Abstract
BackgroundThe 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.MethodsData 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.ResultsStraight 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.ConclusionsUltrasound measurement especially optic nerve sheath diameter can be successfully used instead of invasive intracranial pressure measurement method in patients with brain injury.Level of evidenceIII.
Highlights
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
Intracranial hypertension is a deadly complication and one of the contributing factor in secondary brain injury because its intensity and duration are associated with a fatal outcome [1]
The invasive intracranial pressure measurement method is only used in severe traumatic brain injury when systemic complications are absent [6]
Summary
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. Imaging modalities with clinical examination protocol have a lack of specificity [2] and insufficient accuracy [3]. The invasive intracranial pressure measurement method is only used in severe traumatic brain injury when systemic complications are absent [6]. A prospective, observational study on patients with traumatic brain injuries recommended ocular sonography as a screening test for raised intracranial pressure measurements [7]. Two-depth transcranial Doppler has better diagnostic reliability for intracranial pressure measurements [9, 10]
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