Intrakranijinio spaudimo matavimas yra svarbus apsprendžiant gydymo taktiką daugelio ligų, tokių kaip galvos smegenų traumos, subarachnoidinės kraujosruvos, smegenų insultai bei kitos. Šiuo metu pasaulyje nėra tikslaus bei patvirtinto klinikinei praktikai neinvazinio IKS matavimo metodo. Šio mokslinio tyrimo tikslas nustatyti neinvazinių ultragarsinių intrakranijinio spaudimo matavimo metodų klinikinę vertę. Tyrime atlikti IKS matavimai Lietuvos mokslininkų sukurtu neinvaziniu IKS absoliutinės vertės matavimo įrenginiu, leidžiančiu matuoti IKS mmHg. Toks prietaisas yra unikalus, neturintis analogų, o šia techniškai nauja versija mokslinis tyrimas atliktas pirmą kartą. Tyrime taip pat nagrinėti intrakraniospinalinių pulsinių bangų pokyčiai priklausomai nuo intrakranijinio slėgio kitimo keičiant kūno padėtį. Neinvaziniai IKS absoliučios vertės matavimai, Goslingo pulsacijos indeksai ir kiti kraujotakos parametrai vidurinėse smegenų arterijose (VSA), regos nervo dangalų diametrai bei intimos medijos storis bendrosiose miego arterijose (BMA) buvo palyginti su juosmeninės punkcijos metu išmatuotu smegenų skysčio spaudimu, atspindinčiu IKS. Tyrime nustatėme, kad didžiausią klinikinę vertę bei diagnostinį tikslumą padidėjusiam IKS matuoti parodė neinvazinis IKS absoliutinės vertės matavimo metodas, o Goslingo pulsacijos indeksų VSA, regos nervų dangalų diametrų ir intimos-medijos storio BMA matavimų ultragarsiniai metodai tyrimui atrinktiems pacientams buvo nepakankamai tikslūs. / Measurement of intracranial pressure (ICP) is clinically important in several neurological conditions such as traumatic brain injury, subarachnoid hemorrhage, intracerebral hemorrhage, malignant stroke, idiopathic intracranial hypertension and other. No noninvasive ICP measurement method is clinically approved. In this clinical study we aimed to determine a clinical value of non-invasive ultrasound methods for ICP measurement. In this study we’ve used a unique noninvasive ICP measurement method allowing the measurement of ICP in absolute units- mmHg. This method was invented by Lithuanian scientists. Being technologically new device it was used for the first time in this study. In this study we have analyzed variation of intracraniospinal blood volumetric pulse waves associated with of body posture. Measurements of noninvasive ICP absolute value, Gosling pulsatility index in middle cerebral arteries, ocular nerve sheath diameters and intima-media thickness in common carotid arteries were compared with CSF pressure (reflecting ICP) measurements obtained during lumbar puncture. Noninvasive ICP absolute value measurement method showed best diagnostic accuracy and precision among all noninvasive methods compared in the study. Measurements of Gosling pulsatility index, ocular nerve sheath diameter and intima-media thickness didn’t show sufficient diagnostic accuracy for clinical practice among the patients included.

Newly created software is presented in magister degree thesis. The software was created for the innovative non–invasive cerebral blood flow autoregulation monitor which has no analogy in the global high tech market. It will be possible at first time to get diagnostic information about the cerebral blood flow autoregulation status of patient with severe brain injuries using such non–invasive monitoring technology in clinical practice. That will help with the individual treatment decision making. Clinical studies were conducted in neurosurgical intensive care units using created software. It has been shown that non–invasive and invasive cerebrovascular blood flow autoregulation monitoring technologies provide the same diagnostic information about the patient status. That conclusion is statistically significant and evidence based. Some R & D projects were performed using non–invasive cerebrovascular blood flow autoregulation monitor with implemented new software. The results of such projects were used in order to formulate the metrological – technological requirements for the final design and development of the innovative non–invasive blood flow autoregulation monitor. Such device is under creation in Telematics Scientific Laboratory which works together with Vittamed Technologijos Ltd and conducts 6.015 million Lt project (BPD04-ERPF-3.1.7-03-05/0020).