Bedside measurement of the third ventricle's diameter during episodes of arising intracranial pressure after head trauma

Abstract

Using transcranial real-time sonography, changes in the axial diameter of the third ventricle during manoeuvres, which increased intracranial pressure (ICP), were measured in 28 patients with moderate to severe head injury. The measurements were correlated with ICP measured by epidural pressure monitoring. We observed reductions in diameter ranging from 0.3 to 1.1 mm with rises in intracranial pressure of at least 5 mm in 22 patients of whom only one died. In 6 additional patients, no changes in diameter were seen, and 5 of the 6 died. We interpret that poor outcome as a measurable inability for the brain to expel cerebrospinal fluid into extracerebral compartments during increased ICP. Transcranial real-time sonography may provide additional information about intracranial cerebral fluid dynamics and compliance.

The use of noninvasive measurements of intracranial pressure in patients with traumatic brain injury: a narrative review

“…Mursch et al 19 described the decrease in the axial diameter of the third ventricle measured with TCD in patients with increased ICP in 1995. The study included 28 people admitted to neurointensive care, victims of TBI.…”

The Influence of Airway Pressure Changes on Intracranial Pressure (ICP) and the Blood Flow Velocity in the Middle Cerebral Artery (VMCA)

“…Some adapted methods like the estimation of the cerebrospinal fluid pulse pressure or the calculation of the high frequency centroid [8] have been derived meanwhile. The only bedside technique to avoid intraventricular fluid injections is the reported measurement of the third ventricular diameter using transcranial realtime sonography [9]).…”