Accuracy of head computed tomography in predicting intracranial pressure for nontraumatic intracranial hemorrhage

Few data exists to demonstrate the accuracy of head computed tomography (CT) for patients with spontaneous intracranial hemorrhage. This retrospective review of patients with nontraumatic intracranial hemorrhage treated with external ventricular drain placement offers clarity.
Identification of ≥1 radiographic feature of elevated intracranial pressure had just 32% accuracy in predicting elevated opening pressure. Likewise, identification of ≥1 radiographic feature was only predictive of elevated intracranial pressure during hospitalization in 59% of cases.
The authors concluded that head CT had poor accuracy for predicting elevated intracranial pressure with ≥50% of patients with spontaneous intracranial hemorrhage not displaying radiographic features identifiable by CT.