1. Intracranial Pressure Monitoring: Invasive versus Non-Invasive Methods—A Review
- Author
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B. M. Bellander, Morten Andresen, Bertil Romner, P. H. Raboel, and Jr Bartek
- Subjects
Ventriculostomy ,medicine.medical_specialty ,Optic nerve sheath ,business.industry ,medicine.medical_treatment ,Non invasive ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Gold standard (test) ,Review Article ,lcsh:RC86-88.9 ,Critical Care and Intensive Care Medicine ,Transcranial Doppler ,Surgery ,Medicine ,Intracranial pressure monitoring ,Radiology ,Neurosurgery ,business ,Intracranial pressure - Abstract
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.
- Published
- 2012