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Intracranial Pressure Monitoring: Invasive versus Non-Invasive Methods—A Review

机译:颅内压监测:有创与无创方法—综述

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摘要

Monitoring of intracranial pressure (ICP) has been used for decades in the fields of neurosurgery and neurology. There are multiple techniques: invasive as well as noninvasive. This paper aims to provide an overview of the advantages and disadvantages of the most common and well-known methods as well as assess whether noninvasive techniques (transcranial Doppler, tympanic membrane displacement, optic nerve sheath diameter, CT scan/MRI and fundoscopy) can be used as reliable alternatives to the invasive techniques (ventriculostomy and microtransducers). Ventriculostomy is considered the gold standard in terms of accurate measurement of pressure, although microtransducers generally are just as accurate. Both invasive techniques are associated with a minor risk of complications such as hemorrhage and infection. Furthermore, zero drift is a problem with selected microtransducers. The non-invasive techniques are without the invasive methods' risk of complication, but fail to measure ICP accurately enough to be used as routine alternatives to invasive measurement. We conclude that invasive measurement is currently the only option for accurate measurement of ICP.
机译:颅内压(ICP)的监测已在神经外科和神经病学领域使用了数十年。有多种技术:侵入性和非侵入性的。本文旨在概述最常见和众所周知的方法的优缺点,并评估是否可以采用无创技术(经颅多普勒,鼓膜移位,视神经鞘管直径,CT扫描/ MRI和眼底镜检查)用作侵入性技术(脑室造口术和微传感器)的可靠替代品。心室造口术被认为是精确测量压力的金标准,尽管微传感器通常同样精确。两种侵入性技术均具有较小的并发症风险,例如出血和感染。此外,零漂移是所选微传感器的问题。非侵入性技术没有侵入性方法带来的并发症风险,但是无法足够精确地测量ICP,无法用作侵入性测量的常规替代方法。我们得出的结论是,侵入式测量是当前精确测量ICP的唯一选择。

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