The Use of Lower Body Negative Pressure to reduce Intracranial Pressure – a preliminary study

Prof. Mark Wilson

Intracranial Pressure (ICP – the pressure inside one’s head) is a fundamental measure in many neurological conditions. Brain swelling from oedema, bruising, or blood clots / tumours that enlarge and press on the brain, all increase intracranial pressure. As ICP rises, brain perfusion with blood falls. High ICPs are associated with increased mortality in trauma.

Many of our current treatments aim to lower ICP. These include nursing a patient head up, pharmacologically sedating and paralysing patients, giving diuretics and even surgical procedures such as cerebrospinal fluid drainage and removing of parts of the skull.

Our group has utilised lower body negative pressure (LBNP) in a small pilot study to investigate if this mechanical tool can also be utilised to lower ICP. There are potentially many advantages to such a technique, not least the immediacy of its effect and ability to stop it if required.

The proposed study will take our initial pilot further to investigate the technique in subjects, initially seeing the effects of LBNP on the venous system in the brain (which indicates the effect on ICP without the need for invasive monitoring) and secondly to assess the effect on ICP in patients with concurrent ICP monitoring.