Non-invasive detection of intracranial pressure in clinical practice (review of literature)

Abstract

The aim of the research was to summarize the results of the researches of preoperative diagnostics of intracranial hypertension using data of modern publications and also to determine possible algorithm of diagnostic measures before planning neurosurgical approach at the treatment of intracranial injuries. We analyzed Russian and foreign literary sources for 30 years using key words and search system PubMed. The analysis shows that the search of methods of non-invasive control of intracranial pressure is still actual because of the risk of severe complications of using invasive methods. The most accurate and clinically valuable method of evaluation and prediction of intracranial hypertension in patients with severe craniocerebral injury amongst all considered non-invasive methods (evaluation of tympanic membrane displacement, cochlear microphonia, evaluation of blood pressure in retinal veins, transcranial Doppler imaging, evaluation of optic nerve diameter etc.) is an evaluation of optic nerve diameter using data of ultrasonography, CT imaging and magnetic resonance tomography. Given the fact of operator-dependence of ultrasonography and known limitation for using magnetic resonance tomography in patients with severe craniocerebral injury, CT-data of the optic nerve diameter more than 5,8 mm available from plain preoperative examination can be considered as a reliable prognostic index of development of intracranial hypertension while planning p operative approach.

Keywords

• intracranial pressure
• severe craniocerebral injury
• computed tomography