Skip to main content

Advertisement

Log in

Non-invasive assessment of ICP in children: advances in ultrasound-based techniques

  • Focus Session
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

The assessment of intracranial pressure (ICP) in children with neurological disease remains a cornerstone in their routine management. The quest for a reliable, reproducible and radiation-free non-invasive technique for assessing ICP in children remains somewhat of a holy grail for neurosurgery. This work assesses some of the recent advances in ultrasound-based techniques, addressing both novel processes and modifications aimed at improving the accuracy of existing techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Aiolfi A, Benjamin E, Khor D, Inaba K, Lam L, Demetriades D (2017) Brain Trauma Foundation guidleines for intracranial pressure monitoring: comploiance and effect on outcome. World J Surg 41(6):1543–1549

    Article  Google Scholar 

  2. Al Mufti F, Smith B, Lander M et al (2018) Novel minimally invasive multi-modality monitoring modalities in neurocritical care. J Neurol Sci 15(390):184–192

    Article  Google Scholar 

  3. Behmanesh B, Setzer M, Noack A, Bartels M, Quick-Weller J, Seifert V, Freiman TM (2016) Noninvasive epicutaneous transfontanelle intracranial pressure monitoring in children under the age of 1 year: a novel technique. J Neurosurg Pediatr 18(3):372–376

    Article  Google Scholar 

  4. Bershad EM, Urfy MZ, Pechacek A, McGrath M, Calvillo E, Horton NJ, Voss (2014) Intracranial pressure modulates distortion product otoacoustic emissions: a proof-of-principle study. Neurosurgery 75(4):445–455

    Article  Google Scholar 

  5. Bershad EM, Anand A, DeSantis SM et al (2016) Clinical validation of a transcranial Doppler-based noninvasive intracranial pressure meter: a prospective cross-sectional study. World Neurosurg 89:647–653.e1

    Article  Google Scholar 

  6. Binz DD, Toussaint LG, Friedman JA (2009) Hemorrhagic complications of ventriculostomy placement: a meta-analysis. Neurocrit Care 10:253–256

    Article  Google Scholar 

  7. Cardim D, Robba C, Donnelly J et al (2015) Prospective study on non-invasive assessment of ICP in head injured patients: comparison of four methods. J Neurotrauma 33(8):792–802

    Article  Google Scholar 

  8. Cardim D, Robba C, Bohdanowicz M, Donnelly J, Cabella B, Liu X, Cabeleira M, Smielewski P, Schmidt B, Czosnyka M (2016) Non-invasive monitoring of intracranial pressure using transcranial Doppler ultrasonography: is it possible? Neurocrit Care 25(3):473–491

    Article  Google Scholar 

  9. Czosnyka M, Smielewski P, Kirkpatrick P, Laing RJ, Menon D, Pickard JD (1997) Continuous assessment of the cerebral vaso-motor reactivity in head injury. Neurosurgery 41:11–17

    Article  CAS  Google Scholar 

  10. Dubourg J, Javouhey E, Geeraerts T, Messerer M, Kassai B (2011) Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med 37(7):1059–1068

    Article  Google Scholar 

  11. Ganslandt O, Mourtzoukos S, Stadlbauer A, Sommer B, Rammensee R (2018) Evaluation of a novel noninvasive ICP monitoring device in patients undergoing invasive ICP monitoring: preliminary results. J Neurosurg 128:1653–1660

    Article  Google Scholar 

  12. Hansen HC, Helmke K (1996) The subarachnoid space surrounding the optic nerves. An ultrasound study of the optic nerve sheath. Surg Radiol Anat 18:323–328

    Article  CAS  Google Scholar 

  13. Hansen HC, Lagrèze W, Krueger O, Helmke K (2011) Dependence of the optic nerve sheath diameter on acutely applied subarachnoidal pressure–an experimental ultrasound study. Acta Ophthalmol 89(6):e528–e532

    Article  Google Scholar 

  14. Harary M, Dolmans RG, Gormley W (2017) Intracranial pressure monitoring - review and avenues for development. Sensors 18(2):465

    Article  Google Scholar 

  15. Holloway KL, Barnes T, Choi S, Bullock R, Marshall LF, Eisenberg HM, Jane JA, Ward JD, Young HF, Marmarou A (1996) Ventriculostomy infections: the effect of monitoring duration and catheter exchange in 584 patients. J Neurosurg 85:419–424

    Article  CAS  Google Scholar 

  16. Hutchinson PJ, Kolias AG, Czosnyka M, Kirkpatrick PJ, Pickard JD, Menon DK (2013) Intracranial pressure monitoring in severe traumatic brain injury. BMJ 346:f1000

    Article  Google Scholar 

  17. Kristiansson H, Nissborg E, Bartek J Jr, Andresen M, Reinstrup P, Romner B (2013) Measuring elevated intracranial pressure through noninvasive methods: a review of the literature. J Neurosurg Anesthesiol 25(4):372–385

    Article  Google Scholar 

  18. Miller JD, Stanek A, Langfitt TW (1972) Concepts of cerebral perfusion pressure and vascular compression during intracranial hypertension. Prog Brain Res 35:411–432

    Article  CAS  Google Scholar 

  19. Narayan V, Mohammed N, Savardekar A (2018) Non-invasive intracranial pressure monitoring for severe traumatic brain injury in children: update on current methods. World Neurosurg 114:293–300

    Article  Google Scholar 

  20. Padayachy LC (2016) Non-invasive assessment of ICP. Childs Nerv Syst 32(9):1587–1597

    Article  Google Scholar 

  21. Padayachy LC, Padayachy V, Galal U, Gray R, Fieggen AG (2016) The relationship between transorbital ultrasound measurement of the optic nerve sheath diameter (ONSD) and invasively measured ICP in children. Part I: repeatability, observer variability and general analysis. Childs Nerv Syst 32(10):1769–1778

    Article  Google Scholar 

  22. Padayachy LC, Padayachy V, Galal U (2016) The relationship between transorbital ultrasound measurement of the optic nerve sheath diameter (ONSD) and invasively measured ICP in children. Part II: age-related ONSD cut-off values and patency of the anterior fontanelle. Childs Nerv Syst 32(10):1779–1785

    Article  Google Scholar 

  23. Padayachy L, Brekken R, Fieggen G, Selbekk T (2016) Pulsatile dynamics of the optic nerve sheath and intracranial pressure: an exploratory in vivo investigation. Neurosurgery 79(1):100–107

    Article  Google Scholar 

  24. Padayachy L, Brekken R, Fieggen G, Selbekk T (2018) Noninvasive transorbital assessment of the optic nerve sheath in children: relationship between optic nerve sheath diameter, deformability index, and intracranial pressure. Oper Neurosurg

  25. Ragauskas A, Matijosaitis V, Zakelis R, Petrikonis K, Rastenyte D, Piper I, Daubaris G (2012) Clinical assessment of noninvasive intracranial pressure absolute value measurement method. Neurology 78(21):1684–1891

    Article  CAS  Google Scholar 

  26. Rasulo FA, Bertuetti R, Robba C, Lusenti F, Cantoni A, Bernini M, Girardini A, Calza S, Piva S, Fagoni N, Latronico N (2017) The accuracy of transcranial Doppler in excluding intracranial hypertension following acute brain injury: a multicenter prospective pilot study. Crit Care 21(1):44

    Article  Google Scholar 

  27. Robba C, Bacigaluppi S, Cardim D, Donnelly J, Bertuccio A, Czosnyka M (2016) Non-invasive assessment of intracranial pressure. Acta Neurol Scand 134(1):4–21

    Article  CAS  Google Scholar 

  28. Robba C, Bragazzi NL, Bertuccio A et al (2016) Effects of prone position and positive end-expiratory pressure on noninvasive estimators of ICP: a pilot study. J Neurosurg Anesthesiol 29(3):243–250

    Article  Google Scholar 

  29. Robba C, Cardim D, Donnelly J, Bertuccio A, Bacigaluppi S, Bragazzi N, Cabella B, Liu X, Matta B, Lattuada M, Czosnyka M (2016) Effects of pneumoperitoneum and Trendelenburg position on intracranial pressure assessed using different non-invasive methods. Br J Anaesth 117(6):783–791

    Article  CAS  Google Scholar 

  30. Robba C, Cardim D, Tajsic T, Pietersen J, Bulman M, Donnelly J, Lavinio A, Gupta A, Menon DK, Hutchinson PJA, Czosnyka M (2017) Ultrasound non-invasive measurement of intracranial pressure in neurointensive care: a prospective observational study. PLoS Med 14(7):e1002356

    Article  Google Scholar 

  31. Robba C, Goffi A, Geeraerts T et al (2019) Brain ultrasonography: methodology, basic and advanced principles and clinical applications. A narrative review. Intensive Care Med:1–15

  32. Schoser BGH, Riemenschneider N, Hansen HC (1999) The impact of raised intracranial pressure on cerebral venous hemodynamics: a prospective venous transcranial Doppler ultrasonography study. J Neurosurg 91:744–749

    Article  CAS  Google Scholar 

  33. Sheehan JR, Liu X, Donnelly J, Cardim D, Czosnyka M, Robba C (2018) Clinical application of non-invasive intracranial pressure measurements. Br J Anaesth 121(2):500–501

    Article  CAS  Google Scholar 

  34. Shimbles S, Dodd C, Banister K, Mendelow AD, Chambers IR (2005) Clinical comparison of tympanic membrane displacement with invasive intracranial pressure measurements. Physiol Meas 26(6):1085–1092

    Article  CAS  Google Scholar 

  35. Xie X, Zhang X, Fu J, Wang H, Jonas JB, Peng X, Tian G, Xian J, Ritch R, Li L, Kang Z, Zhang S, Yang D, Wang N, Beijing iCOP Study Group (2013) Noninvasive intracranial pressure estimation by orbital subarachnoid space measurement: the Beijing intracranial and intraocular pressure (iCOP) study. Crit Care 17(4):R162

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Llewellyn C. Padayachy.

Ethics declarations

Conflict of interest

LP and RB are co-inventors of non-invasive ICP assessment technology with a patent pending.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Padayachy, L.C., Robba, C. & Brekken, R. Non-invasive assessment of ICP in children: advances in ultrasound-based techniques. Childs Nerv Syst 36, 95–98 (2020). https://doi.org/10.1007/s00381-019-04371-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-019-04371-1

Keywords

Navigation