Non Invasive Measurements of Intracranial Pressure in Patients With Malignant Glioma
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Glioma
- Sponsor
- Centre Jean Perrin
- Enrollment
- 40
- Locations
- 1
- Primary Endpoint
- Presence of an ICP variation or increase when physician has diagnosed a clinical or morphological aggravation of the tumor with standard diagnose methods (composite outcome measure)
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
In patients at risk of increased intracranial pressure (ICP), ICP measurements require invasive transducers, usually with insertion of a catheter into the cranium, or through a spinal tap. These invasive modalities involve risks and pain and they can be done only in specialized care units, with a high associated cost.
A novel method for detecting changes in ICP has developed recently. The auditory hair cells emit sounds and electric signals in response to sound, which can be easily detected and measured non-invasively with the help of a microphone probe placed in the external ear canal or regular electrodes. Indeed, the cochlear aqueduct connects the cerebrospinal fluid (CSF) spaces to the inner ear in such a way that ICP and inner-ear fluid pressure equalize within seconds.
A symptom of intracranial pressure (ICP) was observed in glioma patient due to a combination of causes: the inflammatory reaction around the tumor, the mass effect of the tumor, secondary vascular changes, a change in the flow of CSF.
The evaluation of intracranial hypertension by increased ICP (invasive) is not used in the monitoring of intracranial tumors. It is then detected by using routine clinical signs, in combination with a standard imaging method (MRI), but still subjective.
The measurement of noninvasive ICP could allow earlier detection of relapse, and evaluate whether the increase in ICP precedes tumor clinical worsening and / or imaging.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients with malignant glioma who underwent a biopsy or a partial surgery of this tumor and a radiotherapy and/or chemotherapy treatment.
- •Valid tympanometry test at least for one ear
- •Between 18 and 65 years of age
- •Cochlear response useful at least for an ear which has validate the tympanometry test
- •Written informed consent reviewed and signed by patient
- •Affiliation to a social security scheme
Exclusion Criteria
- •Patients who underwent a complete resection of their malignant glioma
- •Invalid tympanometry test for the both ears
- •Collect of cochlear responses impossible for the ear or both ear which validate the tympanometry test
- •Patient refusal after enlightened information
Outcomes
Primary Outcomes
Presence of an ICP variation or increase when physician has diagnosed a clinical or morphological aggravation of the tumor with standard diagnose methods (composite outcome measure)
Time Frame: from baseline to 1 year
Presence of an ICP variation or increase when physician has diagnosed a clinical or morphological aggravation of the tumor with standard diagnose methods (composite outcome measure ) : clinical signs, MRI and response assessment in neuro-oncology criteria (RANO) .
Secondary Outcomes
- Evaluate efficiency of the measurement device of ICP changes on repetitive measurement as evaluated by composite outcome measure : clinical signs, MRI and RANO criteria(from baseline to 1 year)
- evolution of ICP before and after the progression of the relapse tumor according to imaging (RMI)(from baseline to 1 year)
- evolution of ICP before and after the progression of the relapse tumor according to clinical sign(from baseline to 1 year)