Raboel P H, Bartek J, Andresen M, Bellander B M, Romner B
Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, DK-2100, Copenhagen, Denmark.
Crit Care Res Pract. 2012;2012:950393. doi: 10.1155/2012/950393. Epub 2012 Jun 8.
Monitoring of intracranial pressure (ICP) has been used for decades in the fields of neurosurgery and neurology. There are multiple techniques: invasive as well as noninvasive. This paper aims to provide an overview of the advantages and disadvantages of the most common and well-known methods as well as assess whether noninvasive techniques (transcranial Doppler, tympanic membrane displacement, optic nerve sheath diameter, CT scan/MRI and fundoscopy) can be used as reliable alternatives to the invasive techniques (ventriculostomy and microtransducers). Ventriculostomy is considered the gold standard in terms of accurate measurement of pressure, although microtransducers generally are just as accurate. Both invasive techniques are associated with a minor risk of complications such as hemorrhage and infection. Furthermore, zero drift is a problem with selected microtransducers. The non-invasive techniques are without the invasive methods' risk of complication, but fail to measure ICP accurately enough to be used as routine alternatives to invasive measurement. We conclude that invasive measurement is currently the only option for accurate measurement of ICP.
颅内压（ICP）监测在神经外科和神经内科领域已应用数十年。有多种技术，包括有创和无创技术。本文旨在概述最常见和知名方法的优缺点，并评估无创技术（经颅多普勒、鼓膜位移、视神经鞘直径、CT扫描/MRI和眼底镜检查）是否可作为有创技术（脑室造瘘术和微传感器）的可靠替代方法。脑室造瘘术在压力精确测量方面被视为金标准，尽管微传感器通常也同样精确。两种有创技术都有诸如出血和感染等轻微并发症风险。此外，选定的微传感器存在零点漂移问题。无创技术没有有创方法的并发症风险，但测量颅内压不够精确，无法用作有创测量的常规替代方法。我们得出结论，目前有创测量是精确测量颅内压的唯一选择。
