OBJECTIVES: To compare the diagnostic reliability of optic nerve sheath diameter (ONSD) ultrasonography with a transcranial Doppler (TCD)-based absolute intracranial pressure (ICP) value measurement method for detection of elevated ICP in neurological patients. The ONSD method has been only tested previously on neurosurgical patients. METHODS: A prospective clinical study of a non-invasive ICP estimation method based on ONSD correlation with ICP and an absolute ICP value measurement method based on a two-depth TCD technology has recruited 108 neurological patients. Ninety-two of these patients have been enrolled in the final analysis of the diagnostic reliability of ONSD ultrasonography and 85 patients using the absolute ICP value measurement method. All non-invasive ICP measurements were compared with 'Gold Standard' invasive cerebrospinal fluid (CSF) pressure measurements obtained by lumbar puncture. Receiver-operating characteristic (ROC) analysis has been used to investigate the diagnostic value of these two methods. RESULTS: The diagnostic sensitivity, specificity, and the area under the ROC curve (AUC) of the ONSD method for detecting elevated intracranial pressure (ICP >14·7 mmHg) were calculated using a cutoff point of ONSD at 5·0 mm and found to be 37·0%, 58·5%, and 0·57, respectively. The diagnostic sensitivity, specificity, and AUC for the non-invasive absolute ICP measurement method were calculated at the same ICP cutoff point of 14·7 mmHg and were determined to be 68·0%, 84·3%, and 0·87, respectively. CONCLUSIONS: The non-invasive ICP measurement method based on two-depth TCD technology has a better diagnostic reliability on neurological patients than the ONSD method when expressed by the sensitivity and specificity for detecting elevated ICP >14·7 mmHg.
OBJECTIVES: To compare the diagnostic reliability of optic nerve sheath diameter (ONSD) ultrasonography with a transcranial Doppler (TCD)-based absolute intracranial pressure (ICP) value measurement method for detection of elevated ICP in neurological patients. The ONSD method has been only tested previously on neurosurgical patients. METHODS: A prospective clinical study of a non-invasive ICP estimation method based on ONSD correlation with ICP and an absolute ICP value measurement method based on a two-depth TCD technology has recruited 108 neurological patients. Ninety-two of these patients have been enrolled in the final analysis of the diagnostic reliability of ONSD ultrasonography and 85 patients using the absolute ICP value measurement method. All non-invasive ICP measurements were compared with 'Gold Standard' invasive cerebrospinal fluid (CSF) pressure measurements obtained by lumbar puncture. Receiver-operating characteristic (ROC) analysis has been used to investigate the diagnostic value of these two methods. RESULTS: The diagnostic sensitivity, specificity, and the area under the ROC curve (AUC) of the ONSD method for detecting elevated intracranial pressure (ICP >14·7 mmHg) were calculated using a cutoff point of ONSD at 5·0 mm and found to be 37·0%, 58·5%, and 0·57, respectively. The diagnostic sensitivity, specificity, and AUC for the non-invasive absolute ICP measurement method were calculated at the same ICP cutoff point of 14·7 mmHg and were determined to be 68·0%, 84·3%, and 0·87, respectively. CONCLUSIONS: The non-invasive ICP measurement method based on two-depth TCD technology has a better diagnostic reliability on neurological patients than the ONSD method when expressed by the sensitivity and specificity for detecting elevated ICP >14·7 mmHg.
Authors: A M Saindane; D Qiu; J N Oshinski; N J Newman; V Biousse; B B Bruce; J F Holbrook; B M Dale; X Zhong Journal: AJNR Am J Neuroradiol Date: 2017-12-28 Impact factor: 3.825
Authors: Peter Le Roux; David K Menon; Giuseppe Citerio; Paul Vespa; Mary Kay Bader; Gretchen M Brophy; Michael N Diringer; Nino Stocchetti; Walter Videtta; Rocco Armonda; Neeraj Badjatia; Julian Böesel; Randall Chesnut; Sherry Chou; Jan Claassen; Marek Czosnyka; Michael De Georgia; Anthony Figaji; Jennifer Fugate; Raimund Helbok; David Horowitz; Peter Hutchinson; Monisha Kumar; Molly McNett; Chad Miller; Andrew Naidech; Mauro Oddo; DaiWai Olson; Kristine O'Phelan; J Javier Provencio; Corinna Puppo; Richard Riker; Claudia Robertson; Michael Schmidt; Fabio Taccone Journal: Intensive Care Med Date: 2014-08-20 Impact factor: 17.440
Authors: Peter Le Roux; David K Menon; Giuseppe Citerio; Paul Vespa; Mary Kay Bader; Gretchen M Brophy; Michael N Diringer; Nino Stocchetti; Walter Videtta; Rocco Armonda; Neeraj Badjatia; Julian Böesel; Randall Chesnut; Sherry Chou; Jan Claassen; Marek Czosnyka; Michael De Georgia; Anthony Figaji; Jennifer Fugate; Raimund Helbok; David Horowitz; Peter Hutchinson; Monisha Kumar; Molly McNett; Chad Miller; Andrew Naidech; Mauro Oddo; DaiWai Olson; Kristine O'Phelan; J Javier Provencio; Corinna Puppo; Richard Riker; Claudia Robertson; Michael Schmidt; Fabio Taccone Journal: Neurocrit Care Date: 2014-12 Impact factor: 3.210