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.

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 Optic Nerve Sheath Diameter in retrobulbar ultrasound as a surrogate measure for intracranial pressure before and after non-invasive strategies.

2019 ◽  
Author(s):  
aldo saad diab ◽  
Benailim Martínez ◽  
Albana Gámez ◽  
Yvan Bucott
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Trendelenburg Position ◽  
Non Invasive ◽  
Nerve Sheath ◽  
Before And After ◽  
Reverse Trendelenburg Position ◽  
Invasive Measurement

Abstract Background : Raised intracranial pressure is a complication that leads to adverse outcomes. In the critically ill, invasive measurement by an intraventricular catheter is the gold standard; its use in non-specialized centers is limited, besides neuroimaging by computed tomography or magnetic resonance imaging scans entail transfer of a critically ill patient out of the ICU. Dilatation of the optic nerve sheath has been shown to be a much earlier manifestation of ICP rise. The optic nerve sheath diameter (ONSD) is fairly easy to visualize by ultrasonography by insonation across the orbitMethods: 90 patients, divided into three groups. Group M received mannitol 20% 0.5gr kg -1 , Group H received NaCl 7.5% 1.5 ml kg -1 and Group P patients were positioned on reverse Trendelenburg position 30 degrees. ONSD was measured 3 mm behind the optic disc. The measurements T1 before and T2 after the strategies according to group 30min, T3 at 60min, and T4 at 90minResults: Similar trend between invasive monitoring and ONSD measurement was observed. Invasive measurement the intracranial pressure was 40.2 at T1, there was a sustained and significant decrease in the three groups at 30, 60 and 90 minutes. ONSD measured at baseline, average was 7.0mm in group M, 7.1 in group H and 6.7 in group P, and subsequently it was significantly reduced at 30, 60 (p=0.002) and 90 minutes (p=0.003).Conclusion: ONSD in retrobulbar ultrasound is a reliable method to detect intracranial pressure variations before and after non-invasive strategies to reduce it acutely Keywords: intracranial hypertension, intracranial pressure, optic nerve sheath diameter, osmotherapy, Reverse Trendelenburg position. Trial registration: Clinical Trials; NCT03634176 ; registered August 16, 2018; https://clinicaltrials.gov/ct2/show/NCT03634176 .

scholarly journals Optic nerve sheath diameter: A novel way to monitor the brain

2017 ◽  
Vol 04 (04) ◽  
pp. S13-S18 ◽  
Author(s):  
Seelora Sahu ◽  
Amlan Swain
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Pressure Management ◽  
Pressure Monitoring ◽  
Nerve Sheath ◽  
Brain Injured ◽  
Injured Patients ◽  
The Brain

AbstractMeasurement and monitoring of intracranial pressure is pivotal in management of brain injured patients. As a rapid and easily done bed side measurement, ultrasonography of the optic nerve sheath diameter presents itself as a possible replacement of the conventional invasive methods of intracranial pressure management. In this review we go through the evolution of optic nerve sheath diameter measurement as a novel marker of predicting raised intracranial pressure, the modalities by which it can be measured as well as its correlation with the invasive methods of intracranial pressure monitoring.

Modern concepts of non-invasive methods for measuring intracranial pressure

2021 ◽  
pp. 32-35
Author(s):  
S. V. Lobzin ◽  
L. G. Nikiforova
Keyword(s):  
Blood Pressure ◽  
Intracranial Pressure ◽  
Magnetic Resonance Tomography ◽  
Doppler Imaging ◽  
Imaging Evaluation ◽  
Non Invasive ◽  
Optic Nerve Diameter ◽  
Functional Features ◽  
Membrane Displacement ◽  
Invasive Measurement

The article presents the review of Russian and foreign literature, with the aim to summarize the results of the researches for the purpose of identification of the most perspective modern techniques of non‑invasive measurement of intracranial pressure. The methods of assessment of intracranial pressure based on morphological and functional features of intracranial organs are described: transcranial Doppler imaging, evaluation of tympanic membrane displacement, evaluation of blood pressure in retinal veins, evaluation of optic nerve diameter, CT imaging and magnetic resonance tomography. The attention is paid to merits and demerits of the presented methods, a possibility of their use in clinical practice.

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.

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