Editors’ Note: WriteClick correspondence this week centers on the article by Dr. Ragauskas et al., “Clinical assessment of noninvasive intracranial pressure absolute value measurement method.” Dr. Liebeskind et al. bring up variability in the microanatomy of the ophthalmic artery that argues against the authors' methodology. Dr. Miller et al. disagree that extracranial ophthalmic arterial blood flow is independent of CSF, citing their own data on the subject. Authors Ragauskas et al. dispute both claims. Megan Alcauskas, MD, and Robert C. Griggs, MD
Ragauskas et al.1 demonstrated that when external pressure is applied, the orbit tends to equilibrate flow in the ipsilateral ophthalmic artery (OA) when its level approaches intracranial pressure (ICP). The authors detected this relationship by making the OA into a “natural pair of scales, in which the intracranial segment of the OA is compressed by extracranial pressure (Pe) applied to the orbit.”
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