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The Utility and Effectiveness of Non-Invasive Intracranial Pressure Monitoring in Craniosynostosis: A Systematic Review
Quan Lu, BA, Anthony DeLeonibus, MD, Niyant Patel, MD
N/A
2023-02-15
Presenter: Quan Lu
Affidavit:
Certify that the following work is original, has not been presented or published prior to this submission.
Director Name: Ananth Murthy, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction:
One of the most significant untoward effects of craniosynostosis is the deleterious sequelae of increased intracranial pressures (ICP). The gold standard for measuring ICP is ventricular catheter. These procedures are invasive, time-consuming, costly, and have risk for morbidity. The objective of this study was to systematically evaluate the literature to report on the utility, success, and failures of non-invasive monitoring (NIM) against direct monitoring in craniosynostosis patients.
Methods:
A PRISMA guided literature review from all recorded history to present was performed utilizing Pubmed, Cochrane, and Web of Science. Inclusion criteria: (NIM) against a direct/invasive ICP monitoring technique in craniosynostosis patients. Exclusion criteria: non-English, non-human, invasive measurement studies alone.
Results:
There were 700 results with 50 (7.17%) final full-text reports. The most common NIM included radiographic findings, clinical signs/symptoms, ocular ultrasonography, fundoscopy, visual evoked potentials, optical coherence tomography, telemetric, epicutaneous monitoring, and transcranial doppler ultrasound. Forty-seven studies reported on the use of NIM and 3 studies reported on telemetric monitoring which provides NIM following implantation. NIM sensitivity and specificity for ICP was reported in 12/50 studies. In total, 8/50 reported a lack of correlation and 22/50 reported associated correlation between invasive and NIM.
Conclusion:
Although direct ICP monitoring is considered the gold standard when evaluating ICP of patients with craniosynostosis, NIM provides medically relevant information pertinent for decision making. The present study concurs that the use of NIM provides valuable information and when used in combination with other methods, allows for detection of elevated ICP with considerably less associated risk.
