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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2019; 38(04): 279-283
DOI: 10.1055/s-0036-1594301
Review Article | Artigo de Revisão
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Non-Invasive Intracranial Pressure Evaluation in an Emergency Room – Point-of-Care Ultrasonography

Avaliação não invasiva da pressão intracraniana em uma sala de emergência – ultrassonografia point-of-care
Daniel Damiani 
1   Pós-Graduação em Neurociências, Universidade Anhembi Morumbi, São Paulo, SP, Brazil
,
Durval Damiani
2   Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
› Author Affiliations
Further Information

Publication History

28 July 2016

30 August 2016

Publication Date:
24 November 2016 (online)

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Abstract

Point-of-care ultrasound is modifying conducts in emergency care. The various medical specialties, in addition to traditional indications in cases of multiple trauma, are using this technique for rapid diagnosis at the bedside without patient mobilization and without radiation. Point-of-care ultrasound in neurocritical patients, through its transorbital window, can estimate the intracranial pressure by a non-invasive method. Through the measurement of the diameter of the optic nerve sheath 3 mm posterior to the retina, the intracranial pressure is estimated if the value of the diameter is > 5 mm, as it has been verified in other studies. The present article describes the most current data on this topic, and it also highlights the need for more multicentric and randomized trials to determine the correct cut-off points that represent the high sensibility and specificity of the method.

Resumo

A ultrassonografia point-of-care está modificando as condutas na sala de emergência. As diversas especialidades, além das indicações tradicionais ao politraumatizado, estão utilizando esta técnica para um rápido diagnóstico à beira do leito, sem a necessidade de mobilização do paciente e sem irradiação. Nos pacientes neurocríticos, a ultrassonografia point-of-care, através de sua janela transorbital, oferece uma técnica não invasiva para avaliação da pressão intracraniana. Por meio da medida do diâmetro da bainha do nervo óptico 3 mm posterior à retina, estima-se a pressão intracraniana se o valor desse diâmetro for superior a 5 mm, conforme verificado em alguns estudos. Este artigo apresenta os dados mais atuais sobre o tema, destacando, ainda, a necessidade de mais estudos multicêntricos, randomizados, para a correta determinação dos valores de corte que representem a alta sensibilidade e especificidade do método.

Keywords

point-of-care ultrasound - ultrasound in emergency room - ultrasound in neurocritical patients - optic nerve sheath ultrasound - intracranial hypertension - bedside point-of-care ultrasound

Palavras-chave

ultrassom point-of-care - ultrassom na sala de emergência - ultrassom em pacientes neurocríticos - ultrassom do diâmetro da bainha do nervo óptico - hipertensão intracraniana - ultrassonografia point of-care à beira do leito
 

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