Table 1.
Summary of quantitative clinical studies to diagnose increased intracranial pressure.
| Author and Year | Study Design | Study Population | Intervention | Comparator | Results |
|---|---|---|---|---|---|
| Kim et al., 2021 [4] | Prospective observational study | 199 adults with suspected raised ICP | Sonographic ONSD | CT scan | Median sonographic ONSD wider in raised ICP patients (5.7 mm vs. 4.3 mm) |
| Ideal cut point of 5.3 mm Sensitivity 75% Specificity 91% | |||||
| Hanafi et al., 2019 [5] | Prospective observational study | 112 adults with traumatic headache vs. controls | Sonographic ONSD | CT scan | Mean sonographic ONSD wider in patients (6.06 mm vs. 3.04 mm) |
| Ideal cut point of 5.3 mm yielding: Sensitivity 96% Specificity 71% | |||||
| Ohle et al., 2015 [6] | Meta-analysis | 478 adults across 12 studies with suspected raised ICP | Sonographic ONSD | CT scan | Sensitivity 96% Specificity 92% +LR 12.5 −LR 0.05 |
| Robba et al., 2018 [7] | Meta-analysis | 320 adults across 7 studies with suspected raised ICP | Sonographic ONSD | Invasive ICP measurement | DOR 68 +LR 5.4 −LR 0.09 |
| Aletreby et al., 2022 [8] | Meta-analysis | 619 adults across 16 studies with suspected raised ICP | Sonographic ONSD | Invasive ICP measurement | Sensitivity 90% Specificity 85% +LR 6.1 −LR 0.11 DOR 46.7 |
| Koziarz et al., 2019 [9] | Meta-analysis | 4551 patients of any age across 71 studies with suspected raised ICP | Sonographic ONSD | Any reference standard (CT or invasive ICP measurement) | Traumatic brain injury: Sensitivity 97% Specificity 86% +LR 6.9 −LR 0.04 |
| Non-traumatic injury Sensitivity 92% Specificity 86% +LR 6.9 −LR 0.09 | |||||
| Optimal cut point of 5.0 mm | |||||
| Kim et al., 2019 [10] | Meta-analysis | 352 adults across 6 studies with suspected raised ICP | Sonographic ONSD with a cut point of 5.0 mm in all included studies | CT scan | Sensitivity 99% Specificity 73% +LR 4.6 −LR 0.05 DOR 178 |
| Fernando et al., 2019 [11] | Meta-analysis | 5123 adults across 40 studies with suspected raised ICP | Physical exam, sonographic ONSD, or CT imaging | Invasive ICP measurement or craniotomy with operative diagnosis of raised ICP | Pupillary dilation: Sensitivity 28% Specificity 86% |
| Motor posturing: Sensitivity 54% Specificity 64% | |||||
| Decreased level of consciousness: Sensitivity 76% Specificity 40% | |||||
| Sonographic ONSD: AUROC 0.94 | |||||
| CT absence or compression of basal cisterns: Sensitivity 86% Specificity 61% | |||||
| CT any midline shift: Sensitivity 81% Specificity 43% | |||||
| CT severe midline shift: Sensitivity 21% Specificity 89% |