Our earlier article on ocular ultrasound for measuring intracranial pressure was met with a common question. Primarily, why not just use papilledema as your initial assessment for intracranial pressure? This is what we are taught in medical school. Optic nerve disc swelling equals increased intracranial pressure (ICP). End of Story. Right? Not exactly… While optic disc swelling can indicate increased ICP, it is an inferior measure of acutely elevated ICP. And here is why…
- It’s an indirect measure.
- It’s a late sign of increased ICP.
- It’s more subjective.
- It’s not a dynamic measurement.
- It’s not always practical.