Ocular sonography in patients with raised intracranial pressure: the papilloedema revisited

doi:10.1186/cc6893

Critical Care
Volume 12
Issue 3

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Commentary

Ocular sonography in patients with raised intracranial pressure: the papilloedema revisited

Thomas Geeraerts¹^,2 , Jacques Duranteau² and Dan Benhamou²

¹University Department of Anaesthesia, Addenbrooke's Hospital and University of Cambridge, Cambridge CB2 2QQ, UK

²AP-HP, Univ Paris-Sud, Hôpital Bicêtre, Département d'Anesthésie-Réanimation, F-94275 Le Kremlin-Bicêtre, France

author email corresponding author email

Critical Care 2008, 12:150doi:10.1186/cc6893


Published:	16 May 2008

See related research by Soldatos et al., http://ccforum.com/content/12/3/R67

Abstract

Invasive devices are recommended for the early detection of raised intracranial pressure (ICP) after severe traumatic brain injury. Owing to contraindication or local issues, however, invasive ICP monitoring is not always possible. Moreover, a significant proportion of moderate traumatic brain injury patients (managed without invasive ICP) will develop raised ICP. Reliable noninvasive ICP techniques are therefore needed. Soldatos and colleagues report the usefulness of ocular sonography in the diagnosis of raised ICP. Focusing on cerebrospinal fluid accumulation around the retrobulbar optic nerve, they show interesting results for the optic nerve sheath diameter in the diagnosis of raised ICP. If confirmed by further studies, and despite important limitations related to sonography, this technique could serve as a screening test in patients at risk for raised ICP, when invasive monitoring is not possible or is not clearly recommended.