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Fig. 5 | Critical Care

Fig. 5

From: Transcranial Doppler as a screening test to exclude intracranial hypertension in brain-injured patients: the IMPRESSIT-2 prospective multicenter international study

Fig. 5

Algorithm for noninvasive intracranial pressure monitoring through the use of transcranial Doppler (ICPtcd). Once indication for ICP monitoring is decided, application of the invasive method (gold standard) is evaluated: If NO (invasive ICP monitoring not possible) for the presence of one or more of the reasons provided, ICPtcd associated with brain imaging should be performed. *The result should not act as a deterrent for transferal towards a hospital with a Neurosurgical facility or to perform further brain imaging studies, instead ICPtcd should be used as an adjunct capable of providing valuable information for the Clinician; if YES (invasive ICP monitoring possible), then burr hole and insertion of a catheter within the brain parenchyma should be performed. *However, brain ultrasound with transcranial Doppler may be useful in order to obtain surrogate information regarding brain hemodynamics through the evaluation of cerebral blood flow velocity

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Critical Care

ISSN: 1364-8535