Transcranial Doppler, Optic Nerve Envelope Diameter and Quantitative Pupillometry Measurements

Study Overview
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Brief Summary
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Non-invasive neuromonitoring tools such as transcranial doppler, optic nerve envelope diameter measurement and quantitative pupillometry are routinely used in acute brain injured patients as part of multimodal neuromonitoring with the aim, among others, of detecting episodes of intracranial hypertension, each method allowing the study of one of the different pathophysiological mechanisms of its impact. However, at present there is no data in the literature on the value of these non-invasive neuromonitoring tools in the management of patients undergoing controlled intracranial surgery. The study aims to help the early detection of postoperative neurological deterioration.

Official Title
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Transcranial Doppler, Optic Nerve Envelope Diameter and Quantitative Pupillometry Measurements in Postoperative Resuscitation Neurosurgery

Conditions
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Neurological Complication

Intervention / Treatment
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* Other: Non-invasive neuromonitoring evaluation (transcranial doppler, optic nerve envelope diameter and quantitative pupillometry)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Regulated intracranial surgery: scheduled > 48 hours French-speaking patient No opposition from the patient or a relative when the patient is unable to consent Exclusion Criteria: Chronic subdural haematoma Isolated cerebral endovascular procedure Stereotactic biopsy Scheduled ventriculoperitoneal shunt or isolated ventriculocisternostomy Specific non-inclusion criteria for quantitative pupillometry: known pupillary abnormalities, glaucoma, cataract surgery and any ocular surgery.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Non-invasive neuromonitoring evaluation (transcranial doppler, optic nerve envelope diameter and quantitative pupillometry)|4 days Post-operation follow-up. Data will be gathered before the surgery and at regular times after the surgery until day 4|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evolution of non-invasive neuromonitoring measures (using transcranial doppler) | This emasure will be performed bilaterally at the level of the first part of the middle cerebral artery, the values collected will be: Systolic, mean and diastolic velocities; pulsatility index Estimation of intracranial pressure | From 1 hour before the surgery until Day 4 post-surgery | 
| Evolution of non-invasive neuromonitoring measures (optic nerve envelope diameter) | The diameter of the optic nerve envelope will be collected bilaterally using an ultrasound machine | From 1 hour before the surgery until Day 4 post-surgery | 
| Evolution of non-invasive neuromonitoring measures (quantitative pupillometry) | The values collected will be : - Size, quantification of the amplitude of variation to light, latency and speed of constriction of the pupil, presence or absence of anisocoria (defined by a difference >1mm in size between the two pupils) | From 1 hour before the surgery until Day 4 post-surgery |