Optic nerve sheath diameter as a quantitative parameter associated with the outcome in patients with traumatic brain injury undergoing hematoma removal

Fujiwara, Gaku; Murakami, Mamoru; Maruyama, Daisuke; Murakami, Nobukuni

doi:10.1007/s00701-022-05479-1

Cited by 2 publications

(2 citation statements)

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“…A technique for assessing ICP non‐invasively is measuring optic nerve sheath diameter (ONSD), both via ultrasound or specific MRI sequences 3 . ONSD has been validated as a surrogate for ICP, shows good correlation with individual ICP dynamics, 4–7 and may correlate with outcome in TBI after hematoma removal 8 . Data on ONSD in glioblastoma are scarce—in a heterogenous group of tumors, a decrease in ONSD was observed postoperatively 9 …”

Section: Introductionmentioning

confidence: 99%

“…3 ONSD has been validated as a surrogate for ICP, shows good correlation with individual ICP dynamics, [4][5][6][7] and may correlate with outcome in TBI after hematoma removal. 8 Data on ONSD in glioblastoma are scarce-in a heterogenous group of tumors, a decrease in ONSD was observed postoperatively. 9 Suspicion of GBM requires timely surgery and concomitant adjuvant care.…”

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confidence: 99%

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Retrospective longitudinal assessment of optic nerve sheath diameter in patients with malignant glioma

Feucht,

Kerscher,

Ruff

et al. 2023

Cancer Medicine

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IntroductionGlioblastoma (GBM) is a tumor with rapid growth and a possible relationship to elevated intracranial pressure (ICP). High ICP may not always be associated with clinical signs. A non‐invasive technique for assessment of ICP is measuring the optic nerve sheath diameter (ONSD). Identifying patients who need immediate intervention is of importance in neuro‐oncological care. The goal of this study is to assess the available magnetic resonance imaging (MRI) of patients with GBM with respect to pre‐ and postoperative ONSD.Methods and MaterialsRetrospective data analysis was performed on all patients operated for GBM at a tertiary care center between 2010 and 2020. Two pre and one postoperative MRI had to be available. Clinical data and ONSD at multiple time points were analyzed and correlated, as well as preoperative volumetrics.ResultsSixty‐seven patients met the inclusion criteria. Clinical signs of elevated ICP were seen in 25.4% (n = 17), while significant perifocal edema was present in 67.2% (n = 45) of patients. Clinical signs of preoperatively elevated ICP were associated with significantly elevated ONSD at diagnosis (p < 0.001) as well as preoperative tumor volume (p < 0.001). Significant perifocal edema at the time of diagnosis was associated with elevated ONSD (p = 0.029) and higher tumor volume (p = 0.003). In patients with significant edema, ONSD increased significantly between preoperative MRIs (p = 0.003/005). In patients with clinical signs of raised ICP, ONSD also increased, whereas it was stable in asymptomatic patients (yes: 5.01+/−4.17 to 5.83+/−0.55 mm, p = 0.010, no: 5.17+/−0.46 mm to 5.38+/−0.41 mm, p = 0.81). A significant increase of ONSD from diagnosis to preoperative MRI and a significant decrease until 3 months postoperatively were observed (p < 0.001).ConclusionsONSD might help identify high ICP in patients with GBM. In this first‐of‐its kind study, we observed a significant increase of ONSD preoperatively, likely associated with edema. Postoperatively, ONSD decreased significantly until 3 months after surgery and increased again at 12 months. Further prospective data collection is warranted.

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