Ultrasound non-invasive intracranial pressure assessment in paediatric neurocritical care: a pilot study

Robba, Chiara; Cardim, Danilo; Czosnyka, Marek; Abecasis, Francisco; Pezzato, Stefano; Buratti, Silvia; Moscatelli, Andrea; Sortica, Cristina; Racca, Fabrizio; Pelosi, Paolo; Rasulo, Frank

doi:10.1007/s00381-019-04235-8

Cited by 22 publications

(19 citation statements)

References 30 publications

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“…Incompressible cerebrospinal fluid carries ICP to the tympanic membrane [24] or the optical nerve sheath [25], where ICP can be measured as a displacement or diameter change, respectively. Ultrasound can be used to measure time of flight from one ear to the other across the brain [26], the blood velocity in the middle cerebral artery [27], or the pulsatility index of cerebral blood flow velocity as measured with transcranial doppler (TCD) [28,29], as well as the critical closing pressure [30]. Recently, an ultrasound based mathematical model of cerebral hemodynamics has shown potential to estimate non-invasive ICP based on pulsatile information [31].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, an ultrasound based mathematical model of cerebral hemodynamics has shown potential to estimate non-invasive ICP based on pulsatile information [31]. All these ultrasound-based measurements can be correlated to ICP [28]. However, many of these examples only measure relative changes in ICP, distinguish only between highly elevated and normal ICP, or are not suited for long-term bedside measurements.…”

Section: Introductionmentioning

confidence: 99%

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Estimating intracranial pressure using pulsatile cerebral blood flow measured with diffuse correlation spectroscopy

Ruesch

Yang

Schmitt

et al. 2020

Biomed. Opt. Express

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Measuring intracranial pressure (ICP) is necessary for the treatment of severe head injury but measurement systems are highly invasive and introduce risk of infection and complications. We developed a non-invasive alternative for quantifying ICP using measurements of cerebral blood flow (CBF) by diffuse correlation spectroscopy. The recorded cardiac pulsation waveform in CBF undergoes morphological changes in response to ICP changes. We used the pulse shape to train a randomized regression forest to estimate the underlying ICP and demonstrate in five non-human primates that DCS-based estimation can explain over 90% of the variance in invasively measured ICP.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Estimating intracranial pressure using pulsatile cerebral blood flow measured with diffuse correlation spectroscopy

Ruesch

Yang

Schmitt

et al. 2020

Biomed. Opt. Express

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“…ONSD ultrasound has been used to quantify variations in the optic nerve sheath and thus to detect elevations of ICP. Several authors have demonstrated a correlation between millimetric increases in the optic nerve sheath and ICHy (36)(37)(38)(39). In 2012, Dubourg et al (40) began a meta-analysis of studies comparing ONSD ultrasound and ICP catheter.…”

Section: Discussionmentioning

confidence: 99%

Estimation of Intracranial Pressure by Ultrasound of the Optic Nerve Sheath in an Animal Model of Intracranial Hypertension

Jeng¹,

Andrade²,

Brasil

et al. 2020

Preprint

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Background: Invasive monitoring of intracranial pressure (ICP) is currently the gold standard method for the safe diagnosis and treatment of intracranial hypertension (ICHy), but it is subject to hemorrhage, infection and malfunction. Ultrasound of the optic nerve sheath diameter (ONSD) has been applied as a non-invasive alternative that is cost effective and available at the bedside. However, ONSD time-lapse behavior in a set of ICHy and its relief by means of whether saline infusion or surgery is still unknown. The objective of this study was to correlate intracranial pressure and ultrasonography of the optic nerve sheath in an experimental animal model of ICHy, and the interval needed to ONSD to return to its baseline levels.Methods: An experimental study was conducted on 30 male and female pigs weighing about 20 kg. The diameter of the optic nerve sheath was evaluated by ultrasound at different measures of ICP given by intraventricular catheter and intracranial balloon inflation, saline infusion and balloon deflation. Laboratory and hemodynamic data were collected from the animals. ICP and ONSD values were correlated at each time point of the study.Results: All the variables obtained by ONSD ultrasonography as left optic nerve, right optic nerve and average of optic nerve sheath (AON) diameter were statistically significant to estimate ICP value. ONSD values changed immediately at balloon inflation, with a delay of 30 minutes average to return to baseline levels after balloon deflation (p = 0.016). No statistical significance was observed in ICP and ONSD values with hypertonic saline infusion. Correlation between ICP and ONSD was linear and can be estimated using the formula: -80.5 + 238.2 x AON, in this swine model. Conclusion: In the present study, ultrasound of optic nerve sheath diameter disclosed linear correlation with ICP, although a short delay in returning to its baseline levels may be observed in the case of sudden intracranial hypertension relief.

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“…ICHy (36)(37)(38)(39). In 2012, Dubourg et al (40) began a meta-analysis of studies comparing ONSD ultrasound and ICP catheter.…”

Section: Icp Several Authors Have Demonstrated a Correlation Betweenmentioning

confidence: 99%

Estimation of intracranial pressure by ultrasound of the optic nerve sheath in an animal model of intracranial hypertension

Jeng

Andrade

Brasil

et al. 2021

Journal of Clinical Neuroscience

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Background: Invasive monitoring of intracranial pressure (ICP) is currently the gold standard method for the safe diagnosis and treatment of intracranial hypertension (ICHy), but it is subject to hemorrhage, infection and malfunction. Ultrasound of the optic nerve sheath diameter (ONSD) has been applied as a non-invasive alternative that is cost effective and available at the bedside. However, ONSD time-lapse behavior in a set of ICHy and its relief by means of whether saline infusion or surgery is still unknown. The objective of this study was to correlate intracranial pressure and ultrasonography of the optic nerve sheath in an experimental animal model of ICHy, and the interval needed to ONSD to return to its baseline levels. Methods: An experimental study was conducted on 30 male and female pigs weighing about 20 kg. The diameter of the optic nerve sheath was evaluated by ultrasound at different measures of ICP given by intraventricular catheter and intracranial balloon in ation, saline infusion and balloon de ation. Laboratory and hemodynamic data were collected from the animals. ICP and ONSD values were correlated at each time point of the study. Results: All the variables obtained by ONSD ultrasonography as left optic nerve, right optic nerve and average of optic nerve sheath (AON) diameter were statistically signi cant to estimate ICP value. ONSD values changed immediately at balloon in ation, with a delay of 30 minutes average to return to baseline levels after balloon de ation (p = 0.016). No statistical signi cance was observed in ICP and ONSD values with hypertonic saline infusion. Correlation between ICP and ONSD was linear and can be estimated using the formula:-80.5 + 238.2 x AON, in this swine model. Conclusion: In the present study, ultrasound of optic nerve sheath diameter disclosed linear correlation with ICP, although a short delay in returning to its baseline levels may be observed in the case of sudden intracranial hypertension relief.

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Ultrasound non-invasive intracranial pressure assessment in paediatric neurocritical care: a pilot study

Cited by 22 publications

References 30 publications

Estimating intracranial pressure using pulsatile cerebral blood flow measured with diffuse correlation spectroscopy

Estimating intracranial pressure using pulsatile cerebral blood flow measured with diffuse correlation spectroscopy

Estimation of Intracranial Pressure by Ultrasound of the Optic Nerve Sheath in an Animal Model of Intracranial Hypertension

Estimation of intracranial pressure by ultrasound of the optic nerve sheath in an animal model of intracranial hypertension

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