Observational studyCritical care (London, England)2020
Multimodal non-invasive assessment of intracranial hypertension: an observational study.
Observational study in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
88 citing papers in PubMed, 4 syntheses or guidelines pooled it, 163 citations in OpenAlex.
- Prognostic value of automated pupillometry in traumatic brain injury: a systematic review and meta-analysis.Neurosurgical review · 2026Pooled it
- Sonographic optic nerve sheath diameter measurement for detecting intracranial hypertension in a suspected population: a systematic review and meta-analysis of diagnostic thresholds and influencing factors.Journal of neurology · 2026Pooled it
- Clinical benefits of invasive intracranial pressure monitoring for spontaneous intracranial hemorrhage: a systematic review and meta-analysis.Journal of neurology · 2025Pooled it
- The potential of point-of-care diagnostics to optimise prehospital trauma triage: a systematic review of literature.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Pooled it
- Noninvasive intracranial pressure waveforms for estimation of intracranial hypertension and outcome prediction in acute brain-injured patients.Journal of clinical monitoring and computing · 2023Trial
- Pulsatility Index Measurement via the Submandibular Internal Carotid Artery: An Alternative to Transcranial Assessment.Neurocritical care · 2026Observational
- Transcranial Doppler findings in patients with COVID-19: a prospective observational study.Arquivos de neuro-psiquiatria · 2026Observational
- The modulating role of memory load on language switching in sentence comprehension: evidence from eye movements.BMC psychology · 2026Article
- Optic Nerve Sheath Diameter and Transcranial Doppler Pulsatility Index for Non-Invasive ICP Assessment in Acute Intracerebral Hemorrhage.Brain sciences · 2026Article
- Paediatric and adult neurological point-of-care ultrasound: Review of the evidence, and the UK accreditation pathway.Journal of the Intensive Care Society · 2026Article
- Non-invasive intracranial pressure estimation in the intensive care unit: narrative review of methods and clinical applications.Intensive care medicine · 2026Review
- Non-invasive ICP monitoring when invasive systems are available in the care of acute brain injured patients: a clinical approach.Journal of anesthesia, analgesia and critical care · 2026Article
- Multimodal Monitoring in Eclamptic Intracerebral Hemorrhage Complicated by Reversible Cerebral Vasoconstriction Syndrome (RCVS): A Case Report.Case reports in critical care · 2026Article
- Systematic review of the diagnostic accuracy of noninvasive intracranial pressure monitoring using optic nerve sheath diameter and the Brain4Care system.Brain & spine · 2026Review
- Application of GHOST-CAP strategy combined with multimodal monitoring in the treatment of a patient with polytrauma complicated by severe traumatic brain injury: a case report.Frontiers in medicine · 2026Article
- A Multimodal Non-invasive Approach for Intracranial Pressure Assessment: A Single-Center Study.Cureus · 2025Article
- Novel and classic imaging signs of increased intracranial pressure.Neuroradiology · 2025Article
- Clinical Performance of the Brain4care System for Noninvasive Detection of Intracranial Hypertension.Neurocritical care · 2025Article
- Is quantitative pupillometry affected by ambient light? A prospective crossover study.Journal of clinical monitoring and computing · 2025Article
- Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough placement of an intra-cerebral catheter remains the gold standard method for measuring intracranial pressure (ICP), several non-invasive techniques can provide useful estimates. The aim of this study was to compare the accuracy of four non-invasive methods to assess intracranial hypertension.
methodsWe reviewed prospectively collected data on adult intensive care unit (ICU) patients with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), or intracerebral hemorrhage (ICH) in whom invasive ICP monitoring had been initiated and estimates had been simultaneously collected from the following non-invasive indices: optic nerve sheath diameter (ONSD), pulsatility index (PI), estimated ICP (eICP) using transcranial Doppler, and the neurological pupil index (NPI) measured using automated pupillometry. Intracranial hypertension was defined as an invasively measured ICP > 20 mmHg.
resultsWe studied 100 patients (TBI = 30; SAH = 47; ICH = 23) with a median age of 52 years. The median invasively measured ICP was 17 [12-25] mmHg and intracranial hypertension was present in 37 patients. Median values from the non-invasive techniques were ONSD 5.2 [4.8-5.8] mm, PI 1.1 [0.9-1.4], eICP 21 [14-29] mmHg, and NPI 4.2 [3.8-4.6]. There was a significant correlation between all the non-invasive techniques and invasive ICP (ONSD, r = 0.54; PI, r = 0.50; eICP, r = 0.61; NPI, r = - 0.41-p < 0.001 for all). The area under the curve (AUC) to estimate intracranial hypertension was 0.78 [CIs = 0.68-0.88] for ONSD, 0.85 [95% CIs 0.77-0.93] for PI, 0.86 [95% CIs 0.77-0.93] for eICP, and 0.71 [95% CIs 0.60-0.82] for NPI. When the various techniques were combined, the highest AUC (0.91 [0.84-0.97]) was obtained with the combination of ONSD with eICP.
conclusionsNon-invasive techniques are correlated with ICP and have an acceptable accuracy to estimate intracranial hypertension. The multimodal combination of ONSD and eICP may increase the accuracy to estimate the occurrence of intracranial hypertension.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.