Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte MG, Brazil.
Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte MG, Brazil.
Arq Neuropsiquiatr. 2023 Jun;81(6):551-563. doi: 10.1055/s-0043-1764411. Epub 2023 Jun 28.
The most frequent cause of death in neurosurgical patients is due to the increase in intracranial pressure (ICP); consequently, adequate monitoring of this parameter is extremely important.
In this study, we aimed to analyze the accuracy of noninvasive measurement methods for intracranial hypertension (IH) in patients with traumatic brain injury (TBI).
The data were obtained from the PubMed database, using the following terms: , , , , and . The selected articles date from 1980 to 2021, all of which were observational studies or clinical trials, in English and specifying ICP measurement in TBI. At the end of the selection, 21 articles were included in this review.
The optic nerve sheath diameter (ONSD), pupillometry, transcranial doppler (TCD), multimodal combination, brain compliance using ICP waveform (ICPW), HeadSense, and Visual flash evoked pressure (FVEP) were analyzed. Pupillometry was not found to correlate with ICP, while HeadSense monitor and the FVEP method appear to have good correlation, but sensitivity and specificity data are not available. The ONSD and TCD methods showed good-to-moderate accuracy on invasive ICP values and potential to detect IH in most studies. Furthermore, multimodal combination may reduce the error possibility related to each technique. Finally, ICPW showed good accuracy to ICP values, but this analysis included TBI and non-TBI patients in the same sample.
Noninvasive ICP monitoring methods may be used in the near future to guide TBI patients' management.
神经外科患者死亡的最常见原因是颅内压（ICP）升高；因此，对该参数进行充分监测非常重要。
本研究旨在分析创伤性脑损伤（TBI）患者颅内高压（IH）的非侵入性测量方法的准确性。
从 PubMed 数据库中使用以下术语获取数据：,,,, 和 。选择的文章日期为 1980 年至 2021 年，均为观察性研究或临床试验，为英文并指定 TBI 中的 ICP 测量。在选择结束时，有 21 篇文章被纳入本综述。
分析了视神经鞘直径（ONSD）、瞳孔计、经颅多普勒（TCD）、多模态组合、使用 ICP 波形的脑顺应性（ICPW）、HeadSense 和视觉闪光诱发压（FVEP）。瞳孔计与 ICP 不相关，而 HeadSense 监测器和 FVEP 方法似乎相关性较好，但灵敏度和特异性数据不可用。ONSD 和 TCD 方法在大多数研究中对侵入性 ICP 值具有良好到中等的准确性，并具有检测 IH 的潜力。此外，多模态组合可能会降低与每种技术相关的错误可能性。最后，ICPW 对 ICP 值具有良好的准确性，但这种分析将 TBI 和非 TBI 患者纳入了相同的样本。
非侵入性 ICP 监测方法可能在不久的将来用于指导 TBI 患者的管理。
