Correlation of intracranial pressure and diameter of the sheath of the optic nerve by computed tomography in severe traumatic brain injury

Turkin, A M; Ошоров, А В; Pogosbekyan, E L; As, Smirnov; Dmitrieva, A S

doi:10.17116/neiro201781681-88

Cited by 7 publications

(8 citation statements)

References 24 publications

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“…Findings from this study add to the growing body of literature on the relationship between ONSD obtained via CT imaging and invasive measures of ICP monitoring and patient outcomes. Previous studies evaluating correlations between CT ONSD values and invasive ICP monitoring have reported modest to strong correlations ( r = 0.32–0.74 4–7 ). However, previous studies used cross-sectional designs, evaluating a single ONSD measurement from CT with ICP values.…”

Section: Discussionmentioning

confidence: 92%

“…6 When examining the ability of CT ONSD scores to predict ICP, our study findings were also consistent with previous reports among patients with TBI using a single CT examination. The AUC for ability of ONSD values to predict increased ICP in previous studies ranged from 0.75 to 0.87, 6,7,9 with cutoff values ranging from 5.3 to 6.3. [4][5][6][7]9 However, these studies did not report specific time points for CT measurement.…”

Section: Discussionmentioning

confidence: 95%

“…The AUC for ability of ONSD values to predict increased ICP in previous studies ranged from 0.75 to 0.87, 6,7,9 with cutoff values ranging from 5.3 to 6.3. [4][5][6][7]9 However, these studies did not report specific time points for CT measurement. Our study found that ONSD measurements obtained with T2 CT scans were the strongest predictor of increased ICP.…”

Section: Discussionmentioning

confidence: 95%

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Serial Optic Nerve Sheath Diameter via Radiographic Imaging

et al. 2021

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Background:Evaluation of optic nerve sheath diameter (ONSD) is a suggested correlate of intracranial pressure (ICP) and potential predictor of outcome after neurological injury. Studies have evaluated sonographic measurement of ONSD, yet clinical limitations to this approach persist. Evaluation of ONSD measurements via routine brain computed tomography (CT) imaging is less studied but offers potential for detection of increased ICP in the absence of invasive monitoring. Previous studies have employed cross-sectional approaches to ONSD measurements via CT scan among traumatic brain injury (TBI) patients. No studies have evaluated serial correlations between CT ONSD measurements and ICP throughout hospitalization and across diagnosis types. The objective of this study was to investigate correlations between ONSD via serial CT imaging, ICP, and outcome at discharge among patients with neurological injury.Methods:Retrospective cohort study of all adult patients admitted during a 12 month period with acute neurological injury requiring ICP monitoring and critical care admission.Results:N=48. There was a strong, positive correlation between right/left ONSD across time points (r=0.7-9, p<0.001), suggesting a consistent bilateral response. Correlations were strongest between initial inpatient CT scan ONSD readings and ICP (r=0.5, p<0.05), but decreased over time. Patients with increased ICP across all diagnosis types experienced higher ONSD values upon presentation to the emergency department (ED) and throughout hospitalization (range 5.7mm-6.4mm, p<0.05).Conclusions:Findings contribute to the utility of CT ONSD measurements as a potential indicator of increased ICP. Measurement of ONSD during serial CT brain imaging may inform clinical decisions regarding need for more invasive monitoring after neurological injury.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

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Serial Optic Nerve Sheath Diameter via Radiographic Imaging

et al. 2021

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“…High-resolution MRI can be used to measure the ONSD for improved diagnosis of elevated ICP (15,16). A positive correlation was reported between the ONSD and ICP; consequently, the ONSD can be used as a diagnostic indicator of increased ICP (17). The absence of a distinct ONSD cutoff value to identify elevated ICP is primarily due to different examining tools, observers' skill levels, or ONSD fluctuation.…”

Section: Introductionmentioning

confidence: 99%

Pediatric optic nerve and globe measurements on magnetic resonance imaging: establishing norms for children

Raffa

Kamal

et al. 2023

Acta Radiol

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Background Normal optic nerve diameter (OND) and optic nerve sheath diameter (ONSD) may be beneficial for describing optic nerve pathway abnormality reflecting increased intracranial pressure. Nonetheless, magnetic resonance imaging (MRI) measurement of the normal ONSD range and its associations with clinical factors and eyeball transverse diameter (ETD) are not well established in children. Purpose To establish normal OND, ONSD, ETD, and OND/ONSD and ONSD/ETD measurements in children and their associations with age and sex. Material and Methods We evaluated and analyzed 336 brain MRI studies of children aged 0.5 months to 18 years. We measured a total of 672 optic nerves. The OND and ONSD were measured 1 cm anterior to the optic foramina and 3 mm behind the optic disc on an axial T2 sequence. Results The mean OND 3 mm and 1 cm, ONSD 3 mm and 1 cm, and ETD were 0.23 ± 0.05 mm and 0.16 ± 0.04 mm, 0.53 ± 0.08 mm and 0.38 ± 0.06 mm, and 2.3 ± 0.13, respectively. Only ONSD 1 cm was independent of age ( P = 0.247). ONSD 3 mm and ETD were significantly wider in boys compared to girls and significantly influenced by age (both P < 0.001). Age at scan and ETD were significantly correlated ( P < 0.001). Conclusion We established MRI-based OND, ONSD, ETD, and ONSD/ETD and OND/ONSD ratio normative values in children, which can be helpful in pediatric populations with disease.

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“…High-resolution MRI can be used as a tool for measuring optic nerve sheath diameter (ONSD) adding in diagnosis of raised intracranial pressure [5,6]. A positive correlation was found between the measurement of optic nerve sheath diameter and the intracranial pressure value, so the optic nerve sheath diameter value can be used as an additional criterion for the diagnosis of increased intracranial pressure [7].…”

Section: Introductionmentioning

confidence: 99%

MRI measurement of optic nerve sheath diameter using 3D driven equilibrium sequence as a non-invasive tool for the diagnosis of idiopathic intracranial hypertension

Abdelrahman

Barakat

2020

Egypt J Radiol Nucl Med

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Background: The idiopathic intracranial hypertension is a disease that is represented by high intracranial pressure of unknown reason. The visual disturbance presents the main medical problem of this syndrome. This study was conducted to assess the diagnostic value of the optic nerve sheath diameter (ONSD) measured using MRI 3D DRIVE in the diagnosis of idiopathic intracranial hypertension.Results: The mean value of the ONSD measured using 3D DRIVE sequence in the patient group (5.81 ± 0.33) was significantly higher than the mean value of the normal control group (4.95 ± 0.45) (p < 0.001). The optimal optic nerve sheath diameter cut-off value for diagnosing idiopathic intracranial hypertension was > 5.31 mm, with 94.12% sensitivity and 93.3% negative predictive value. Conclusion:The high resolution of 3D DRIVE provides an accurate measurement of ONSD which correlated with elevated cerebrospinal fluid pressure and hence the diagnosis of idiopathic intracranial hypertension.

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Correlation of intracranial pressure and diameter of the sheath of the optic nerve by computed tomography in severe traumatic brain injury

Abstract: We found a correlation between the CT-based ONSD and the median ICP (R=0.32, p<0.05). An ONSD value of 6.35 mm and more is one of the signs of previous or existing ICP.

Cited by 7 publications

References 24 publications

Serial Optic Nerve Sheath Diameter via Radiographic Imaging

Serial Optic Nerve Sheath Diameter via Radiographic Imaging

Pediatric optic nerve and globe measurements on magnetic resonance imaging: establishing norms for children

MRI measurement of optic nerve sheath diameter using 3D driven equilibrium sequence as a non-invasive tool for the diagnosis of idiopathic intracranial hypertension

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