Ultrasound measurements versus invasive intracranial pressure measurement method in patients with brain injury: a retrospective study

Abstract

Background The invasive method for intracranial pressure measurement is ‘gold standard’ but not always feasible because the intraventricular catheter/ intraparenchymal micro transducer used in the measurement of intracranial pressure measurement may cause complications. Imaging modalities with clinical examination protocol have a lack of specificity and accuracy. The objective of the study was to compare the accuracy of diagnostic parameters of ultrasound measurements in patients with brain injury underwent invasive intracranial pressure measurement method. Methods Data of invasive intracranial pressure measurement method and ultrasound measurements of 185 patients with brain injury who required admission diagnosis were included in the analysis. Pearson correlation was tested for diagnostic parameters. Logistical regression analysis was performed for diagnostic parameters of death patients to evaluate independent parameter of mortality. Results Straight sinus flow velocities, middle cerebral artery flow velocities, and optic nerve sheath diameter were correlated with intracranial pressure ( p < 0.0001 for all). Arterial blood pressure ( p = 0.127) and middle cerebral artery pulsatility index ( p = 0.06) were not correlated with intracranial pressure. A total of 47 patients died during the study period. Intracranial pressure ( p = 0.015) and optic nerve sheath diameter ( p = 0.035) were found to be independent predictor of mortality. Conclusions Ultrasound measurement especially optic nerve sheath diameter can be successfully used instead of invasive intracranial pressure measurement method in patients with brain injury. Level of evidence III.

Impact of Intracranial Hypertension on Outcome of Severe Traumatic Brain Injury Pediatric Patients: A 15-Year Single Center Experience

“…Researchers have repeatedly reported the difficulties of performing prospective randomized clinical trials to evaluate the effect of ICP monitoring on outcomes of PICU patients, since there are ethical concerns of not monitoring ICP in the control group of patients. Major pediatric TBI guidelines are currently based on ICP measurements, while ICP monitoring has been established as a standard of care for sTBI [ 30 , 37 , 38 ]. Moreover, studies show that the implementation of evidence-based TBI treatment algorithms are associated with improved outcomes, highlighting the importance of future precise ICP-based guidelines in order to reduce practice disparity among TBI patients [ 39 ].…”

A meta-analysis and systematic review of intracranial pressure monitoring on severe craniocerebral injury

“…Jahns et al [2019] (16) found that patients with severe head injury receiving intracranial pressure monitoring and intensive care can reduce the fatality rate by more than 12%. In addition, the implementation of intracranial pressure monitoring can early detect changes in intracranial disease, determines cerebral perfusion pressure and cerebral blood flow, guides clinical treatment, and determines the prognosis of patients early and treat them early (17).…”

Ultrasonic Assessment of Optic Nerve Sheath Diameter in Patients at Risk of Sepsis-Associated Brain Dysfunction: A Preliminary Report

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