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Braz J Med Biol Res. 2017 Aug 7;50(9):e6392. doi: 10.1590/1414-431X20176392.

Noninvasive intracranial pressure monitoring for HIV-associated cryptococcal meningitis.

Author information

1
Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
2
Braincare Health Technology, São Carlos, SP, Brasil.
3
Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
4
Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil.

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.

PMID:
28793057
PMCID:
PMC5572848
DOI:
10.1590/1414-431X20176392
[Indexed for MEDLINE]
Free PMC Article

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