Noninvasive intracranial pressure monitoring methods: a critical review
ABSTRACT Background: Intracranial pressure (ICP) monitoring has been used for decades in management of various neurological conditions. The gold standard for measuring ICP is a ventricular catheter connected to an external strain gauge, which is an invasive system associated with a number of compli...
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Thieme Revinter Publicações
2021-06-01
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| Series: | Arquivos de Neuro-Psiquiatria |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000500437&tlng=en |
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| _version_ | 1850244939053531136 |
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| author | Fabiano Moulin de Moraes Gisele Sampaio Silva |
| author_facet | Fabiano Moulin de Moraes Gisele Sampaio Silva |
| author_sort | Fabiano Moulin de Moraes |
| collection | DOAJ |
| description | ABSTRACT Background: Intracranial pressure (ICP) monitoring has been used for decades in management of various neurological conditions. The gold standard for measuring ICP is a ventricular catheter connected to an external strain gauge, which is an invasive system associated with a number of complications. Despite its limitations, no noninvasive ICP monitoring (niICP) method fulfilling the technical requirements for replacing invasive techniques has yet been developed, not even in cases requiring only ICP monitoring without cerebrospinal fluid (CSF) drainage. Objectives: Here, we review the current methods for niICP monitoring. Methods: The different methods and approaches were grouped according to the mechanism used for detecting elevated ICP or its associated consequences. Results: The main approaches reviewed here were: physical examination, brain imaging (magnetic resonance imaging, computed tomography), indirect ICP estimation techniques (fundoscopy, tympanic membrane displacement, skull elasticity, optic nerve sheath ultrasound), cerebral blood flow evaluation (transcranial Doppler, ophthalmic artery Doppler), metabolic changes measurements (near-infrared spectroscopy) and neurophysiological studies (electroencephalogram, visual evoked potential, otoacoustic emissions). Conclusion: In terms of accuracy, reliability and therapeutic options, intraventricular catheter systems still remain the gold standard method. However, with advances in technology, noninvasive monitoring methods have become more relevant. Further evidence is needed before noninvasive methods for ICP monitoring or estimation become a more widespread alternative to invasive techniques. |
| format | Article |
| id | doaj-art-a8547eea32434db2b7f0d326756923bf |
| institution | OA Journals |
| issn | 1678-4227 |
| language | English |
| publishDate | 2021-06-01 |
| publisher | Thieme Revinter Publicações |
| record_format | Article |
| series | Arquivos de Neuro-Psiquiatria |
| spelling | doaj-art-a8547eea32434db2b7f0d326756923bf2025-08-20T01:59:35ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272021-06-0179543744610.1590/0004-282x-anp-2020-0300Noninvasive intracranial pressure monitoring methods: a critical reviewFabiano Moulin de Moraeshttps://orcid.org/0000-0002-4838-2840Gisele Sampaio Silvahttps://orcid.org/0000-0002-3247-3123ABSTRACT Background: Intracranial pressure (ICP) monitoring has been used for decades in management of various neurological conditions. The gold standard for measuring ICP is a ventricular catheter connected to an external strain gauge, which is an invasive system associated with a number of complications. Despite its limitations, no noninvasive ICP monitoring (niICP) method fulfilling the technical requirements for replacing invasive techniques has yet been developed, not even in cases requiring only ICP monitoring without cerebrospinal fluid (CSF) drainage. Objectives: Here, we review the current methods for niICP monitoring. Methods: The different methods and approaches were grouped according to the mechanism used for detecting elevated ICP or its associated consequences. Results: The main approaches reviewed here were: physical examination, brain imaging (magnetic resonance imaging, computed tomography), indirect ICP estimation techniques (fundoscopy, tympanic membrane displacement, skull elasticity, optic nerve sheath ultrasound), cerebral blood flow evaluation (transcranial Doppler, ophthalmic artery Doppler), metabolic changes measurements (near-infrared spectroscopy) and neurophysiological studies (electroencephalogram, visual evoked potential, otoacoustic emissions). Conclusion: In terms of accuracy, reliability and therapeutic options, intraventricular catheter systems still remain the gold standard method. However, with advances in technology, noninvasive monitoring methods have become more relevant. Further evidence is needed before noninvasive methods for ICP monitoring or estimation become a more widespread alternative to invasive techniques.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000500437&tlng=enBrain InjuryIntracranial HypertensionStrokeIntracranial PressureHead Trauma |
| spellingShingle | Fabiano Moulin de Moraes Gisele Sampaio Silva Noninvasive intracranial pressure monitoring methods: a critical review Arquivos de Neuro-Psiquiatria Brain Injury Intracranial Hypertension Stroke Intracranial Pressure Head Trauma |
| title | Noninvasive intracranial pressure monitoring methods: a critical review |
| title_full | Noninvasive intracranial pressure monitoring methods: a critical review |
| title_fullStr | Noninvasive intracranial pressure monitoring methods: a critical review |
| title_full_unstemmed | Noninvasive intracranial pressure monitoring methods: a critical review |
| title_short | Noninvasive intracranial pressure monitoring methods: a critical review |
| title_sort | noninvasive intracranial pressure monitoring methods a critical review |
| topic | Brain Injury Intracranial Hypertension Stroke Intracranial Pressure Head Trauma |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000500437&tlng=en |
| work_keys_str_mv | AT fabianomoulindemoraes noninvasiveintracranialpressuremonitoringmethodsacriticalreview AT giselesampaiosilva noninvasiveintracranialpressuremonitoringmethodsacriticalreview |