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Can intracranial pressure be measured non-invasively bedside using a two-depth Doppler-technique?
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
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2017 (English)In: Journal of clinical monitoring and computing, ISSN 1387-1307, E-ISSN 1573-2614, Vol. 31, no 2, 459-467 p.Article in journal (Refereed) Published
Abstract [en]

Measurement of intracranial pressure (ICP) is necessary in many neurological and neurosurgical diseases. To avoid lumbar puncture or intracranial ICP probes, non-invasive ICP techniques are becoming popular. A recently developed technology uses two-depth Doppler to compare arterial pulsations in the intra- and extra-cranial segments of the ophthalmic artery for non-invasive estimation of ICP. The aim of this study was to investigate how well non-invasively-measured ICP and invasively-measured cerebrospinal fluid (CSF) pressure correlate. We performed multiple measurements over a wide ICP span in eighteen elderly patients with communicating hydrocephalus. As a reference, an automatic CSF infusion apparatus was connected to the lumbar space. Ringer's solution was used to create elevation to pre-defined ICP levels. Bench tests of the infusion apparatus showed a random error (95 % CI) of less than ±0.9 mmHg and a systematic error of less than ±0.5 mmHg. Reliable Doppler signals were obtained in 13 (72 %) patients. An infusion test could not be performed in one patient. Thus, twelve patients and a total of 61 paired data points were studied. The correlation between invasive and non-invasive ICP measurements was good (R = 0.74), and the 95 % limits of agreements were -1.4 ± 8.8 mmHg. The within-patient correlation varied between 0.47 and 1.00. This non-invasive technique is promising, and these results encourage further development and evaluation before the method can be recommended for use in clinical practice.

Place, publisher, year, edition, pages
2017. Vol. 31, no 2, 459-467 p.
Keyword [en]
Non-invasive ICP, Transcranial-Doppler, Intracranial pressure, Ophthalmic artery, Infusion test
National Category
Neurology
Identifiers
URN: urn:nbn:se:umu:diva-131142DOI: 10.1007/s10877-016-9862-4ISI: 000396348800027PubMedID: 26971794OAI: oai:DiVA.org:umu-131142DiVA: diva2:1071852
Available from: 2017-02-06 Created: 2017-02-06 Last updated: 2017-05-29Bibliographically approved

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Koskinen, Lars-Owe D.Malm, JanEklund, Anders
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CiteExportLink to record
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Citation style
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