title: Estimation of intracranial pressure using computed tomography scan findings in patients with severe head injury.
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.
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, University of Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Mizutani
authors.forename: S
authors.initials: S
authors.lastname: Manaka
authors.forename: H
authors.initials: H
authors.lastname: Tsutsumi
mesh_terms: D000293:Adolescent; D000328:Adult; D001924:Brain Concussion / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging; D002946:Cisterna Magna / Q000000981:diagnostic imaging; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging*; D006801:Humans; D007427:Intracranial Pressure; D008875:Middle Aged; D011007:Pneumocephalus / Q000000981:diagnostic imaging; D012044:Regression Analysis; D014057:Tomography, X-Ray Computed