Review of non-invasive intracranial pressure measurement techniques for ophthalmology applications

2019 ◽  
Vol 104 (7) ◽  
pp. 887-892
Author(s):  
David Andrew Price ◽  
Andrzej Grzybowski ◽  
Jennifer Eikenberry ◽  
Ingrida Januleviciene ◽  
Alice Chandra Verticchio Vercellin ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Measurement Techniques ◽  
Optic Nerve Sheath Diameter ◽  
Transcranial Ultrasound ◽  
Invasive Technique ◽  
Non Invasive ◽  
Nerve Sheath ◽  
Assessment And Monitoring ◽  
Invasive Techniques ◽  
The Relationship

Assessment and monitoring of intracranial pressure (ICP) are important in the management of traumatic brain injury and other cerebral pathologies. In the eye, ICP elevation and depression both correlate with optic neuropathies, the former because of papilledema and the latter related to glaucoma. While the relationship between ICP elevation and papilledema is well established, the relationship between low ICP and glaucoma is still poorly understood. So far, ICP monitoring is performed invasively, but this entails risks including infection, spurring the study of non-invasive alternatives. We review 11 methods of non-invasive estimation of ICP including correlation to optic nerve sheath diameter, intraocular pressure, ophthalmodynamometry and two-depth transcranial Doppler of the ophthalmic artery. While none of these methods can fully replace invasive techniques, certain measures show great potential for specific applications. Although only used in small studies to date, a MRI based method known as MR-ICP, appears to be the best non-invasive technique for estimating ICP, with two-depth transcranial ultrasound and ophthalmodynamometry showing potential as well.

scholarly journals Intracranial Pressure Monitoring: Invasive versus Non-Invasive Methods—A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
P. H. Raboel ◽  
J. Bartek ◽  
M. Andresen ◽  
B. M. Bellander ◽  
B. Romner
Keyword(s):  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Pressure Monitoring ◽  
Advantages And Disadvantages ◽  
Non Invasive ◽  
Nerve Sheath ◽  
A Minor ◽  
Invasive Techniques ◽  
Membrane Displacement ◽  
Invasive Measurement

Monitoring of intracranial pressure (ICP) has been used for decades in the fields of neurosurgery and neurology. There are multiple techniques: invasive as well as noninvasive. This paper aims to provide an overview of the advantages and disadvantages of the most common and well-known methods as well as assess whether noninvasive techniques (transcranial Doppler, tympanic membrane displacement, optic nerve sheath diameter, CT scan/MRI and fundoscopy) can be used as reliable alternatives to the invasive techniques (ventriculostomy and microtransducers). Ventriculostomy is considered the gold standard in terms of accurate measurement of pressure, although microtransducers generally are just as accurate. Both invasive techniques are associated with a minor risk of complications such as hemorrhage and infection. Furthermore, zero drift is a problem with selected microtransducers. The non-invasive techniques are without the invasive methods' risk of complication, but fail to measure ICP accurately enough to be used as routine alternatives to invasive measurement. We conclude that invasive measurement is currently the only option for accurate measurement of ICP.

scholarly journals Invasive and Ultrasound Based Monitoring of the Intracranial Pressure in an Experimental Model of Epidural Hematoma Progressing towards Brain Tamponade on Rabbits

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Konstantinos Kasapas ◽  
Angela Diamantopoulou ◽  
Nicolaos Pentilas ◽  
Apostolos Papalois ◽  
Emmanuel Douzinas ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Epidural Hematoma ◽  
Prediction Models ◽  
Autologous Blood ◽  
Optic Nerve Sheath Diameter ◽  
Exponential Relationship ◽  
Pupillary Light ◽  
Nerve Sheath ◽  
Pupil Constriction ◽  
The Relationship

Introduction. An experimental epidural hematoma model was used to study the relation of ultrasound indices, namely, transcranial color-coded-Doppler (TCCD) derived pulsatility index (PI), optic nerve sheath diameter (ONSD), and pupil constriction velocity (V) which was derived from a consensual sonographic pupillary light reflex (PLR) test with invasive intracranial pressure (ICP) measurements.Material and Methods. Twenty rabbits participated in the study. An intraparenchymal ICP catheter and a 5F Swan-Ganz catheter (SG) for the hematoma reproduction were used. We successively introduced 0.1 mL increments of autologous blood into the SG until the Cushing reaction occurred. Synchronous ICP and ultrasound measurements were performed accordingly.Results. A constant increase of PI and ONSD and a decrease ofVvalues were observed with increased ICP values. The relationship between the ultrasound variables and ICP was exponential; thus curved prediction equations of ICP were used. PI, ONSD, andVwere significantly correlated with ICP (r2=0.84±0.076,r2=0.62±0.119, andr2=0.78±0.09, resp. (allP<0.001)).Conclusion. Although statistically significant prediction models of ICP were derived from ultrasound indices, the exponential relationship between the parameters underpins that results should be interpreted with caution and in the current experimental context.

scholarly journals Optic Nerve Sheath Diameter Assessment Used As a Non-Invasive Tool To Dynamically Monitor Intracranial Pressure

2021 ◽  
Author(s):  
Guo-Biao Wu ◽  
Jun Tian ◽  
Xiao-Bing Liu ◽  
Zhi-Yong Wang ◽  
Jian-Ying Guo
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Supine Position ◽  
Dynamic Test ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Strongly Correlated ◽  
Non Invasive ◽  
Nerve Sheath ◽  
Good Agreement

Abstract Objective: This study aimed to detect whether optic nerve sheath diameter (ONSD) can be used to dynamically monitor intracranial pressure (ICP). Methods: Adult patients being monitored for invasive ICP on day one after hospital admission were included. For each patient, ONSD was first measured in the supine position, then at the 30° head-up position. The dynamic test was conducted in 16 patients. The ONSD was measured in the supine position once a day for three continuous days (day one to day three after admission).Results: The ONSD and ICP values obtained in the supine position on admission were strongly correlated (r of 0.799). When patients changed their position from supine to the 30° head-up position, the ICP and ONSD values decreased correspondingly. However, the change in ICP did not correlate well with the change in ONSD (r of 0.358). In the dynamic test, a good agreement between ICP and ONSD only existed in three (18.75%) patients. In addition, three patients had completely different profiles for ICP and ONSD.Conclusions: The results suggest that the changes in ONSD and ICP values were not correlated well after dynamic observation. Measurement of ONSD may not be a suitable tool to dynamically monitor ICP.

scholarly journals Intracranial pressure monitoring

2015 ◽  
Vol 02 (03) ◽  
pp. 193-203 ◽  
Author(s):  
Mary Abraham ◽  
Vasudha Singhal
Keyword(s):  
Intracranial Pressure ◽  
Cost Effective ◽  
Optic Nerve Sheath Diameter ◽  
Icp Monitoring ◽  
Non Invasive ◽  
Injured Brain ◽  
Neurological Patients ◽  
Catheter Tip ◽  
Long Term Prognosis ◽  
Invasive Techniques

AbstractBrain specific monitoring enables detection and prevention of secondary cerebral insults, especially in the injured brain, thereby preventing permanent neurological damage. Intracranial pressure (ICP) monitoring is widely used in various neurological, neurosurgical and even medical conditions, both intraoperatively and in critical care, to improve patient outcome. It is especially useful in patients with traumatic brain injury, as a robust predictor of cerebral perfusion, and can help to guide therapy and assess long-term prognosis. Intraventricular catheters remain the gold standard for ICP monitoring, as they are the most reliable, accurate and cost-effective, and allow therapeutic cerebrospinal fluid drainage. Newer fibreoptic catheter tip and microchip transducer techniques have revolutionised ICP monitoring, with their ease of insertion in patients with narrow ventricles, and reduced risk of infection and haemorrhage. Furthermore, non-invasive methods of ICP monitoring, such as transcranial Doppler, optic nerve sheath diameter, etc., have emerged as promising techniques for screening patients with raised ICP in settings where invasive techniques are either not feasible (patients with severe coagulopathy) or not available (setups without access to a neurosurgeon). Therefore, ICP monitoring, as a part of multi-modality neuromonitoring, is a useful tool in the armamentarium of the neuro-intensivist in decreasing morbidity and mortality of critically ill neurological patients.

Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: a systematic review and meta-analysis

2018 ◽  
Vol 44 (8) ◽  
pp. 1284-1294 ◽  
Author(s):  
Chiara Robba ◽  
Gregorio Santori ◽  
Marek Czosnyka ◽  
Francesco Corradi ◽  
Nicola Bragazzi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Meta Analysis ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Non Invasive ◽  
Nerve Sheath
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