Journal ArticleDOI
Clinical comparison of tympanic membrane displacement with invasive intracranial pressure measurements.
TLDR
TMD measurements do not provide a reliable non-invasive measure of ICP in patients with shunted hydrocephalus, and Vm cannot be used as a surrogate for ICP.Abstract:
A non-invasive method of assessing intracranial pressure (ICP) would be of benefit to patients with abnormal cerebral pathology that could give rise to changes in ICP. In particular, it would assist the regular monitoring of hydrocephalus patients. This study evaluated a technique using tympanic membrane displacement (TMD) measurements, which has been reported to provide a reliable, non-invasive measure of ICP. A group of 135 hydrocephalus patients was studied, as well as 13 patients with benign intracranial hypertension and a control group of 77 volunteers. TMD measurements were carried out using the Marchbanks measurement system analyser and compared between the groups. In 36 patients, invasive measurements of ICP carried out at the same time were compared with the TMD values. A highly significant relationship was found between TMD and ICP but intersubject variability was high and the predictive value of the technique low. Taking the normal range of ICP to be 10–15 mmHg, the predictive limits of the regression are an order of magnitude wider than this and therefore Vm cannot be used as a surrogate for ICP. In conclusion, TMD measurements do not provide a reliable non-invasive measure of ICP in patients with shunted hydrocephalus.read more
Citations
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Journal ArticleDOI
Monitoring the injured brain: ICP and CBF
Luzius A. Steiner,Pjd Andrews +1 more
TL;DR: There is no clear evidence that incorporating data from CBF monitors into management strategies improves outcome in brain-injured patients, but some applications of these methods in current research are highlighted.
Journal ArticleDOI
Intracranial Pressure Monitoring: Invasive versus Non-Invasive Methods-A Review
TL;DR: An overview of the advantages and disadvantages of the most common and well-known methods as well as whether noninvasive techniques can be used as reliable alternatives to the invasive techniques is provided.
Journal ArticleDOI
Ultrasound non-invasive measurement of intracranial pressure in neurointensive care: A prospective observational study
Chiara Robba,Chiara Robba,Danilo Cardim,Tamara Tajsic,Justine Pietersen,Michael Bulman,Joseph Donnelly,Andrea Lavinio,Arun K. Gupta,David K. Menon,Peter J. Hutchinson,Marek Czosnyka,Marek Czosnyka +12 more
TL;DR: The novel combination of ONSD ultrasonography and vTCD of the straight sinus is a promising and easily available technique for identifying critically ill patients with intracranial hypertension.
Journal ArticleDOI
Ultrasonography of the optic nerve in neurocritically ill patients
Riccardo Moretti,Barbara Pizzi +1 more
TL;DR: Bedside ultrasonographic measurement of ONSD has been proposed as a non‐invasive and reliable means to detect raised ICP in neurocritically ill patients and in several studies, it proves to have a good correlation with the direct measurement of ICP and a low interobserver variability.
Journal ArticleDOI
Non-invasive assessment of intracranial pressure.
TL;DR: A possible flowchart based on the combination of non‐invasive techniques including those characterizing morphologic changes and physiological changes is proposed, which could aid in deciding whether to place an invasive monitor, or how to titrate therapy when invasive ICP measurement is contraindicated or unavailable.
References
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Journal ArticleDOI
Studies on Cochlear Aqueduct Patency
TL;DR: Patency of the cochlear aqueduct renders possible a two-way spread of infection from the cerebrospinal fluid to the innerEar and vice versa, CSF otorrhea, and sudden sensorineural hearing impairment through rises in CSF pressure, while in the absence of patency, the accumulation of harmful products of metabolism in the perilymph has a deleterious effect on the sensory elements of the inner ear.
Journal ArticleDOI
Cochlear and cerebrospinal fluid pressure: Their inter-relationship and control mechanisms
R J Marchbanks,A Reid +1 more
TL;DR: Techniques are now available which provide non-invasive indirect measures of perilymphatic pressure and CSF-perilymphic pressure transfer on an individual subject basis and the tympanic membrane displacement measurement technique has been used to provide reliable measures.
Journal ArticleDOI
Effects of posture and age on tympanic membrane displacement measurements.
A. J. Phillips,R J Marchbanks +1 more
TL;DR: The magnitude of the tympanic membrane displacement was found to decrease with age in agreement with previous studies showing decrease of stapedial reflex magnitude with increasing age, suggesting that the communication between cochlear and cranial fluids may be important in the pathogenesis of auditory dysfunction in several patient groups.
Book ChapterDOI
Bilateral ICP monitoring: its importance in detecting the severity of secondary insults.
TL;DR: It is advocated that ICP is recorded IPSILATERAL to the lesion in patients with SHI due to acute subdural haematoma, because expanding mass lesions are associated with the development of ICP gradients.
Journal ArticleDOI
Quantitative assessment of intracranial pressure by the tympanic membrane displacement audiometric technique in children with shunted hydrocephalus.
TL;DR: The tympanic membrane displacement test as a non-invasive diagnostic tool in predicting changes in intracranial pressure had a sensitivity of 93% and specificity of 100%, and the test can therefore be used for regular assessment of shunted hydrocephalics to enable correlation of intrac Cranial pressure with symptoms in individual patients.