ultrasound increased intracranial pressure

BACKGROUND: Severely elevated intracranial pressure due to various reasons, such as decreased cerebral perfusion, can lead to devastating neurological outcomes, such as brain herniation. Decompression craniectomy is a life-saving procedure that is commonly performed for such a critical situation, but the changes in cerebral microvessels after brain herniation and decompression are unclear. Ultrafast power Doppler imaging (uPDI) is a new microvascular imaging technology that utilizes high frame rate plane/diverging wave transmission and advanced clutter filters...

BACKGROUND: The goal is to estimate the additional value of ultrasonographic optic nerve sheath diameter (ONSD) measurement on days 1-3, on top of electroencephalography (EEG), pupillary light reflexes (PLR), and somatosensory evoked potentials (SSEP), for neurological outcome prediction of comatose cardiac arrest patients. We performed a prospective longitudinal cohort study in adult comatose patients after cardiac arrest. ONSD was measured on days 1-3 using ultrasound. Continuous EEG, PLR, and SSEP were acquired as standard care...

Ocular Point of Care Ultrasound (PoCUS) is emerging as a valuable utility within emergency medicine. Optic nerve sheath diameter (ONSD) has been demonstrated to correlate closely with intracranial pressure (ICP) and an elevated measurement can detect raised ICP readily, where fundoscopy may not, owing to both technical challenges and insufficient clinical skills. A previously fit and well 10-year-old girl presented to the paediatric emergency department with worsening headache, fever and lethargy. On examination, her left pupil was large, and not reactive to light...

The timely diagnosis and treatment of elevated intracranial pressure (ICP) reduces morbidity rates and prevents mortality. The aim of the present systematic review and meta-analysis was to determine the diagnostic accuracy of optic nerve sheath diameter (ONSD) vs. standard invasive ICP measurements in patients with traumatic brain injury (TBI). The PubMed, Embase, Web of Science and Cochrane Library databases were systematically searched for studies including adult patients with TBI with suspected elevated ICP, and the sonographic ONSD measurements were compared with those from a standard invasive method...

Background Orthopedic surgeries of the lower extremities frequently require exsanguination and the use of pneumatic tourniquets. However, the deflation of the tourniquet is accompanied by predominant metabolic changes such as an increase in PaCO2 . Prior studies have reported the existence of a correlation between tourniquet deflation and an increase in intracranial pressure in patients undergoing surgery under general anesthesia. However, there is a dearth of literature demonstrating such relationships among patients undergoing surgery under subarachnoid block in the Indian setting...

PURPOSE: To compare transorbital point-of-care ultrasound techniques -optic nerve sheath diameter (US-ONSD) and optic disc elevation (US-ODE)- with fundoscopic papilledema to detect potentially raised intracranial pressure (ICP) with treatment indication in children. METHODS: In a prospective study, 72 symptomatic children were included, 50 with later proven disease associated with raised ICP (e.g. pseudotumour cerebri, brain tumour, hydrocephalus) and 22 with pathology excluded...

OBJECTIVES: Timely diagnosis and management of elevated intracranial pressure (ICP) in patients with traumatic brain injury (TBI) can significantly reduce mortality rates. Ultrasound examination of the optic nerve sheath diameter (ONSD) is considered a potential, noninvasive, and effective method for assessing ICP. We conducted a systematic review and meta-analysis of ONSD ultrasound detection and invasive ICP monitoring methods to compare and evaluate the diagnostic accuracy of ONSD ultrasound detection methods for intracranial hypertension (IH) in patients with TBI...

BACKGROUND:  Intracerebral hemorrhage (ICH) is a deadly disease and increased intracranial pressure (ICP) is associated with worse outcomes in this context. OBJECTIVE:  We evaluated whether dilated optic nerve sheath diameter (ONSD) depicted by optic nerve ultrasound (ONUS) at hospital admission has prognostic value as a predictor of mortality at 90 days. METHODS:  Prospective multicenter study of acute supratentorial primary ICH patients consecutively recruited from two tertiary stroke centers...

BACKGROUND/AIM: Cerebral edema is common in patients with sepsis-associated encephalopathy (SAE) and is a major cause of elevated intracranial pressure (ICP); however, the relationship between elevated ICP and SAE is unclear. The aim of this study was to investigate the association between optic nerve sheath diameter (ONSD), a surrogate of ICP, and the incidence of SAE. PATIENTS AND METHODS: A prospective observational study was performed in a medical-surgical adult intensive care unit (ICU)...

Transverse sinus (TS) stenosis is common in individuals with venous pulsatile tinnitus (PT). While PT can be addressed by endoluminal or extraluminal methods, the former has shown promise in alleviating symptoms associated with increased intracranial pressure. This study explores the potential of extraluminal methods to alleviate TS stenosis and eliminate PT caused by sigmoid sinus diverticulum. A 31-year-old male patient presenting with left-sided PT, attributed to a large, pedunculated sigmoid sinus diverticulum along with severe ipsilateral TS stenosis and contralateral TS hypoplasia, underwent ipsilateral extraluminal TS decompression surgery following sigmoid sinus wall reconstruction under local anesthesia...

To describe the setting, feasibility, and safety of static cerebral autoregulation testing in critically injured adults with traumatic brain injury (TBI).  Methods: We reviewed static autoregulation testing using transcranial Doppler (TCD) ultrasound in patients > 18 years with TBI ICD codes between January 1, 2014, and December 31, 2021. Adverse events during testing were defined as systemic hypertension (systolic blood pressure (SBP>180 mmHg), bradycardia (HR<40 bpm), and high ICP (>30 mmHg)...

PURPOSE: During middle ear surgery, the patient's head is turned away from the surgical site, which may increase the intracranial pressure. Anesthetics also affect the intracranial pressure. The optic nerve sheath diameter (ONSD) measured using ultrasonography is a reliable marker for estimating the intracranial pressure. This aim of this study was to investigate the effect of sevoflurane and propofol on the ONSD in patients undergoing middle ear surgery. METHODS: Fifty-eight adult patients were randomized into sevoflurane group (n = 29) or propofol group (n = 29)...

We present a 52-year-old male patient with cardiogenic shock who was placed on veno-arterial extracorporeal membrane oxygenation (ECMO) as a bridge to an orthotopic heart transplant. While on ECMO, the patient developed an acute intracranial bleed confirmed on computerized tomography (CT). However, his clinical status deteriorated and he was unstable for transport to evaluate for worsening hemorrhage. Instead, optic nerve sheath (ONS) ultrasonography was utilized to confirm increased intracranial pressure, which guided the goals of care until he stabilized enough to transport for advanced imaging...

Introduction: Cerebral pulsation is a vital aspect of cerebral hemodynamics. Changes in arterial pressure in response to cardiac pulsation cause cerebral pulsation, which is related to cerebrovascular compliance and cerebral blood perfusion. Cerebrovascular compliance and blood perfusion influence the mechanical properties of the brain, causing pulsation-induced changes in cerebral stiffness. However, there is currently no imaging technique available that can directly quantify the pulsation of brain stiffness in real time...

BACKGROUND: Diagnostic tests are not routinely used for the diagnosis of primary headaches. It is possible that laboratory tests could be developed and implemented at tertiary headache centers to be an integrated part of the diagnosis and management of headache patients, and laboratory tests that can be used on-site at headache centers could help in evaluating patients with secondary headache disorders. METHODS: In this narrative review, we present some of the studies that have been made so far at the Headache Diagnostic Laboratory at the Danish Headache Center that aim to investigate and phenotype primary headaches and investigate secondary headaches as well as improve management...

This study sought to determine to what extent acute exposure to microgravity (0G) and related increases in central blood volume (CBV) during parabolic flight influence the regional redistribution of intra and extra cranial cerebral blood flow (CBF). Eleven healthy participants performed during two PF campaigns aboard the Airbus A310-ZERO G aircraft. The response of select variables for each of the 15 parabolas involving exposure to both 0G and hypergravity (1.8G) were assessed in the seated position. Mean arterial blood pressure (MAP) and heart rate (HR) were continuously monitored and used to calculate stroke volume (SV), cardiac output (Q ̇) and systemic vascular resistance (SVR)...

This case report describes a 14-year-old boy presenting with cerebral malaria in a resource-limited setting. The patient exhibited optic disc elevation, indicating increased intracranial pressure (ICP). Due to the unavailability of advanced neuroimaging, point-of-care ultrasound (POCUS) was employed to assess the optic disc. After administration of a weight-based dose of mannitol, optic disc elevation resolved completely, accompanied by clinical improvement. This case highlights the potential of POCUS as a valuable tool for the assessment and management of cerebral malaria in resource-limited settings...

The brain-gut axis represents a bidirectional communication linking brain function with the gastrointestinal (GI) system. This interaction comprises a top-down communication from the brain to the gut, and a bottom-up communication from the gut to the brain, including neural, endocrine, immune, and humoral signaling. Acute brain injury (ABI) can lead to systemic complications including GI dysfunction. Techniques for monitoring GI function are currently few, neglected, and many under investigation. The use of ultrasound could provide a measure of gastric emptying, bowel peristalsis, bowel diameter, bowel wall thickness and tissue perfusion...

PURPOSE: Intracranial pressure increases in head-down tilt (HDT) body posture. This study evaluated the effect of HDT on the optic nerve sheath diameter (ONSD) in normal subjects. METHODS: Twenty six healthy adults (age 28 [4.7] years) participated in seated and 6° HDT visits. For each visit, subjects presented at 11:00 h for baseline seated scans and then maintained a seated or 6° HDT posture from 12:00 to 15:00 h. Three horizontal axial and three vertical axial scans were obtained at 11:00, 12:00 and 15:00 h with a 10 MHz ultrasonography probe on the same eye, randomly chosen per subject...

OBJECTIVE: The precise mechanism and determinants of brain tissue pulsations (BTPs) are poorly understood, and the impact of blood pressure (BP) on BTPs is relatively unexplored. This study aimed to explore the relationship between BP parameters (mean arterial pressure [MAP] and pulse pressure [PP]) and BTP amplitude, using a transcranial tissue Doppler prototype. METHODS: A phantom brain model generating arterial-induced BTPs was developed to observe BP changes in the absence of confounding variables and cerebral autoregulation feedback processes...