Answer: Various noninvasive methods have been suggested to estimate higher ICP. These include
- Transcranial Doppler (TCD)
- Tissue resonance analysis (TRA)
- Ocular sonography
- Intraocular pressure
- Tympanic membrane displacement
Ocular sonography provides a noninvasive estimate of high ICP by the measurement of optic nerve sheath diameter. Diameters of 5 to 6 mm is a reliable discriminate cutoff between normal and elevated ICP. This can be very helpful in patients with intracranial hemorrhage or traumatic brain injury.
#neuro-surgery
#opthalmology
References:
1. Moretti R, Pizzi B, Cassini F, Vivaldi N. Reliability of optic nerve ultrasound for the evaluation of patients with spontaneous intracranial hemorrhage. Neurocrit Care 2009; 11:406.
2. Dubourg J, Javouhey E, Geeraerts T, et al. Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med 2011; 37:1059.
3. Geeraerts T, Merceron S, Benhamou D, et al. Non-invasive assessment of intracranial pressure using ocular sonography in neurocritical care patients. Intensive Care Med 2008; 34:2062.
4. Kimberly HH, Shah S, Marill K, Noble V. Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure. Acad Emerg Med 2008; 15:201.
#neuro-surgery
#opthalmology
References:
1. Moretti R, Pizzi B, Cassini F, Vivaldi N. Reliability of optic nerve ultrasound for the evaluation of patients with spontaneous intracranial hemorrhage. Neurocrit Care 2009; 11:406.
2. Dubourg J, Javouhey E, Geeraerts T, et al. Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med 2011; 37:1059.
3. Geeraerts T, Merceron S, Benhamou D, et al. Non-invasive assessment of intracranial pressure using ocular sonography in neurocritical care patients. Intensive Care Med 2008; 34:2062.
4. Kimberly HH, Shah S, Marill K, Noble V. Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure. Acad Emerg Med 2008; 15:201.
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