Estimation of intracranial pressure using computed tomography scan findings in patients with severe head injury

Surg Neurol. 1990 Mar;33(3):178-84. doi: 10.1016/0090-3019(90)90181-n.

Abstract

The relationship between initial intracranial pressure and the findings of the first computed tomography scan on admission was assessed in 100 consecutive moderate-to-severe head injury patients using a method of multiple regression analysis. Intracranial pressure was measured through a slender subarachnoid catheter with a transducer. Thirty-nine checkpoints of computed tomography findings, including a shift of midline structure, the status of ventricles or cisterns, and the amount of subarachnoid hemorrhage, were investigated. The results were as follows: (1) The computed tomography findings that contributed to estimating intracranial pressure were the appearance of cisterns, the size of a subdural hematoma (number of slices), ventricular size, status of subarachnoid hemorrhage, status of cerebral contusion, magnitude of midline shift, and ventricular index, in that order. (2) Approximately 80% of predicted cases of intracranial pressure were included within the range of measured intracranial pressure +/- 10 mmHg. When the predicted intracranial pressure was less than 30 mmHg, the discrepancy between both intracranial pressures was small. It is concluded that an equation using several computed tomography findings gives a reasonably accurate intracranial pressure for the initial stage of severe head injury.

MeSH terms

  • Adolescent
  • Adult
  • Brain Concussion / diagnostic imaging
  • Cerebral Hemorrhage / diagnostic imaging
  • Cisterna Magna / diagnostic imaging
  • Craniocerebral Trauma / diagnostic imaging*
  • Humans
  • Intracranial Pressure*
  • Middle Aged
  • Pneumocephalus / diagnostic imaging
  • Regression Analysis
  • Tomography, X-Ray Computed*