Andy Pye reports on the innovative use of ultrasonic scanning technology to achieve swift diagnoses of potentially fatal cases of elevated cranial pressure.
Elevated cranial pressure, the result of head traumas and brain tumours, is a potentially deadly complication. But although time is of the essence in detecting irregular cranial pressures, conventional diagnosis relies on time-consuming, invasive surgery at increased risk for patients. Now, a new generation of innovative scanning devices invented by Kaunas University of Technology in Lithuania by researcher Arminas Ragauskas solves the problem. .
Traumatic brain injury (TBI) and central nervous system tumours rank among the leading causes of death worldwide. In Europe, approximately 2.5 million people suffer a TBI each year, leading to 75,000 fatalities. As timely diagnosis is the key to optimal treatment outcomes.
Third-party analysts estimate the global brain monitoring market – including diagnostic devices for TBI, strokes and tumours at a value of EUR 6.6 billion, expected to grow to EUR 10.1 billion by 2020.
At first sight, the previous state-of-the-art in diagnosing elevated cranial pressures appears as a throwback to mediaeval times. As part of an invasive surgery, patients needed to be anaesthetised before doctors would drill a small-sized hole into the skull for a reading of intracranial pressures. Needless to say, the procedure itself poses potential for further complications. Drawing on the Doppler wavelength effect, Ragauskas and his team implemented ultrasound technology for a far more benign and gentle process.
Based on the sonic Doppler wavelength effect, the ultrasound scanners provide precise and instant pressure measurements via a probe applied to the patient’s eye. Besides elevated cranial pressures, the devices also detect stroke, glaucoma, and brain tumours.
For this achievement, the European Patent Office (EPO) has named Arminas Ragauskas as one of three finalists for the European Inventor Award 2016 in the SME category.
Thanks to the invention by Ragauskas and colleagues Gediminas Daubaris and Algis Dziugys from the Health Telematics Science Institute at Kaunas University of Technology, physicians and emergency hospital ward staff can now make informed decisions on the necessary course of treatment in a timely fashion – with potentially life-saving consequences.
Based on a quick and simple reading obtained from a sensor placed on the patient’s eye, the team’s devices compute the pressure differential between the inside and outside the skull.
“Our lab had already patented devices for various industrial applications”, says Ragauskas. “Because of our extremely sensitive ultrasonic devices, it was possible to think about medical applications.”
Similar to the principle of the inflated armband used to measure blood pressure, the ultrasound scanners measure brain pressure by applying a small amount of pressure to the eye to match the pressure of the artery just behind the eye, called the central retinal artery, which leads directly to the brain.
The technology then arrives at the measurement by comparing the applied external pressure to the autonomous intracranial pressure. For perspective, intracranial pressure (ICP) is usually in the range of 0 to 10 mmHg in healthy adults – roughly 10% of the pressure created by the human heart to circulate blood – while pressure greater than 20mmHg is considered abnormal. Precise and accurate measurements as achieved by Ragauskas’ scanners are important, because relatively small increments in pressure can have devastating effects on pressure-sensitive brain tissue: Levels above 40mmHg are almost always associated with neurological dysfunction (impairment of consciousness, problems breathing) while pressures above 60mmHg tend to be fatal.
Ragauskas has co-founded spin-off company Vittamed to market the concept. Marketed as the non-invasive intracranial pressure meter Vittamed 205 and non-invasive cerebral auto-regulation monitor Vittamed 505, the devices have now received the CE Mark seal of approval. Vittamed is currently pursuing product launches in Europe, Australia, and other countries, together with a submission to the US Food and Drug Administration (FDA).
As a side note, the devices are also being investigated by the US National Space Biomedical Research Institute to explore the effects of simulated spaceflight conditions on brain physiology.