Near infrared spectrophotometry: potential role during increased intracranial pressure

Two experiments were conducted to assess the feasibility of near infrared spectrophotometry (niroscopy) to directly monitor the effects of increased intracranial pressure on brain metabolism. Intracranial pressure (ICP) was increased in cats by subarachnoid infusion of a "mock" CSF solution. Cytochrome a,a3 redox state, oxyhemoglobin, deoxyhemoglobin and cerebral blood flow were non-invasively and continuously monitored by niroscopy. The results of both experiments indicated that untreated increases in ICP correlated with a reduction in cytochrome a,a3 redox state (p less than 0.01), a decrease in the quantity of oxyhemoglobin and cerebral blood flow (p less than 0.01), and an increase in deoxyhemoglobin. This study suggests that niroscopy has the potential for providing noninvasively and continuously data assessing brain metabolic activity. The excellent correlations obtained with simultaneous direct measurements of intracranial pressure make this an attractive method for eventual application to humans at risk for increased intracranial pressure. The value of niroscopy is even more evident in Exp. II where it can be seen that knowledge only of ICP would give the physician a false sense of security, whereas direct, non-invasive, continuous assessment of brain perfusion and oxygenation may well prove to be more appropriate parameters to monitor.