Non-invasive Monitoring of Intracranial Pressure Using Transcranial Doppler Ultrasonography: Is It Possible?

Danilo Cardim , C. Robba , Michał Bohdanowicz , J. Donnelly , B. Cabella , X. Liu , M. Cabeleira , Piotr Smielewski , B Schmidt , Marek Czosnyka


Although intracranial pressure (ICP) is essential to guide management of patients suffering from acute brain diseases, this signal is often neglected outside the neurocritical care environment. This is mainly attributed to the intrinsic risks of the available invasive techniques, which have prevented ICP monitoring in many conditions affecting the intracranial homeostasis, from mild traumatic brain injury to liver encephalopathy. In such scenario, methods for non-invasive monitoring of ICP (nICP) could improve clinical management of these conditions. A review of the literature was performed on PUBMED using the search keywords ‘Transcranial Doppler non-invasive intracranial pressure.’ Transcranial Doppler (TCD) is a technique primarily aimed at assessing the cerebrovascular dynamics through the cerebral blood flow velocity (FV). Its applicability for nICP assessment emerged from observation that some TCD-derived parameters change during increase of ICP, such as the shape of FV pulse waveform or pulsatility index. Methods were grouped as: based on TCD pulsatility index; aimed at non-invasive estimation of cerebral perfusion pressure and model-based methods. Published studies present with different accuracies, with prediction abilities (AUCs) for detection of ICP C20 mmHg ranging from 0.62 to 0.92. This discrepancy could result from inconsistent assessment measures and application in different conditions, from traumatic brain injury to hydrocephalus and stroke. Most of the reports stress a potential advantage of TCD as it provides the possibility to monitor changes of ICP in time. Overall accuracy for TCD-based methods ranges around ±12 mmHg, with a great potential of tracing dynamical changes of ICP in time, particularly those of vasogenic nature.
Author Danilo Cardim
Danilo Cardim,,
, C. Robba
C. Robba,,
, Michał Bohdanowicz ISE
Michał Bohdanowicz,,
- The Institute of Electronic Systems
, J. Donnelly
J. Donnelly,,
, B. Cabella
B. Cabella,,
, X. Liu
X. Liu,,
, M. Cabeleira
M. Cabeleira,,
, Piotr Smielewski
Piotr Smielewski,,
, B Schmidt
B Schmidt,,
, Marek Czosnyka ISE
Marek Czosnyka,,
- The Institute of Electronic Systems
Journal seriesNeurocritical Care, ISSN 1541-6933
Issue year2016
Publication size in sheets0.9
Keywords in EnglishNon-invasive intracranial pressure monitoring Transcranial Doppler Ultrasonography Intracranial pressure
Languageen angielski
10.1007%2Fs12028-016-0258-6.pdf / 1.17 MB / 10.1007%2Fs12028-016-0258-6.pdf 1.17 MB
Score (nominal)30
ScoreMinisterial score = 25.0, 02-11-2017, ArticleFromJournal
Ministerial score (2013-2016) = 30.0, 02-11-2017, ArticleFromJournal
Publication indicators WoS Impact Factor: 2016 = 2.752 (2) - 2016=2.877 (5)
Citation count*17 (2018-02-15)
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* presented citation count is obtained through Internet information analysis and it is close to the number calculated by the Publish or Perish system.