Smart device-based methods to detect raised ICP
Research type
Research Study
Full title
Smart-device based methods to non-invasively detected raised intracranial pressure
IRAS ID
247501
Contact name
Peter Hutchinson
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundation Trust and University of Cambridge
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Intracranial hypertension (ICH) is associated with a less favourable outcome in a number of neurosurgical and neurological conditions, including traumatic brain injury, malignancy and hydrocephalus. As such, the measurement of intracranial pressure (ICP) is central to the management of these conditions. The current gold standard for measuring ICP is an intraparenchymal or ventricular probe (Brain Trauma Foundation guidelines). However, the placement of an ICP probe is an expensive and invasive procedure with risks such as bleeding and infection. Moreover, its placement requires a sterile environment (such as critical care or the operating theatre) and a clinician with experience in placement of the device. As such, its use is restricted to very specific settings. A portable, inexpensive, user-friendly device to diagnose ICH would be of great value to patients and their clinicians.
Optic nerve sheath diameter (ONSD) has been demonstrated to be able to predict raised intracranial pressure with reasonable accuracy. ONSD can be measured via CT/MRI scan or using an ultrasound probe. The measurement of ONSD using ultrasound is a relatively inexpensive, simple examination to perform which provides a point of care estimate of ICP. Moreover, it has good temporal resolution which is of particular importance in the assessment of conditions where ICP is potentially very labile. However, ultrasound machines equipped with the appropriate linear array transducer to acquire images of the optic nerve sheath are not currently available in every setting where this diagnostic test would have utility.We propose the use of a smartphone-based ultrasound probe to measure ONSD and predict ICP. In addition, we plan to assess the feasibility of using a smart device-based retinal camera to reliably diagnose papilloedema in neurosurgical patients. Together, these technologies could potentially create a suite of smart device-based diagnostic modalities that could reliably diagnose ICH.
REC name
Wales REC 3
REC reference
18/WA/0303
Date of REC Opinion
19 Dec 2018
REC opinion
Further Information Favourable Opinion