Exploring Neurophysiology Through Monitoring the ICP Waveforms in Shunted Pregnant Patients with a Non-invasive Device - A Case Series
Savio Batista1, Leonardo Barros Oliveira2, Lucca Biolcati3, Raphael Bertani4
1Medical School, UFRJ, 2Medical School, University of Ponta Grossa (UPG), 3Medical School, UniEduk, 4Neurosurgery, University of São Paulo (USP)
Objective:
To investigate the utility of non-invasive monitoring of intracranial pressure waveforms (ICPw) in assessing changes in P2/P1 ratios among pregnant patients diagnosed with idiopathic intracranial hypertension (IIH) and hydrocephalus. The study aims to elucidate whether fluctuations in these ratios correlate with symptom severity during pregnancy and postpartum periods, thereby exploring the potential for this monitoring technique to serve as a diagnostic or prognostic tool for clinical management of these conditions.
Background:

Pregnancy can exacerbate the symptoms of idiopathic intracranial hypertension (IIH) and hydrocephalus due to increases in abdominal pressure. Non-invasive monitoring of intracranial pressure waveforms (ICPw) may provide insights into the neurophysiology of these conditions during pregnancy. The present case series describes two pregnant patients with IIH and hydrocephalus, who were monitored with a non-invasive device to assess changes in their P2/P1 ratios during pregnancy.

Design/Methods:

Two pregnant patients, one with IIH and one with hydrocephalus, were monitored with a non-invasive device to assess changes in their P2/P1 ratios during pregnancy. Symptoms were also evaluated.

Results:

Both patients showed an increase in their P2/P1 ratios during pregnancy, which correlated with progressively worsening symptoms. After delivery, both patients showed improvement in symptoms, as well as a normalization of their P2/P1 ratios.

Conclusions:

The present case series suggests that non-invasive monitoring of ICPw can provide insights into the neurophysiology of IIH and hydrocephalus during pregnancy. The increase in P2/P1 ratios during pregnancy may be indicative of worsening symptoms, and normalization of P2/P1 ratios after delivery may be coincide with symptom improvement. Further studies with larger sample sizes are needed to confirm these findings and translate them into clinical use, such the ability to have baseline parameters that may help with faster identification of shunt dysfunction, for example.

10.1212/WNL.0000000000205024