scholarly journals Optic Nerve Sheath Diameter as a Bedside Assessment for Elevated Intracranial Pressure

2017 ◽  
Vol 2017 ◽  
pp. 1-2 ◽  
Author(s):  
Peter Williams
Keyword(s):  
Computed Tomography ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Elevated Intracranial Pressure ◽  
Computed Tomography Scan ◽  
Obstructive Lesion ◽  
Nerve Sheath ◽  
Tomography Scan

A previously fit and healthy 26-year-old lady with no significant medical history presented with a two-month history of headaches. The headaches were prolonged, generalised, and unusually severe for the patient. Examination revealed papilloedema. The patient’s optic nerve sheath diameter was measured 3 mm posterior to the globe and found to be 7.5 mm. The patient subsequently had computed tomography scan of her brain that showed an optic nerve sheath diameter of 7.56 mm as measured 3 mm posterior to the globe. After an obstructive lesion was ruled out on the computed tomography scan, a lumbar puncture was then performed and cerebrospinal fluid was drained. An ultrasound of the optic nerve sheath diameter was repeated showing a reduced diameter of 5.6 mm. The patient was admitted to the neurology unit and ultimately diagnosed with idiopathic intracranial hypertension. This case report highlights the potential of rapidly identifying elevated intracranial pressure using a noninvasive method.

scholarly journals Optic Nerve Sheath Diameter Correlation with Elevated Intracranial Pressure Determined via Ultrasound

Cureus ◽  
2019 ◽  
Author(s):  
Kamran Munawar ◽  
Muhammad Tariq Khan ◽  
Syed Waqar Hussain ◽  
Aayesha Qadeer ◽  
Zahid Siddique Shad ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Elevated Intracranial Pressure ◽  
Nerve Sheath

scholarly journals Elevated Intracranial Pressure Diagnosis with Emergency Department Bedside Ocular Ultrasound

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
D. Amin ◽  
T. McCormick ◽  
T. Mailhot
Keyword(s):  
Emergency Department ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Vision Loss ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Elevated Intracranial Pressure ◽  
Nerve Sheath ◽  
Ocular Ultrasound ◽  
Fundoscopic Examination

Bedside sonographic measurement of optic nerve sheath diameter can aid in the diagnosis of elevated intracranial pressure in the emergency department. This case report describes a 21-year-old female presenting with 4 months of mild headache and 2 weeks of recurrent, transient binocular vision loss. Though limited by patient discomfort, fundoscopic examination suggested the presence of blurred optic disc margins. Bedside ocular ultrasound (BOUS) revealed wide optic nerve sheath diameters and bulging optic discs bilaterally. Lumbar puncture demonstrated a cerebrospinal fluid (CSF) opening pressure of 54 cm H2O supporting the suspected diagnosis of idiopathic intracranial hypertension. Accurate fundoscopy can be vital to the appropriate diagnosis and treatment of patients with suspected elevated intracranial pressure, but it is often technically difficult or poorly tolerated by the photophobic patient. BOUS is a quick and easily learned tool to supplement the emergency physician’s fundoscopic examination and help identify patients with elevated intracranial pressure.

scholarly journals The relationship between computed tomography measurement of the optic nerve sheath diameter and elevated intracranial pressure in non-trauma patients

2016 ◽  
Vol 20 (1) ◽  
Author(s):  
Daniël Luyt ◽  
Delmé Hurter ◽  
Gina Joubert
Keyword(s):  
Computed Tomography ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Digital Images ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Trauma Patients ◽  
Cross Sectional ◽  
Nerve Sheath ◽  
The Brain

Background: The early detection and treatment of raised intracranial pressure (ICP) is critical in the prevention of mortality and morbidity as a result of secondary ischemic brain injury. Measuring the optic nerve sheath diameter (ONSD) on computed tomography (CT) to predict raised ICP may be useful in cases where routine CT investigations of the brain are indicated and invasive ICP monitoring is not available, or a lumbar puncture (LP) is contraindicated.Objective: The purpose of this study was to determine if the ONSD can be measured on digital images obtained by routine CT investigations of the brain, to identify patients with non-traumatic causes of elevated ICP, and to provide the observer with a non-invasive, objective measurement to predict elevated ICP.Method: We conducted a cross-sectional, retrospective analysis of anonymised patient data, comparing the ONSD on CT imaging with the opening pressure manometry during LP on patients who presented with focal neurology or with a Glasgow coma scale score of less than 15. The study sample consisted of 67 patients, ≥18 years of age, treated at the emergency department of the Kimberly Hospital Complex from 01 March 2013 to 31 December 2014.Results: An ONSD measurement of ≥4.8 mm identified patients with an elevated ICP with a sensitivity of 92.9% and a specificity of 97.6%, using a 95% confidence interval. Raising the ONSD cut-off value to ≥5.0 mm decreased the sensitivity to 85.7% but increased the specificity to 100%, eliminating all patients with a normal ICP.Conclusion: The ONSD can be measured on digital images obtained by routine CT investigations of the brain to predict elevated ICP in non-trauma patients, ≥18 years of age, with acceptable sensitivity and specificity.

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