Research Mentor Name
James Paxton, M.D., M.B.A.
Research Mentor Email Address
james.paxton@wayne.edu
Institution / Department
Wayne State University School of Medicine
Document Type
Research Abstract
Research Type
healthimprovement
Graduate Level Research
no
Abstract
Introduction and Purpose of Review:
Intracranial hypertension (IHTN) is a serious complication associated with neurological injuries. Once IHTN is detected, it is crucial to make swift decisions regarding medical treatments. This review focuses on the effectiveness and utility of noninvasive methods used to detect IHTN in the emergency department (ED).
Methods:
We conducted a comprehensive search for PubMed articles to find data on non-invasive intracranial pressure (ICP) evaluation methods including; optic nerve sheath diameter ultrasound (ONSS), automated infrared pupillometry (AIP), Tympanic Membrane Displacement (TMD), Transcranial Doppler Ultrasound (TDU), CT, and MRI. We compared; cost, accuracy, estimated time per method, specificity and sensitivity in detecting IHTN.
Results:
For ICP>20mmHg; AIP [Specificity= 70%, Sensitivity= 65%, AUC= 0.71-0.72, estimated cost= $300USD, time to use= 3s-1min], ONSS [Specificity=87%, Sensitivity=90%, AUC=0.95, cost= $15,000-75,000 USD, time to use= 10min], TDU [Specificity= 70%, Sensitivity= 72%, AUC= 0.725, cost=$15,000-75,000 USD, time to use= 30min-hr], CT [Specificity= 79%, Sensitivity= 93-96%, cost=$80,000-300,000 USD, time to use M=18min], MRI [Specificity= 90-99%, cost=$500,000-7million USD, time to use Mdn=38min.], TMD [Specificity= 100%, Sensitivity= 65%, cost~$34,000 USD, time to use < 5 min].
Conclusion:
When considering time-to-use, cost, sensitivity, specificity, and accuracy, AIP and ONSS show the most promise as first-line methods to rapidly assess ICP in an emergency setting. If ICP is high, this could guide decision-making as to whether a CT or MRI would be warranted to examine underlying pathology.
Disciplines
Medicine and Health Sciences
Recommended Citation
Santoyo, B.S., Danielle; Mylfurry, B.S., Eric; Li, B.S., Marilyn; Mellor, B.S., Matthew; Untono, B.S., Mercylia; Mehveen, B.S., Urva; Ramakrishnan, B.S., Hari; and Paxton, M.D., M.B.A., James, "Comparison of Non-Invasive Methods for Measuring Intracranial Hypertension" (2026). Medical Student Research Symposium. 490.
https://digitalcommons.wayne.edu/som_srs/490