Abstract
Intracranial pressure (ICP) monitoring is important in managing neurosurgical, neurological, and ophthalmological patients with open-angle glaucoma. Non-invasive two-depth transcranial Doppler (TCD) technique is used in a novel method for ICP snapshot measurement that has been previously investigated prospectively, and the results showed clinically acceptable accuracy and precision. The aim of this study was to investigate possibility of using the ophthalmic artery (OA) as a pressure sensor for continuous ICP monitoring. First, numerical modeling was done to investigate the possibility, and then a pilot clinical study was conducted to compare two-depth TCD-based non-invasive ICP monitoring data with readings from an invasive Codman ICP microsensor from patients with severe traumatic brain injury. The numerical modeling showed that the systematic error of non-invasive ICP monitoring was < 1.0 mmHg after eliminating the intraorbital and blood pressure gradient. In a clinical study, a total of 1928 paired data points were collected, and the extreme data points of measured differences between invasive and non-invasive ICP were − 3.94 and 4.68 mmHg (95% CI − 2.55 to 2.72). The total mean and SD were 0.086 ± 1.34 mmHg, and the correlation coefficient was 0.94. The results show that the OA can be used as a linear natural pressure sensor and that it could potentially be possible to monitor the ICP for up to 1 h without recalibration.
Highlights
Intracranial pressure (ICP) monitoring is important in managing neurosurgical, neurological, and ophthalmological patients with open-angle glaucoma
Prospective and retrospective studies using lumbar puncture technique have revealed that glaucoma patients have lower ICP than age-matched healthy subjects[6,7,8,9], which suggests that ICP might be one of the influential factors in the pathophysiology of g laucoma[10]
Ragauskas et al reported a novel non-invasive snapshot method for the measurement of ICP based on the two-depth transcranial Doppler (TCD) technique, which can be used for simultaneously measuring blood flow
Summary
Intracranial pressure (ICP) monitoring is important in managing neurosurgical, neurological, and ophthalmological patients with open-angle glaucoma. Non-invasive two-depth transcranial Doppler (TCD) technique is used in a novel method for ICP snapshot measurement that has been previously investigated prospectively, and the results showed clinically acceptable accuracy and precision. Numerical modeling was done to investigate the possibility, and a pilot clinical study was conducted to compare two-depth TCD-based non-invasive ICP monitoring data with readings from an invasive Codman ICP microsensor from patients with severe traumatic brain injury. Ragauskas et al reported a novel non-invasive snapshot method for the measurement of ICP based on the two-depth transcranial Doppler (TCD) technique, which can be used for simultaneously measuring blood flow. The innovative two-depth TCD-based non-invasive ICP snapshot measurement technique has clinically acceptable accuracy, precision, and diagnostic r eliability[14,15,16]
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