Association Between Optic Nerve Sheath Diameter and Mortality in Patients with Severe Traumatic Brain Injury

Sekhon, Mypinder S.; McBeth, Paul B.; Zou, Jie; Qiao, Lu; Kolmodin, Leif; Henderson, William R.; Reynolds, Steve; Griesdale, Donald

doi:10.1007/s12028-014-0003-y

Cited by 70 publications

(49 citation statements)

References 32 publications

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“…Overall, the cohort had a mean age of 35 years and 171 of 220 were male. The median admission GCS was 6 (Sekhon et al, 2014). The correlation between ONSD and mortality was further supported by another study where the enlargement of ONSD on initial CT scan has been found to be associated with increased mortality after severe TBI.…”

Section: Traumatic Optic Neuropathymentioning

confidence: 99%

An insight into the vision impairment following traumatic brain injury

Sen

2017

Neurochemistry International

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Traumatic brain injury (TBI) is one of the major cause of morbidity and mortality and it affects more than 1.7 million Americans each year. Depending on its location and severity, TBI leads to structural and functional damage in several parts of the brain such as cranial nerves, optic nerve tract or other circuitry involved in vision, and occipital lobe. As a result, the function associated with vision processing and perception are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. In this mini-review, we will focus the recent progress made to understand the pathology and underlying cellular/molecular mechanisms involved in the impairment of the integrity of visual systems following TBI.

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Section: Traumatic Optic Neuropathymentioning

confidence: 99%

An insight into the vision impairment following traumatic brain injury

Sen

2017

Neurochemistry International

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“…Noninvasive devices do not reliably quantify ICP [46]. However, they may be used to estimate ICP when invasive monitoring is not feasible, along with information from imaging [47][48][49]. It remains a mandatory prerequisite, exploring the volume relationship inside the skull, when other intracranial monitors, exploring other domains, are used to provide a framework for optimal interpretation (Fig.…”

Section: Intracranial and Cerebral Perfusion Pressure Monitoringmentioning

confidence: 99%

Recommendations for the use of multimodal monitoring in the neurointensive care unit

Citerio

Oddo

Taccone

2015

Current Opinion in Critical Care

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MMM allows comprehensive exploration of the complex pathophysiology of acute brain damage and, depending on the different configuration of the pathological condition we are treating, the application of targeted individualized care. Unfortunately, we still lack robust evidence on how to better integrate MMM-derived information at the bedside to improve patient management. Advanced informatics is promising and may provide us a supportive tool to interpret physiologic events and guide pathophysiological-based therapeutic decisions.

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“…ONSD has been shown to correlate with ICP and with outcome in the setting of traumatic brain injury (TBI). 9,10 In TBI, ICP monitoring as a means to guide therapy is the standard of care, and the ONSD may be a useful surrogate. 11 Whereas the role of ICP monitoring in TBI is well established, its role in HIBI is less clear.…”

Section: Introductionmentioning

confidence: 99%

Optic nerve sheath diameter on computed tomography not predictive of neurological status post-cardiac arrest

Rush

Wormsbecker

Berger

et al. 2016

CJEM

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Objective: Optic nerve sheath diameter (ONSD) measured on a head computed tomography (CT) has been suggested as a potential prognostic factor for poor neurological outcome after cardiac arrest. We performed a single centre retrospective cohort analysis to further investigate this relationship. Methods: All patients >18 years of age admitted to St. Paul's Hospital in Vancouver, Canada who survived a cardiac arrest and had a CT scan of the head within 48 hours were included in the analysis. Results: A total of 72 patients met inclusion criteria for the study; 54 (75.0%) of the patients had a poor neurological outcome, whereas 18 (25.0%) patients were discharged from the hospital with a good outcome. A CT head was obtained for patients in the good outcome group in a mean time of 9.3 hours (SD 10.0) compared to 10.2 hours (SD 11.2) for the poor outcome group (p = 0.75). There was no difference in average ONSD observed between the two outcome groups (6.66 mm SD 0.78 v. 6.60 mm SD 0.82, p = 0.77). Multiple logistic regression failed to show any association between ONSD and neurological outcome when adjusted for all other covariates (OR 1.32 95% CI 0.40-4.34, p = 0.65). Setting an ONSD threshold of >8 mm (OR 2.32, 95% CI 0.14-39.40, p = 0.55) or >7 mm (OR 0.28, 95% CI 0.03-2.77, p = 0.28) also failed to show any association on neurological outcome. Conclusion: There was no observed difference in ONSD between those with a good neurological outcome and those with a poor outcome. ONSD was not an independent predictor of poor neurological outcome. RÉSUMÉObjectifs : Certains sont d'avis que la mesure du diamètre de la gaine du nerf optique par une tomodensitométrie (TDM) de la tête pourrait se révéler un facteur pronostique possible de séquelles neurologiques graves à la suite d'un arrêt cardiaque. Les auteurs de l'étude ont donc procédé à une analyse rétrospective, unicentrique de cohorte afin d'approfondir l'existence de la relation. Méthode : Tous les patients âgés de plus de 18 ans, admis à l'hôpital St-Paul à Vancouver, au Canada, qui ont survécu à un arrêt cardiaque et qui ont subi une TDM de la tête dans les 48 heures ont été inclus dans l'analyse. Résultats : Soixante-douze patients respectaient les critères d'inclusion dans l'étude; sur ce nombre, 54 (75,0 %) ont connu des séquelles neurologiques graves, tandis que 18 (25,0 %) sont sortis de l'hôpital dans un bon état. Il s'est écoulé en moyenne 9,3 heures (écart-type [σ] : 10,0) avant que la TDM de la tête soit réalisée dans le groupe ayant connu une évolution favorable contre 10,2 heures (σ : 11,2) dans le groupe ayant connu une évolution défavorable (p = 0,75). Aucun écart n'a été relevé entre les deux groupes en ce qui concerne le diamètre moyen de la gaine du NO (6,66 mm; σ : 0,78 contre 6,60 mm; σ : 0,82; p = 0,77). Plusieurs analyses de régression logistique ont été réalisées, et aucune n'a démontré l'existence d'une relation entre le diamètre de la gaine du NO et l'état neurologique après rajustement de toutes les autres covariables (risque relatif ...

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Association Between Optic Nerve Sheath Diameter and Mortality in Patients with Severe Traumatic Brain Injury

Abstract: In patients with TBI, ONSD measured on CT scanning was independently associated with ICP and mortality.

Cited by 70 publications

References 32 publications

An insight into the vision impairment following traumatic brain injury

An insight into the vision impairment following traumatic brain injury

Recommendations for the use of multimodal monitoring in the neurointensive care unit

Optic nerve sheath diameter on computed tomography not predictive of neurological status post-cardiac arrest

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