Noninvasive intracranial pressure monitoring for HIV-associated cryptococcal meningitis
AUTOR(ES)
Bollela, V.R., Frigieri, G., Vilar, F.C., Spavieri Jr, D.L., Tallarico, F.J., Tallarico, G.M., Andrade, R.A.P., de Haes, T.M., Takayanagui, O.M., Catai, A.M., Mascarenhas, S.
FONTE
Braz J Med Biol Res
DATA DE PUBLICAÇÃO
07/08/2017
RESUMO
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.
