Noninvasive intracranial pressure monitoring for HIV-associated cryptococcal meningitis

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V.R. Bollela ; G. Frigieri ; F.C. Vilar ; D.L. Spavieri Jr ; F.J. Tallarico ; G.M. Tallarico ; R.A.P. Andrade ; T.M. de Haes ; O.M. Takayanagui ; A.M. Catai ; S. Mascarenhas

• Document type: Journal article
• Source: Brazilian Journal of Medical and Biological Research; v. 50, n. 9 2017-08-07.

Abstract

Mortality and adverse neurologic sequelae from HIV-associated cryptococcal meningitis (HIV-CM) remains high due to raised intracranial pressure (ICP) complications. Cerebrospinal fluid (CSF) high opening pressure occurs in more than 50% of HIV-CM patients. Repeated lumbar puncture with CSF drainage and external lumbar drainage might be required in the management of these patients. Usually, there is a high grade of uncertainty and the basis for clinical decisions regarding ICP hypertension tends to be from clinical findings (headache, nausea and vomiting), a low Glasgow coma scale score, and/or fundoscopic papilledema. Significant neurological decline can occur if elevated CSF pressures are inadequately managed. Various treatment strategies to address intracranial hypertension in this setting have been described, including: medical management, serial lumbar punctures, external lumbar and ventricular drain placement, and either ventricular or lumbar shunting. This study aims to evaluate the role of a non-invasive intracranial pressure (ICP-NI) monitoring in a critically ill HIV-CM patient. (AU)

• FAPESP's process: 15/50361-5 - Noninvasive intracranial pressure monitoring for resource-limited regions
• Grantee: Sergio Mascarenhas Oliveira
• Support Opportunities: Regular Research Grants