Efficacy of Noninvasive Technologies in Triaging Traumatic Brain Injury and Correlating With Intracranial Pressure: A Prospective Study

Singer, Kathleen E.; Wallen, Taylor E; Jalbert, Timothy; Wakefield, Devin L.; Spuzzillo, Anthony; Sharma, Sameer; Earnest, Ryan E.; Heh, Victor; Foreman, Brandon; Goodman, Michael D.

doi:10.1016/j.jss.2020.12.042

Cited by 16 publications

(31 citation statements)

References 21 publications

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“…16 To substantiate these findings in our study, we considered 26 patients, 22 male and 4 females, with an average age of 43.57 years ± S.D. 19.95 (range 18-78 years).…”

Section: Original Articlementioning

confidence: 65%

“…The mean age of the population involved in this study is 43.57 years ± S.D. 19.95 (range 18-78 years), with male preponderance in a ratio of 5.5:1. Pearson's correlation coefficient of peak systolic velocity in middle cerebral artery and intracranial pressure was 0.715 (p < 0.000) demonstrating a significant positive correlation.…”

Section: Resultsmentioning

confidence: 99%

“…Notably, middle cerebral artery peak systolic velocity and carotid flow velocity performed well and correlated with the intracranial pressure among these patients. 19 As noted by Bishop et al from London in 1986 in his landmark paper the resting middle cerebral artery peak systolic velocity has wide normal range from 36 cm/sec to 140 cm/sec and also that any change in middle cerebral artery peak systolic velocity reliably correlate with change in cerebral blood flow. 20 Similar to the noted conclusion, in our study also all measured middle cerebral artery peak…”

Section: Kafle Et Al In His Paper Gave Insight About Demographic Dist...mentioning

confidence: 96%

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Peak Systolic Velocity in Middle Cerebral Artery in Patients with Severe Traumatic Brain Injury as an Indicator of Detrimental Rise in Intracranial Pressure

Shrestha

Lakshmipathy

2021

Kathmandu Univ. Med. J.

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Background Intracranial pressure (ICP) is the major concern for neurosurgeons while treating patients with severe traumatic brain injury, as any troublesome escalation in intracranial pressure heralds feared complications leading to definite morbidity or even mortality. Objective This study focuses on analyzing the correlation between peak systolic velocity in middle cerebral artery derived from transcranial doppler ultrasonographic spectral analysis and intracranial pressure values derived from invasive intracranial pressure monitoring system in a patient with severe traumatic brain injury. Method A prospective observational study was performed using a convenience sample technique including all adult patients with severe traumatic brain injury who had invasive intracranial monitors placed as part of their clinical care. Transcranial doppler ultrasonography was performed with a 2 MHz linear probe of ACUSON X300 ultrasound system while simultaneous intracranial pressure readings were obtained directly from invasive intracranial pressure monitoring. The association between peak systolic velocity in the middle cerebral artery and invasive intracranial pressure was assessed with Pearson’s correlation coefficient. Result One hundred one transcranial doppler ultrasound spectral analysis was performed on 26 individual patients. The mean age of the population involved in this study is 43.57 years ± S.D. 19.95 (range 18-78 years), with male preponderance in a ratio of 5.5:1. Pearson’s correlation coefficient of peak systolic velocity in middle cerebral artery and intracranial pressure was 0.715 (p < 0.000) demonstrating a significant positive correlation. With further evaluation of area under curve characteristics, peak systolic velocity in middle cerebral artery of 39.6 cm/s yielded the most favorable balance of test characteristics to diagnose elevation of intracranial pressure, with a resulting sensitivity of 82.1% and specificity of 84.4%. Conclusion Peak systolic velocity in middle cerebral artery can be explored further as a dependable screening tool to evaluate intracranial pressure among patients with severe traumatic brain injury in settings with unavailability of invasive intracranial pressure monitoring facilities.

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“…16 To substantiate these findings in our study, we considered 26 patients, 22 male and 4 females, with an average age of 43.57 years ± S.D. 19.95 (range 18-78 years).…”

Section: Original Articlementioning

confidence: 65%

Section: Resultsmentioning

confidence: 99%

Section: Kafle Et Al In His Paper Gave Insight About Demographic Dist...mentioning

confidence: 96%

See 1 more Smart Citation

Peak Systolic Velocity in Middle Cerebral Artery in Patients with Severe Traumatic Brain Injury as an Indicator of Detrimental Rise in Intracranial Pressure

Shrestha

Lakshmipathy

2021

Kathmandu Univ. Med. J.

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“…Singer et al ( 60 ) suggested to combine ONSD measurement with pupillometry and transcranial ultrasonographic Doppler to estimate and follow ICP in patients with severe TBI.…”

Section: Resultsmentioning

confidence: 99%

Ultrasound Detection of Intracranial Hypertension in Brain Injuries

et al. 2022

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In recent years, the measurement of optic nerve sheath diameter with ultrasound to detect the presence of increased intracranial pressure has widely spread. It can be qualitatively and effectively used to identify intracranial hypertension. Intracranial pressure can rise due to acute injury, cerebral bleeding, hydrocephalus, brain tumors and other space-occupying abnormalities, and it is linked to a high death rate. The purpose of this review is to give a general overview of the most relevant scientific publications on ultrasonographic evaluation of the optic nerve in case of brain injuries published in the last 30 years, as well as to analyze the limits of the most extensively used B-scan approach. Fifty-two papers chosen from the PubMed medical database were analyzed in this review. Our findings revealed that ocular ultrasound is an useful diagnostic tool in the management of intracranial hypertension when it exceeds a certain value or after head trauma. As a result, an ultrasound of the optic nerve can be extremely helpful in guiding diagnosis and treatment. The blooming effect is one of the most critical restrictions to consider when using B-scan ultrasonography. Since amplitude-scan ultrasound, also known as A-scan, does not have this limit, these two diagnostic techniques should always be used together for a more full, accurate, and trustworthy ultrasound examination, ensuring more data objectivity.

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“…Similarly, in another study, NPi values < 3 were associated with high ICP and early NPi deterioration could also predict the rise in ICP [ 27 ]. In another study, recovery of NPi was observed within 2 h in TBI patients treated with osmotics, in particular if the pre-intervention NPi was below 3 [ 28 ]. In our study, we used the TIL score to assess the intensity of ICP-directed interventions; lower NPi values on admission were observed in those patients with the highest TIL during the ICU stay.…”

Section: Discussionmentioning

confidence: 99%

Early Pupillometry Assessment in Traumatic Brain Injury Patients: A Retrospective Study

et al. 2021

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Background: The aim of this study was to evaluate whether the early assessment of neurological pupil index (NPi) values derived from automated pupillometry could predict neurological outcome after traumatic brain injury (TBI). Methods: Retrospective observational study including adult (>18 years) TBI patients admitted from January 2018 to December 2020, with available NPi on admission. Abnormal NPi was considered if <3. Unfavorable neurological outcome (UO) at hospital discharge was considered for a Glasgow Outcome Scale of 1–3. Results: 100 patients were included over the study period (median age 48 (34–69) years and median GCS on admission 11 (6–15)); 49 (49%) patients had UO. On admission, 20 (20%) patients had an abnormal NPi (NPi < 3); median worst (i.e., from both eyes) NPi was 4.2 (3.2–4.5). Median worst and mean NPi on admission were significantly lower in the UO group than others (3.9 (1.7–4.4) vs. 4.4 (3.7–4.6); p = 0.005–4.0 (2.6–4.5) vs. 4.5 (3.9–4.7); p = 0.002, respectively). The ROC curve for the worst and mean NPi showed a moderate accuracy to predict UO (AUC 0.66 (0.56–0.77); p = 0.005 and 0.68 (0.57–0.78); p = 0.002). However, in a generalized linear model, the prognostic role of NPi on admission was limited. Conclusions: Low NPi on admission has limited prognostic value in TBI.

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Efficacy of Noninvasive Technologies in Triaging Traumatic Brain Injury and Correlating With Intracranial Pressure: A Prospective Study

Cited by 16 publications

References 21 publications

Peak Systolic Velocity in Middle Cerebral Artery in Patients with Severe Traumatic Brain Injury as an Indicator of Detrimental Rise in Intracranial Pressure

Peak Systolic Velocity in Middle Cerebral Artery in Patients with Severe Traumatic Brain Injury as an Indicator of Detrimental Rise in Intracranial Pressure

Ultrasound Detection of Intracranial Hypertension in Brain Injuries

Early Pupillometry Assessment in Traumatic Brain Injury Patients: A Retrospective Study

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