Comparison of Non-invasive Methods for Measuring Intracranial Hypertension

Stocchetti N, Maas AI. Traumatic intracranial hypertension. N Engl J Med. 2014;370(22):2121–30. https://doi.org/10.1056/NEJMra1208708.

Article  PubMed  CAS  Google Scholar 

Olaru C, Langberg S, McCoin NS. A review of the clinical presentation, causes, and diagnostic evaluation of increased intracranial pressure in the emergency department. West J Emerg Med. 2024;25(6):1003–10. https://doi.org/10.5811/westjem.18500.

Article  PubMed  PubMed Central  Google Scholar 

Badri S, Chen J, Barber J, Temkin NR, Dikmen SS, Chesnut RM, et al. Mortality and long-term functional outcome associated with intracranial pressure after traumatic brain injury. Intensive Care Med. 2012;38(11):1800–9. https://doi.org/10.1007/s00134-012-2655-4.

Article  PubMed  Google Scholar 

Godoy DA, Nunez-Patino RA, Zorrilla-Vaca A, Ziai WC, Hemphill JC 3rd. Intracranial hypertension after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis of prevalence and mortality rate. Neurocrit Care. 2019;31(1):176–87. https://doi.org/10.1007/s12028-018-0658-x.

Article  PubMed  Google Scholar 

Mahto N, Owodunni OP, Okakpu U, Kazim SF, Varela S, Varela Y, et al. Postprocedural complications of external ventricular drains: a meta-analysis evaluating the absolute risk of hemorrhages, infections, and revisions. World Neurosurg. 2023;171:41–64. https://doi.org/10.1016/j.wneu.2022.11.134.

Article  PubMed  Google Scholar 

Evensen KB, Paulat K, Prieur F, Holm S, Eide PK. Utility of the tympanic membrane pressure waveform for non-invasive estimation of the intracranial pressure waveform. Sci Rep. 2018;8(1):15776. https://doi.org/10.1038/s41598-018-34083-6.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Doximity AI for doctors (2010), Doximity Inc, San Francisco, https://www.doximity.com/ .Accessed 15 June 2026.

511KeV (2024) File: MRI Brain T2 Axial (7).jpg. Wikimedia Commons. https://commons.wikimedia.org/wiki/File:MRI_T2_Brain_axial_image.jpg Accessed 15 June 2026.

Haggstrom, Mikael (2019) File: CT of a normal brain (thumbnail).png. Wikimedia Commons. https://commons.wikimedia.org/wiki/File:CT_of_a_normal_brain_(thumbnail).png Accessed 15 June 2026.

Gopen Q, Rosowski JJ, Merchant SN. Anatomy of the normal human cochlear aqueduct with functional implications. Hear Res. 1997;107(1–2):9–22. https://doi.org/10.1016/s0378-5955(97)00017-8.

Article  PubMed  CAS  Google Scholar 

CCFP | Cerebral Cochlear Fluid Pressure Analyser. https://www.marchbanks.co.uk/ccfp-analyser Accessed 8 Jun 2026.

Marchbanks R. MarchBanks TMD Inquiry Email. In: Mellor M, editor.2025.

Thalen EO, Wit HP, Segenhout JM, Albers FW. Dynamics of inner ear pressure change caused by intracranial pressure manipulation in the guinea pig. Acta Otolaryngol. 2001;121(4):470–6.

Article  PubMed  CAS  Google Scholar 

Olson DM, Fishel M. The use of automated pupillometry in critical care. Crit Care Nurs Clin North Am. 2016;28(1):101–7. https://doi.org/10.1016/j.cnc.2015.09.003.

Article  PubMed  Google Scholar 

Jiang J, Sari H, Goldman R, Huff E, Hanna A, Samraj R, et al. Neurological pupillary index (NPi) Measurement using pupillometry and outcomes in critically Ill children. Cureus. 2023;15(10):e46480. https://doi.org/10.7759/cureus.46480.

Article  PubMed  PubMed Central  Google Scholar 

Neuroptics. https://neuroptics.com/pupillometry-clinical-overview/ Accessed 8 Jun 2026.

Pansell J, Hack R, Rudberg P, Bell M, Cooray C. Can quantitative pupillometry be used to screen for elevated intracranial pressure? A retrospective cohort study. Neurocrit Care. 2022;37(2):531–7. https://doi.org/10.1007/s12028-022-01518-y.

Article  PubMed  PubMed Central  Google Scholar 

Robba C, Pozzebon S, Moro B, Vincent JL, Creteur J, Taccone FS. Multimodal non-invasive assessment of intracranial hypertension: an observational study. Crit Care. 2020;24(1):379. https://doi.org/10.1186/s13054-020-03105-z.

Article  PubMed  PubMed Central  Google Scholar 

Taylor WR, Chen JW, Meltzer H, Gennarelli TA, Kelbch C, Knowlton S, et al. Quantitative pupillometry, a new technology: normative data and preliminary observations in patients with acute head injury. Technical note. J Neurosurg. 2003;98(1):205–13. https://doi.org/10.3171/jns.2003.98.1.0205.

Article  PubMed  Google Scholar 

NPi-200 manual. https://neuroptics.com/wp-content/uploads/2017/02/NPi-200_Instructions.pdf Accessed 8 Jun 2026.

Stutzman S, Iype P, Marshall J, Speir K, Schneider N, Tran C, et al. Inter-device reliability of the NPi-200 and NPi-300 pupillometers. J Clin Neurosci. 2022;100:180–3. https://doi.org/10.1016/j.jocn.2022.04.023.

Article  PubMed  Google Scholar 

Hsu CH, Kuo LT. Application of pupillometry in neurocritical patients. J Pers Med. 2023. https://doi.org/10.3390/jpm13071100.

Article  PubMed  PubMed Central  Google Scholar 

Bowser M. Pupillometer Cost- DMC Email. In: Santoyo D, editor.2025.

Lussier BL, Olson DM, Aiyagari V. Automated pupillometry in neurocritical care: research and practice. Curr Neurol Neurosci Rep. 2019;19(10):71. https://doi.org/10.1007/s11910-019-0994-z.

Article  PubMed  Google Scholar 

Petrosino M, Gouvea Bogossian E, Rebora P, Galimberti S, Chesnut R, Bouzat P, et al. Neurological pupil index and intracranial hypertension in patients with acute brain injury: a secondary analysis of the ORANGE Study. JAMA Neurol. 2025;82(2):176–84. https://doi.org/10.1001/jamaneurol.2024.4189.

Article  PubMed  PubMed Central  Google Scholar 

Montgomery SP, Moore B, Hampton SM, Macy G, Li W, Bronshteyn YS. Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition. J Vis Exp. 2023(198). https://doi.org/10.3791/64929.

Berhanu D, Ferreira JC, Abegao Pinto L, Aguiar de Sousa D, Lucas Neto L, Tavares Ferreira J. The role of optic nerve sheath ultrasonography in increased intracranial pressure: a systematic review and meta analysis. J Neurol Sci. 2023;454:120853. https://doi.org/10.1016/j.jns.2023.120853.

Article  PubMed  Google Scholar 

Koziarz A, Sne N, Kegel F, Nath S, Badhiwala JH, Nassiri F, et al. Bedside optic nerve ultrasonography for diagnosing increased intracranial pressure: a systematic review and meta-analysis. Ann Intern Med. 2019;171(12):896–905. https://doi.org/10.7326/M19-0812.

Article  PubMed  Google Scholar 

Rajajee V, Fletcher JJ, Rochlen LR, Jacobs TL. Comparison of accuracy of optic nerve ultrasound for the detection of intracranial hypertension in the setting of acutely fluctuating vs stable intracranial pressure: post-hoc analysis of data from a prospective, blinded single center study. Crit Care. 2012;16(3):R79. https://doi.org/10.1186/cc11336.

Article  PubMed  PubMed Central  Google Scholar 

Purkayastha S, Sorond F. Transcranial Doppler ultrasound: technique and application. Semin Neurol. 2012;32(4):411–20. https://doi.org/10.1055/s-0032-1331812.

Article  PubMed  Google Scholar 

Rasulo FA, Calza S, Robba C, Taccone FS, Biasucci DG, Badenes R, et al. Transcranial Doppler as a screening test to exclude intracranial hypertension in brain-injured patients: the IMPRESSIT-2 prospective multicenter international study. Crit Care. 2022;26(1):110. https://doi.org/10.1186/s13054-022-03978-2.

Article  PubMed  PubMed Central  Google Scholar 

Wang Y, Duan YY, Zhou HY, Yuan LJ, Zhang L, Wang W, et al. Middle cerebral arterial flow changes on transcranial color and spectral Doppler sonography in patients with increased intracranial pressure. J Ultrasound Med. 2014;33(12):2131–6. https://doi.org/10.7863/ultra.33.12.2131.

Article  PubMed  Google Scholar 

Qu X, Wang H, Du C, Sun B. Value of transcranial color-coded duplex sonography-derived middle cerebral artery pulsatility index in intracranial pressure assessment at moderate to high altitudes. Sci Rep. 2026. https://doi.org/10.1038/s41598-026-44246-5.

Article  PubMed  PubMed Central  Google Scholar 

Rasulo FA, Bertuetti R, Robba C, Lusenti F, Cantoni A, Bernini M, et al. The accuracy of transcranial Doppler in excluding intracranial hypertension following acute brain injury: a multicenter prospective pilot study. Crit Care. 2017;21(1):44. https://doi.org/10.1186/s13054-017-1632-2.

Article  PubMed  PubMed Central  Google Scholar 

de Moraes FM, Adissy ENB, Rocha E, Barros FCD, Freitas FGR, Miranda M, et al. Multimodal monitoring intracranial pressure by invasive and noninvasive means. Sci Rep. 2023;13(1):18404. https://doi.org/10.1038/s41598-023-45834-5.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Horton JC. Idiopathic intracranial hypertension. N Engl J Med. 2025;393(14):1409–19. https://doi.org/10.1056/NEJMra2404929.

Comments (0)

No login
gif