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Purpose of Review <p>Intracranial hypertension (IHTN) is a serious condition associated with neurological injuries, making detection crucial to guide swift treatment. This review investigates optimal non-invasive methods for detecting IHTN in the Emergency Department by comparing the effectiveness and utility of different technologies.</p> Recent Findings <p>Automated infrared pupillometry (AIP) was the most cost-effective (NPi-300 cost $0.60USD/use) and timely (3&#xa0;s) method within this study. CT had the highest average sensitivity (93%), and tympanic membrane displacement (TMD) had the highest average specificity (95.9%) when screening for IHTN. Alternatively, ultrasound-detected optic nerve sheath diameter (US-ONSD) provides a cost-effective ($0.75–3.75USD/use) and timely option (~ 10-min), with the second-highest sensitivity (91.9%).</p> Summary <p>AIP and US-ONSD are promising first-line methods to rapidly exclude IHTN in the ED. This guides decision-making on whether neuroimaging is warranted. Future studies could compare non-invasive IHTN screening combinations to create an optimized screening algorithm.</p>

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Comparison of Non-invasive Methods for Measuring Intracranial Hypertension

  • 期刊论文

  • 发表日期：

    2026年7月27日

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  • Danielle Santoyo,
  • Eric Mylfurry,
  • Marilyn Li,
  • Mercylia Untono,
  • Matthew Mellor,
  • Urva Mehveen,
  • Hariharan Ramakrishnan,
  • David Williams,
  • James Paxton

摘要

Purpose of Review

Intracranial hypertension (IHTN) is a serious condition associated with neurological injuries, making detection crucial to guide swift treatment. This review investigates optimal non-invasive methods for detecting IHTN in the Emergency Department by comparing the effectiveness and utility of different technologies.

Recent Findings

Automated infrared pupillometry (AIP) was the most cost-effective (NPi-300 cost $0.60USD/use) and timely (3 s) method within this study. CT had the highest average sensitivity (93%), and tympanic membrane displacement (TMD) had the highest average specificity (95.9%) when screening for IHTN. Alternatively, ultrasound-detected optic nerve sheath diameter (US-ONSD) provides a cost-effective ($0.75–3.75USD/use) and timely option (~ 10-min), with the second-highest sensitivity (91.9%).

Summary

AIP and US-ONSD are promising first-line methods to rapidly exclude IHTN in the ED. This guides decision-making on whether neuroimaging is warranted. Future studies could compare non-invasive IHTN screening combinations to create an optimized screening algorithm.