Cerebrovascular Responses in a Patient with Lundberg B Waves Following Subarachnoid Haemorrhage Assessed with a Novel Non-Invasive Brain Pulse Monitor: A Case Report

作者：Elliot Teo, Sigrid Petautschnig, Jack Hellerstedt, Sally Grace, Jacqui Savage, Brendan Fafiani, Paul Smith, Ashu Jhamb, Timothy Haydon, Barry Dixon · 发表于：Medical Devices Evidence and Research · 年份：2024 · DOI：10.2147/mder.s452938 · 被引用次数：5 · 研究领域：Traumatic Brain Injury and Neurovascular Disturbances、Optical Imaging and Spectroscopy Techniques、Non-Invasive Vital Sign Monitoring

Abstract: Subarachnoid haemorrhage (SAH) can trigger a range of poorly understood cerebrovascular responses that may play a role in delayed cerebral ischemia. The brain pulse monitor is a novel non-invasive device that detects a brain photoplethysmography signal that provides information on intracranial pressure (ICP), compliance, blood flow and tissue oxygen saturation. We monitored the cerebrovascular responses in a patient with Lundberg B waves following a SAH. The patient presented with a Fischer grade 4 SAH that required urgent left posterior communicating artery aneurysm coiling and ventricular drain insertion. On hospital day 4 oscillations or spikes on the invasive ICP were noted, consistent with Lundberg B waves. Brain pulse monitoring demonstrated concurrent pulse waveform features consistent with reduced brain compliance and raised ICP over both brain hemispheres. Oxygen levels also demonstrated slow oscillations correlated with the ICP spikes. Brief infrequent episodes of reduced and absent brain pulses were also noted over the right hemisphere. Our findings suggest that the brain pulse monitor holds promise for early detection of delayed cerebral ischemia and could offer insights into the vascular mechanisms at play. Plain Language Summary: In this study, we examined a patient with a serious brain bleed, known as subarachnoid hemorrhage (SAH). Patients with SAH can suffer from vasospasm and consequent delayed cerebral ischemia (DCI), which can happen from 4 to 14...