on Empirical Studies Using TCD V_mca and Invasively Determined Continuous ABP Measurements as Variables

[0255]A prototype system for collecting data, deriving and applying a non-linear relationship between the variables of cranial blood vessel velocity and ABP was assembled using commercially available components. This prototype consisted of a notebook computer with a PCMCIA National Instruments (NI) 6024-E data acquisition (DAQ) card, a box containing the exposed backplane of the NI-DAQ card and a microphone input matching circuit, a specialized adapter designed to mate to the signal output port of a Spacelabs telemetry unit, and a Spencer Technologies TCD 100M Power M-Mode Digital Transcranial Doppler device and control pad with standard TCD ultrasound transducer and FDA-approved headband device for mechanical fixation to the head. The Spencer TCD 100M device was not modified in any way from its FDA-approved configuration. All electronic items were powe...

example 2

ICP Prediction Results Based on Empirical Studies and Training and Validation of an ANN

[0266]The prototype device described in Example 1 and the nICP determination methodology described in this specification was successfully tested on eighteen (18) patients at Harborview Medical Center in Seattle Wash., using blood pressure derived either directly from an arterial line or using arterial line-based ABP data simplified to mimic ABP data obtained from a blood-pressure cuff. A detailed description of the results for eight (8) of the eighteen patients was presented above in Example 1. Additional results are summarized below.

[0267]To determine the constants in the ICP prediction methodology, we acquired data from a set of patients (known as the ‘training set’) for whom we knew invasively measured ICP, as well as acoustic backscatter and ABP. For patients within the training set having a focal injury, their ICP was invasively measured from the same hemisphere as the injury focus, and the a...

example 3

[0275]Additional feasibility and efficacy testing of the methodology described above was performed using the experimental system described in Example 1. Acoustic backscatter, ABP and invasively measured ICP data was collected from a set of 25 patients (the ‘training set’). For training set patients having a focal injury, the ICP was invasively measured from the same hemisphere as the injury focus and acoustic backscatter was measured from this hemisphere as well. The acoustic backscatter data was collected from the MCA and MCA flow velocity values were derived from the acoustic backscatter using conventional Doppler techniques. An empirical algorithm was derived using this data and the neural network training protocol described above.

[0276]The derived algorithm was then tested in an iterative fashion to determine ICP for 21 patients using only acoustic backscatter and ABP data for the 21 validation patients for whom invasively measured ICP data had also been collected. The results o...

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Abstract

Systems and methods for determining ICP based on parameters that can be measured using non-invasive or minimally invasive techniques are provided. Systems for acquiring acoustic data from a desired target site in a subject's body using various types of acoustic source and detector elements are also provided, including single use acoustic source / detector combinations are also provided. Acoustic arrays for use with these systems may include multiple capacitive micro-machined ultrasound transducer (cMUT) elements, and may include a combination of different types of acoustic arrays. Methods of targeting localized sites within a broad target area based on acoustic data having various properties are also disclosed.

Description

REFERENCE TO PRIORITY APPLICATION[0001]This application is a divisional application of U.S. patent application Ser. No. 10 / 861,197, filed Jun. 3, 2004, which claims priority to U.S. Provisional Application No. 60 / 475,803 filed Jun. 3, 2003 and U.S. Provisional Application No. 60 / 508,836 filed Oct. 1, 2003. U.S. patent application Ser. No. 10 / 861,197 is also a continuation-in-part of U.S. patent application Ser. No. 09 / 995,897, filed Nov. 28, 2001, issued as U.S. Pat. No. 6,875,176 on Apr. 4, 2005 and which claims priority to U.S. Provisional Application No. 60 / 253,959, filed Nov. 28, 2000. These patent applications are incorporated herein by reference in their entireties.GOVERNMENT SUPPORT AND RIGHTS[0002]Subject matter disclosed in this application was supported by federally sponsored research and development funding. The U.S. Government may have certain rights in inventions disclosed in this application as provided for by the terms of Grant No. K25NS02234-02 awarded by the Nationa...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61B8/00A61B5/03A61B8/04A61B8/06A61B8/08
CPCA61B5/0048A61B8/4236A61B5/415A61B5/418A61B5/4824A61B8/00A61B8/04A61B8/065A61B8/08A61B8/4472A61B8/485A61B8/488A61B5/7267A61B8/0808A61B5/031A61B8/4444A61B8/4483A61B5/4064A61B5/0051G16H50/70
Inventor MOURAD, PIERRE D.MOHR, BRANDTKLIOT, MICHELFREDERICKSON, ROBERT C.A.THOMPSON, R. LEESEAWALL, JASON L.
Owner PHYSIOSONICS
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