TCD Monitoring is a Non-invasive Method for Assessing Intracranial Pressure before Shunt Surgery in Patients with Hydrocephalus after Head Trauma

Objective: To investigate the predictive value of transcranial Doppler (TCD) spectral parameters on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in patients with hydrocephalus after head trauma. Methods: Lumbar puncture manometry was performed on patients with hydrocephalus after head trauma, TCD examination was performed before lumbar puncture, and the correlation analysis of TCD data and lumbar puncture pressure was carried out and compared with the control group. Results: In the post-traumatic hydrocephalus group with elevated ICP, TCD showed a high-resistance blood flow spectrum, the waveform generally became sharper, the systolic blood flow (Vs) did not change significantly, the diastolic blood flow (Vd) slowed down, and the pulsatile index (PI) increased. Blood flow velocity was significantly faster than in the control group. According to the TCD parameters and the regression equations for predicting ICP (ICPe) and predicting CPP (CPPe), the values of ICPe and CPPe were positively correlated with the measured ICP and CPP values (r=0.594 and 0.910, both P<0.001). Conclusion: TCD spectral parameters can accurately predict the changes of ICP and CPP in patients with post-traumatic hydrocephalus, and can provide reliable guidance for intracranial pressure in such patients before shunt surgery.