脑内压力评估的多式非侵入性方法:一个单中心研究
Dana Klavansky1, Helaina Lehrer2, Aris Desai3
1Neurocritical Care, Mount Sinai Hospital, New York, USA.
Cureus
|January 9, 2026
概括
使用眼睛超声波和横多普勒的非侵入性多模式方法显示,在侵入性监测是不可行的情况下,在急性脑损伤患者中检测升高的内压力 (ICP) 是有前途的.
科学领域:
- 神经科学是一个神经科学.
- 关键护理医学 关键护理医学
- 医疗成像医学成像
背景情况:
- 内压力 (ICP) 监测对于治疗急性脑损伤至关重要.
- 侵入性ICP监测具有局限性和禁忌.
- 需要一种经过验证的非侵入性方法来检测ICP.
研究的目的:
- 验证一种多式,非侵入性的方法来检测升高的ICP.
- 评估非侵入性参数和侵入性ICP测量之间的相关性.
主要方法:
- 追溯性研究包括急性脑损伤患者与外部心室排水 (EVD) 放置.
- 利用眼睛超声波检查视神经外直径 (ONSD) 和视神经圆盘升高 (ONDE).
- 用于中脑动脉脉动指数 (PI) 和评估瞳孔反应率的跨骨多普勒测试.
主要成果:
- 三个或更多的非侵入性变量的组合 (例如,ONSD>5mm,ONDE,MCAPI>1.2,不反应的学生) 显示了高特异性和PPV的ICP≥15mmHg.
- 实现了0.84的ROC曲线下的面积,表明了良好的诊断性能.
- 在非侵入性评估和EVD测量的ICP之间显示出强烈的相关性和一致性.
结论:
- 非侵入性多式评估是可行的,可以在床边进行.
- 这种方法与高的ICP有很好的相关性,在侵入性监测是不可能的情况下,提供了有价值的替代方案.
相关概念视频
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...