Kawoos Usmah, McCarron Richard M, Auker Charles R, Chavko Mikulas
Department of NeuroTrauma, Naval Medical Research Center, Silver Spring, MD 20910, USA.
Int J Mol Sci. 2015 Dec 4;16(12):28979-97. doi: 10.3390/ijms161226146.
Intracranial pressure (ICP) measurements are essential in evaluation and treatment of neurological disorders such as subarachnoid and intracerebral hemorrhage, ischemic stroke, hydrocephalus, meningitis/encephalitis, and traumatic brain injury (TBI). The techniques of ICP monitoring have evolved from invasive to non-invasive-with both limitations and advantages. Some limitations of the invasive methods include short-term monitoring, risk of infection, restricted mobility of the subject, etc. The invasiveness of a method limits the frequency of ICP evaluation in neurological conditions like hydrocephalus, thus hampering the long-term care of patients with compromised ICP. Thus, there has been substantial interest in developing noninvasive techniques for assessment of ICP. Several approaches were reported, although none seem to provide a complete solution due to inaccuracy. ICP measurements are fundamental for immediate care of TBI patients in the acute stages of severe TBI injury. In severe TBI, elevated ICP is associated with mortality or poor clinical outcome. ICP monitoring in conjunction with other neurological monitoring can aid in understanding the pathophysiology of brain damage. This review article presents: (a) the significance of ICP monitoring; (b) ICP monitoring methods (invasive and non-invasive); and (c) the role of ICP monitoring in the management of brain damage, especially TBI.
颅内压（ICP）测量对于评估和治疗多种神经系统疾病至关重要，如蛛网膜下腔出血和脑内出血、缺血性中风、脑积水、脑膜炎/脑炎以及创伤性脑损伤（TBI）。ICP监测技术已从侵入性发展到非侵入性，二者各有局限性和优势。侵入性方法的一些局限性包括短期监测、感染风险、受试者活动受限等。一种方法的侵入性限制了在脑积水等神经系统疾病中进行ICP评估的频率，从而妨碍了对ICP受损患者的长期护理。因此，人们对开发非侵入性ICP评估技术产生了浓厚兴趣。虽然有几种方法被报道，但由于准确性问题，似乎都没有提供一个完整的解决方案。在严重TBI损伤的急性期，ICP测量对于TBI患者的即时护理至关重要。在严重TBI中，ICP升高与死亡率或不良临床结局相关。结合其他神经学监测进行ICP监测有助于了解脑损伤的病理生理学。这篇综述文章介绍了：（a）ICP监测的意义；（b）ICP监测方法（侵入性和非侵入性）；以及（c）ICP监测在脑损伤管理中的作用，尤其是TBI。
