ArticleCritical care (London, England)2017
The accuracy of transcranial Doppler in excluding intracranial hypertension following acute brain injury: a multicenter prospective pilot study.
Article in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
63 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Profiling cerebral hemodynamics in sepsis and septic shock patients with transcranial doppler: a systematic review and meta-analysis.Journal of clinical monitoring and computing · 2026Pooled it
- Diagnosis of elevated intracranial pressure in critically ill adults: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2019Pooled it
- Brain ultrasonography: methodology, basic and advanced principles and clinical applications. A narrative review.Intensive care medicine · 2019Pooled it
- A pilot clinical study to estimate intracranial pressure utilising cerebral photoplethysmograms in traumatic brain injury patients.Acta neurochirurgica · 2024Trial
- Transcranial Doppler findings in patients with COVID-19: a prospective observational study.Arquivos de neuro-psiquiatria · 2026Observational
- Ultrasound measurement of the optic nerve and its sheath using the CLOSED protocol: comparison with MRI in a porcine in-vivo model.BMC veterinary research · 2026Article
- Non-invasive intracranial pressure estimation in the intensive care unit: narrative review of methods and clinical applications.Intensive care medicine · 2026Review
- Transcranial Doppler Pulsatility Index and MRI Findings in Meningoencephalitis: A Pilot Observational Retrospective Cohort Study in Critically Ill Patients.Clinics and practice · 2026Article
- Bilateral Stellate Ganglion Block After Ventricular Arrhythmia May Hide Clinical Signs of the Cushing Triad: A Case Study and Review of the Literature.Case reports in critical care · 2026Article
- Noninvasive Intracranial Pressure Prediction Using a Multimodal Ultrasound-Based Hemispheric Modeling Strategy: A Prospective Dual-Center Study.Neurocritical care · 2025Article
- Transcranial ultrasound in the critically ill patient: a narrative review.Intensive care medicine experimental · 2025Review
- Machine learning approach for noninvasive intracranial pressure estimation using pulsatile cranial expansion waveforms.NPJ digital medicine · 2025Article
- The Brussels consensus for non-invasive ICP monitoring when invasive systems are not available in the care of TBI patients (the B-ICONIC consensus, recommendations, and management algorithm).Intensive care medicine · 2025Article
- Managing Intracranial Pressure Crisis.Current neurology and neuroscience reports · 2024Review
- Optimizing brain protection after cardiac arrest: advanced strategies and best practices.Interface focus · 2024Review
- Brain health: A concern for anaesthesiologists and intensivists.European journal of anaesthesiology and intensive care · 2024Review
- Brain Ultrasonography in Critically Ill Septic Patients: A Scoping Review.Journal of clinical medicine · 2024Article
- Noninvasive Intracranial Pressure Monitoring: Are We There Yet?Neurocritical care · 2024Article
- Analysis of phase shift between pulse oscillations of macro- and microvascular cerebral blood flow in patients with traumatic brain injury.Acta neurochirurgica · 2024Observational
- Estimated Cerebral Perfusion Pressure and Intracranial Pressure in Septic Patients.Neurocritical care · 2024Article
3 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUntimely diagnosis of intracranial hypertension may lead to delays in therapy and worsening of outcome. Transcranial Doppler (TCD) detects variations in cerebral blood flow velocity which may correlate with intracranial pressure (ICP). We investigated if intracranial hypertension can be accurately excluded through use of TCD.
methodThis was a multicenter prospective pilot study in patients with acute brain injury requiring invasive ICP (ICPi) monitoring. ICP estimated with TCD (ICPtcd) was compared with ICPi in three separate time frames: immediately before ICPi placement, immediately after ICPi placement, and 3 hours following ICPi positioning. Sensitivity and specificity, and concordance correlation coefficient between ICPi and ICPtcd were calculated. Receiver operating curve (ROC) and the area under the curve (AUC) analyses were estimated after measurement averaging over time.
resultsA total of 38 patients were enrolled, and of these 12 (31.6%) had at least one episode of intracranial hypertension. One hundred fourteen paired measurements of ICPi and ICPtcd were gathered for analysis. With dichotomized ICPi (≤20 mmHg vs >20 mmHg), the sensitivity of ICPtcd was 100%; all measurements with high ICPi (>20 mmHg) also had a high ICPtcd values. Bland-Altman plot showed an overestimation of 6.2 mmHg (95% CI 5.08-7.30 mmHg) for ICPtcd compared to ICPi. AUC was 96.0% (95% CI 89.8-100%) and the estimated best threshold was at ICPi of 24.8 mmHg corresponding to a sensitivity 100% and a specificity of 91.2%.
conclusionsThis study provides preliminary evidence that ICPtcd may accurately exclude intracranial hypertension in patients with acute brain injury. Future studies with adequate power are needed to confirm this result.
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