Abstract
Objective
The aim of this study is to prospectively compare the accuracies of transcranial color-coded
sonography (TCCS) and transcranial Doppler (TCD) in the diagnosis of elevated intracranial
pressure.
Methods
A prospective, blinded, head-to-head comparison of TCD and TCCS methods using intracranial
pressure (ICP) measured continuously via an intraparenchymal catheter as the reference
standard in 2 groups of 20 neurocritical care patients each: high ICP (group 1) and
normal ICP (group 2). Middle cerebral artery (MCA) pulsatility index (PI) recordings
from all patients' sonographic reports were selected based on the highest left or
right recorded MCA PI. Transcranial Doppler was performed using a dedicated TCD device,
and TCCS was performed using a portable ultrasound system.
Results
The PI values obtained did not differ significantly between the 2 methods (group 1,
P = .46; group 2, P = .11). Linear regression analysis identified a significant relationship between
PI obtained with both methods (r = 0.897; P < .0001). The duration of PI measurement was statistically longer with TCCS than
TCD (group 1, P < .01; group 2, P < .01). Diagnostic accuracies were good and similar for both methods (TCD area under
curve, 0.901; TCCS area under curve 0.870; P = .69).
Conclusions
This work is a pilot study comparing TCCS and TCD in the detection of elevated ICP.
This study suggests that a bedside portable ultrasound system may be useful to determine
MCA PI with accuracy similar to that of a dedicated TCD device.
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Article Info
Publication History
Published online: June 13, 2011
Accepted:
May 5,
2011
Received in revised form:
April 11,
2011
Received:
February 22,
2011
Footnotes
☆Conflict of Interest Statement: The authors have no conflicts of interest to report. This study was supported by internal department funds.
☆☆Meeting at which the article was presented (preliminary results): 51st meeting of the Société Française d’Anesthésie Réanimation in Paris, France, September 23 to 26, 2009.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
