Noninvasive intracranial pressure monitoring for HIV-associated cryptococcal meningitis

Braz J Med Biol Res. 2017 Aug 7;50(9):e6392. doi: 10.1590/1414-431X20176392.


Mortality and adverse neurologic sequelae from HIV-associated cryptococcal meningitis (HIV-CM) remains high due to raised intracranial pressure (ICP) complications. Cerebrospinal fluid (CSF) high opening pressure occurs in more than 50% of HIV-CM patients. Repeated lumbar puncture with CSF drainage and external lumbar drainage might be required in the management of these patients. Usually, there is a high grade of uncertainty and the basis for clinical decisions regarding ICP hypertension tends to be from clinical findings (headache, nausea and vomiting), a low Glasgow coma scale score, and/or fundoscopic papilledema. Significant neurological decline can occur if elevated CSF pressures are inadequately managed. Various treatment strategies to address intracranial hypertension in this setting have been described, including: medical management, serial lumbar punctures, external lumbar and ventricular drain placement, and either ventricular or lumbar shunting. This study aims to evaluate the role of a non-invasive intracranial pressure (ICP-NI) monitoring in a critically ill HIV-CM patient.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections / complications*
  • Adult
  • Humans
  • Intracranial Hypertension / diagnosis*
  • Intracranial Hypertension / etiology
  • Male
  • Meningitis, Cryptococcal / complications*
  • Neurophysiological Monitoring / instrumentation*
  • Neurophysiological Monitoring / methods
  • Reproducibility of Results