Dubost C, Motuel J, Geeraerts T
Département d'anesthésie-réanimation, HIA Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris 05, France.
Ann Fr Anesth Reanim. 2012 Jun;31(6):e125-32. doi: 10.1016/j.annfar.2012.04.016. Epub 2012 Jun 8.
The invasive monitoring of intracranial pressure is useful in circumstances associated with high-risk of raised intracranial pressure. However the placement of intracranial probe is not always possible and non-invasive assessment of intracranial pressure may be useful, particularly in case of emergencies. Transcranial Doppler measurements allow the estimation of perfusion pressure with the pulsatility index. Recently, new ultrasonographic methods of cerebral monitoring have been developed: the diameter of the optic nerve sheath diameter, a surrogate marker of raised intracranial pressure and the estimation of median shift line deviation.
颅内压的有创监测在颅内压升高风险较高的情况下很有用。然而,颅内探头的放置并非总是可行,颅内压的无创评估可能会很有用,尤其是在紧急情况下。经颅多普勒测量可通过搏动指数估计灌注压。最近,已开发出用于脑监测的新超声方法:视神经鞘直径,这是颅内压升高的替代标志物,以及中线移位线偏差的估计。