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Evaluation of intracranial pressure from transcranial Doppler studies in cerebral disease

J Klingelhöfer1, B Conrad, R Benecke

  • 1Abteilungen für Klinische Neurophysiologie, Universität Göttingen, Federal Republic of Germany.

Journal of Neurology
|January 1, 1988
PubMed

Insights

This study explored using middle cerebral artery blood flow patterns to estimate intracranial pressure (ICP). Transcranial Doppler (TCD) showed distinct flow changes with increasing ICP, correlating well with direct ICP measurements.

Area of Science:

  • Neurology
  • Medical Devices
  • Biomedical Engineering

Background:

  • Intracranial pressure (ICP) monitoring is crucial for managing severe cerebral diseases.
  • Non-invasive methods for ICP estimation are highly desirable to reduce risks associated with invasive monitoring.

Purpose of the Study:

  • To investigate the correlation between intracranial flow patterns and intracranial pressure.
  • To determine if transcranial Doppler (TCD) can provide reliable estimations of ICP.

Main Methods:

  • Recorded middle cerebral artery blood flow velocity using a transcranial Doppler (TCD) device in 26 patients.
  • Simultaneously measured mean intracranial pressure (ICP) invasively via an epidural device.
  • Monitored arterial carbon-dioxide tensions using blood gas analysis.

Main Results:

  • Observed distinct changes in middle cerebral artery flow patterns with increasing ICP, including decreased mean flow velocity and increased Pourcelot index.
  • Found a significant correlation (r = 0.873; P < 0.001) between ICP and specific flow parameters in a subset of 13 patients with stable conditions.
  • Identified a predictive parameter: (mean systemic arterial pressure x Pourcelot index) / mean flow velocity.

Conclusions:

  • Transcranial Doppler (TCD) derived flow patterns show potential for non-invasively estimating intracranial pressure (ICP).
  • Specific flow parameters, particularly when combined with arterial pressure, correlate well with invasively measured ICP.
  • Further research with standardized conditions may validate TCD as a valuable tool for ICP monitoring.

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