This disclosure relates generally to neurological monitoring and specifically to accurate placement of neurological electrodes.
Neurological monitoring is done as a part of neurological research and during surgical operations. Neurological monitoring involves attaching electrodes to the patient's head and connecting the electrodes electrically to amplifiers for display of the electrical activity of the patient's brain.
The electrodes are positioned in specific parts of the head for several reasons and primarily to provide output that can be compared from one monitoring event to the next. Technicians are trained to know these locations and there are international standards for electrode placement (i.e. the “10-20” system) that are generally followed by those trained in neurological monitoring.
To facilitate correct placement of the electrodes, a template may be placed on the head of the patient. A template serves as a map for locating the standard positions for electrodes. Harnesses are templates that have the electrodes already in place. Templates and harnesses are made of straps that are sewn together in a web-like construction. The positions of the electrodes may be indicated at the intersection of the straps and also between intersections.
Of course, the template or harness, are made with care and precision, and be put on the patient's head correctly and oriented properly for it to effectively guide the positioning of the electrodes, although absolute precision is not required and the heads of humans vary somewhat in size and shape.
A better template would be of advantage particularly in circumstances where technicians are not available to position the electrodes.
This disclosure teaches a unitary template, that is, a template that is made in one piece with contiguous, integral straps. The ends of which are joined together, for example with hook and loop fasteners, “key and slot” fastening, or adhesives, to form the completed, three-dimensional template. Moreover, the material of which it is made may be inexpensive and can accommodate a reasonable degree of flexibility in fitting patients whose heads are of different sizes and shapes or be custom-made.
An aspect of the disclosure is a device that is a template for locating electrodes on a patient's head, the template having rows and columns integrally connected to each other, that is, the rows and columns are made of one piece of material. In one example of the present template, the template has one row and five columns. The row crosses the five columns with one of the five columns being the central column and with two columns on its first side and two columns on its second side, opposite the first side of the central column. The central column has a first junction on a first end and a second junction on an opposing, second end. The first ends of the two columns on the first side of the central column and the first ends of the two columns on the second side of the central column are attachable to the first junction of the central column. Similarly, the second ends of the two columns on the first side of the central column and the second ends of the two columns on the second side of the central column are attachable to the second junction of the central column. When rows and columns are connected, the unitary template forms a template conforming to the head of a patient.
In another example, the template has one row and three columns. In other examples, there may be more than one row integral with several columns.
The row and the five columns are marked to indicate the locations of electrodes. For example, the central column may be marked with five locations for electrodes, the first column may be marked with four locations for electrodes, the fourth column may be marked with four locations for electrodes, the second column may be marked with three locations for electrodes, the third column may be marked with three locations for electrodes, and the row may be marked for five locations for electrodes including three locations of the five that coincide with locations on the columns.
Each location may also carry a number or a code to identify the electrode that is to be placed at each location. The row carries a nasion marker or an inion marker or both, one on each of its opposing ends.
A feature of the disclosure is that the rows and columns of the template may be made with a material that has expandable sections, sections that can be expanded by pulling on its ends and which expandable sections may be formed by features such as plural cuts or plural folds that allow expansion, and combinations thereof.
Another feature of the present template is that the template made be custom made for a patient. A few measurements are made of the patient's head and used to program a device that produces a flat template which can be cut, laser cut, perforated or three-dimensionally printed so as to be a flat, unitary version of the present template, perhaps printed with the positions marked.
A feature of the disclosure is that the rows and the columns are made of cords and that the locations on the cords and identities of the electrodes for those locations may be marked by tags.
A feature of the disclosure is that the device may include a bolo, which is an adhesive bridge piece or interlocking loops to connect the first end of the central column with the opposing second end of the central column.
These and other features and their advantages will be apparent to those skilled in the art of neurological monitoring from a careful reading of the detailed descriptions of embodiments accompanied by the drawings.
In the figures,
The disclosed device is a unitary template, which is a template made of a piece of material in contrast to a prior art templates such as that shown in
Turning now to
First column 74 and fourth column 86 are longer than second column 78 and third column 82. First column 74 and fourth column 86 have four electrode locations 90 spaced at intervals, with two electrode locations 90 on either side of row 54. Both second column 78 and third column 82 have three electrode locations 90 spaced at intervals thereon, including one electrode location 90 on second column 78 and third column 82 where they cross row 54. Central column 62 has five electrode locations 90 spaced at intervals with one of those five electrode locations 90 on row 54. Thus, there are five electrode locations 90 on row 54 of which one location of the five electrode locations 90 coincides with second column 78, another electrode location 90 coincides with central column 58, and a third electrode location coincides with third column 82. Two more electrode locations are on row 54, one between central column 62 and second column 78 and the other between central column 62 and third column 83. Altogether, there are 21 electrode locations 90 on template 50 as shown in
Row 54 has a first end 94 and a second end 98. First end 94 is marked with a letter I to indicate the Inion; second end 98 is marked with a letter N to indicate Nasion. The portion of first end 94 with the letter I is to be used to position template 50 on the patient so the location of the letter I corresponds to the inion or bump on the back of the patient's head. The portion of second end 98 if row 54 with the letter N is to be used to position template 50 on the patient so that the location of the letter N is on the bridge of the patient's nose.
Central column 62 has two junctions integrally connected to the ends of first column 74, second column 78, a third column 82 and fourth column 86. Specifically, on a first end 102 of central column 62, a junction 106 has first connection 110, a second connection 114, a third connection 118, and a fourth connection 122. On a second end 126 of central column 62, there is a junction 130 that has a fifth connection 134, a sixth connection 138, a seventh connection 142, and an eighth connection 146. The second ends 154, 162, 168, and 172 of first column 74, second column 78, third column 82, and fourth column 86, respectively, are attached to fifth connection 134, sixth connection 138, seventh connection 142, and eighth connection 146 of second junction 126.
Specifically, first column 74 has a first end 150 and an opposing second end 154 and second column 78 has a first end 158 and an opposing second end 162. Third column 82 has a first end 166 and an opposing second end 170; fourth column has a first end 174 and an opposing second end 178. First end 150 of first column 74, first end 158 of second column 78, first end 166 of third column 82 and first end 174 of fourth column 86 are attached to first connection 110, second connection 114, third connection 118, and fourth connection 122, respectively, of junction 106. Second end 154 of first column 74, second end 162 of second column 78, second end 168 of third column 82 and second end 172 of fourth column are attached to second junction 126
The mode of attachment is not critical. For example, adhesives on first junction 106 and on second junction 126 (or on the ends of columns 74, 78, 82, 86) with release paper covers may be used. An alternative attachment mode is shown in
The result of connecting column ends to junctions as described above is shown in
Similar templates may be made of different numbers of row and columns. For example, a template can be made with at least one row and at least two columns. Templates may be made with two rows and three columns, for example, for a ten-electrode template. The numbers of rows and columns may be chosen once the basic electrode pattern is established, and which may be custom pattern for electrodes or a standard 10-20 pattern.
Template 50 may be made by removing material from a large solid piece for stacking, storage and sihpping, and then by attaching the ends to conform the template to the shape of a head at the time of use. The template may be alternatively be formed by three-dimensional printing either as a two dimensional pattern with thickness or a three-dimensional pattern with thickness.
Template 50 may be made from a flat sheet to fit the head of a specific patient at the time of need. A child may require a template 50 that is smaller, for example. Simple measurements, as shown in
Template 50 can be made of prior art materials that have resilience:
woven materials with resilience. In the alternative, unitary templates 50 may be made with a material that is lower cost, strong and resilient, such as synthetic, non-woven, laminated, fibrous material. An example of such material is commonly used for house wrap, and sold by E. I. DuPont de Nemours & Company, Inc., under the trademark TYVEK.
As an alternative to material that has resilience, template 50 may be made with selectively expandable portions. In row 54 of template 50, for example, which crosses the “crown” of template 50 when assembled and worn a selectively expandable portion may be useful to accommodate the shape of the crown.
First end 102 and second end 126 of central column 62 need to be joined when template 50 or template 200 is worn by a patient.
Many modifications and substitutions may be made in the foregoing detailed description without departing from the spirit and scope of the disclosure which is defined in the appended claims.
Number | Date | Country | |
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62474222 | Mar 2017 | US |