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Updated: Feb 25, 2026
Intracranial Pressure Monitoring In Nontraumatic Intraventricular Hemorrhage Rodent Model
Published on: February 8, 2022
Noninvasive intracranial pressure monitoring for HIV-associated cryptococcal meningitis
V R Bollela1, G Frigieri2, F C Vilar1
1Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Insights
High intracranial pressure (ICP) complicates HIV-associated cryptococcal meningitis (HIV-CM). This study explores non-invasive ICP monitoring (ICP-NI) to improve management of critically ill patients with HIV-CM.
Area of Science:
- Neuroscience
- Infectious Diseases
- Critical Care Medicine
Background:
- HIV-associated cryptococcal meningitis (HIV-CM) has high mortality and neurological sequelae, often due to intracranial pressure (ICP) complications.
- Elevated cerebrospinal fluid (CSF) opening pressure affects over 50% of HIV-CM patients, necessitating interventions like CSF drainage.
- Current management of ICP hypertension in HIV-CM relies on clinical signs and invasive measures, leading to uncertainty.
Observation:
- Critically ill patients with HIV-CM frequently experience elevated ICP.
- Clinical assessment for ICP hypertension includes headache, nausea, vomiting, low Glasgow Coma Scale scores, and papilledema.
- Inadequate management of elevated CSF pressure can lead to significant neurological decline.
Findings:
- The study evaluates the utility of non-invasive intracranial pressure (ICP-NI) monitoring in critically ill HIV-CM patients.
- Assesses the role of ICP-NI in guiding clinical decisions for managing intracranial hypertension.
- Compares ICP-NI data with traditional clinical indicators of elevated ICP.
Implications:
- Non-invasive ICP monitoring may offer a safer and more accurate method for managing intracranial hypertension in HIV-CM.
- Improved ICP management could reduce mortality and adverse neurologic outcomes in HIV-CM.
- Findings may inform clinical guidelines for monitoring and treating ICP in resource-limited settings.
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.
