Intracranial Pressure

TCD ultrasonography is a crucial non-invasive tool for the detection and management of elevated ICP in critical care settings. It is a safe and rapid method to evaluate for the presence of intracranial hypertension. It can be completed by ICU providers of various skill levels with good repeatability and an easily attainable level of competence. Although it is not deemed a consistently accurate substitute for invasive ICP monitoring, it is helpful in early evaluation and triage when invasive monitoring cannot be employed due to contraindication or availability. By providing real-time insights into cerebral hemodynamics, TCD ultrasonography aids in early diagnosis, continuous monitoring, and guiding therapeutic interventions for patients with elevated ICP. In our practice, we commonly employ TCD, TCCD, PI, and ONSD to evaluate for intracranial hypertension in critical illness when invasive ICP monitors are contraindicated or carry significant risk.