Optic nerve sheath diameter ultrasonography at admission as a predictor of intracranial hypertension in traumatic brain injured patients: a prospective observational study

2020 ◽  
Vol 132 (4) ◽  
pp. 1279-1285 ◽  
Author(s):  
Chiara Robba ◽  
Joseph Donnelly ◽  
Danilo Cardim ◽  
Tamara Tajsic ◽  
Manuel Cabeleira ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Reactivity Index ◽  
Nerve Sheath ◽  
Secondary Injuries ◽  
Patients At Risk ◽  
Severe Tbi ◽  
Injured Patients

OBJECTIVEIntracranial hypertension and impaired cerebral autoregulation are common causes of secondary injuries in patients with traumatic brain injury (TBI). The primary outcome of this study was to assess whether a noninvasive method to estimate intracranial pressure (ICP) based on the ultrasonography of the optic nerve sheath diameter (ONSD) measured at the time of neurocritical care unit (NCCU) admission is correlated with the mean ICP during NCCU stay. Secondary outcomes were to assess whether ONSD is correlated with the dose of ICP > 20 mm Hg and impaired autoregulation during NCCU stay and with instantaneous ICP and whether ONSD is associated with NCCU mortality.METHODSThis prospective observational monocentric study included adults with severe TBI. ONSD was measured at NCCU admission, immediately after invasive ICP insertion. ONSD-predicted noninvasive ICP (nICPONSD) was calculated according the formula: nICPONSD= 5 × ONSD − 14 (nICPONSDin mm Hg, ONSD in mm). Autoregulation was measured using the pressure reactivity index (PRx).RESULTSIn total, 100 patients were included in this study. ONSD was significantly correlated with mean ICP (r = 0.46, p < 0.0001), with mean PRx (r = 0.21, p = 0.04), and with the dose of ICP > 20 mm Hg during NCCU stay (r = 0.49, p < 0.0001). Admission nICPONSDwas shown to be significantly correlated with instantaneous ICP (r = 0.85, p < 0.001). ONSD at admission was significantly correlated with NCCU mortality (p = 0.02).CONCLUSIONSONSD measured at NCCU admission can give important information about patients at risk of developing intracranial hypertension and impaired autoregulation. ONSD examination could be useful to screen patients at admission to determine who would benefit from further invasive ICP monitoring.

scholarly journals MRI of the optic nerve sheath and globe in cats with and without presumed intracranial hypertension

2020 ◽  
pp. 1098612X2097610
Author(s):  
Joanna Lodzinska ◽  
Elizabeth Munro ◽  
Darren J Shaw ◽  
Anna Suñol
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Transverse Diameter ◽  
Mri Findings ◽  
Good Reliability ◽  
Nerve Sheath

Objectives The study aimed to: (1) test MRI repeatability of measurements of optic nerve sheath diameter (ONSD), optic nerve diameter (OND) and eye globe transverse diameter (ETD); (2) investigate the associations between the OND, ONSD and ETD; (3) assess whether these measurements are affected by age or body weight; and (4) test the association between ONSD, OND, ETD and ONSD: ETD ratio with presumed intracranial pressure (ICP) status. Methods This was a retrospective and blinded study where patients were allocated to presumed normal or intracranial hypertension groups based on MRI findings. The ONSD and ETD were measured and recorded. Interclass correlation coefficient (ICC) was calculated to investigate interobserver agreement. Data were analysed using the Pearson correlation coefficient, two-sample t-test and general linear model ANOVA. Results: Seventy-seven cats were included, 62 with presumed normal ICP and 15 with presumed intracranial hypertension. The ICC showed moderate-to-good reliability for all measurements. Positive correlations were identified for: (1) ETD and weight; (2) ONSD and age; (3) OND and age; (4) ONSD and ETD; (5) ONSD: ETD ratio and presumed ICP status; and (6) ONSD and presumed ICP status. No difference was detected between the presumed normal and intracranial hypertension groups and ONSD, as well as ONSD: ETD ratio and presumed ICP status when patient age was considered. Conclusions and relevance The measurement of the ONSD and the ONSD: ETD ratio on T2-weighted MRI might not be reliable as non-invasive tests for diagnosing intracranial hypertension in cats.

scholarly journals Optic nerve sheath diameter: A novel way to monitor the brain

2017 ◽  
Vol 04 (04) ◽  
pp. S13-S18 ◽  
Author(s):  
Seelora Sahu ◽  
Amlan Swain
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Pressure Management ◽  
Pressure Monitoring ◽  
Nerve Sheath ◽  
Brain Injured ◽  
Injured Patients ◽  
The Brain

AbstractMeasurement and monitoring of intracranial pressure is pivotal in management of brain injured patients. As a rapid and easily done bed side measurement, ultrasonography of the optic nerve sheath diameter presents itself as a possible replacement of the conventional invasive methods of intracranial pressure management. In this review we go through the evolution of optic nerve sheath diameter measurement as a novel marker of predicting raised intracranial pressure, the modalities by which it can be measured as well as its correlation with the invasive methods of intracranial pressure monitoring.

Measurement of Optic Nerve Sheath Diameter for the Assessment of Risk of Raised Intracranial Pressure

2009 ◽  
Vol 4 (1) ◽  
pp. 50 ◽  
Author(s):  
Thomas Geeraerts ◽  
David K Menon ◽  
Dan Benhamou ◽  
◽  
◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Brain Magnetic Resonance Imaging ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Raised Intracranial Pressure ◽  
Nerve Sheath ◽  
Patients At Risk ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri

Raised intracranial pressure (ICP) is associated with poor outcome after brain injury, but is difficult to detect without invasive devices. As a part of the central nervous system, the optic nerve is surrounded by a dural sheath, and the subarachnoid space surrounding the optic nerve is subject to the same pressure changes as the intracranial compartment. Distension of the optic nerve sheath reflects an increase in cerebrospinal fluid (CSF) pressure and can be used to estimate the risk of raised ICP. Ocular sonography or brain magnetic resonance imaging (MRI) enables valid measurement of the distension of the dural sheath surrounding the optic nerve. An optic nerve sheath diameter greater than 5.8mm is likely to be associated with raised ICP. This non-invasive estimate of ICP may detect patients at risk, help make decisions regarding the placement of invasive ICP devices and allow the selection of patients for transfer to specialist centres.

Sonographic assessment of the optic nerve sheath diameter in the diagnosis of idiopathic intracranial hypertension

2016 ◽  
Vol 361 ◽  
pp. 122-127 ◽  
Author(s):  
Pablo del Saz-Saucedo ◽  
Olga Redondo-González ◽  
Ángel Mateu-Mateu ◽  
Rafael Huertas-Arroyo ◽  
Rafael García-Ruiz ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Nerve Sheath ◽  
Sonographic Assessment
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