Optic nerve sonography in the diagnostic evaluation of adult brain injury

Soldatos, Theodoros; Karakitsos, Dimitrios; Chatzimichail, Katerina; Papathanasiou, Matilda; Γουλιάμος, Αθανάσιος; Karabinis, Andréas

doi:10.1186/cc6897

Cited by 259 publications

(252 citation statements)

References 38 publications

(65 reference statements)

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“…As a result intracranial pressure changes are transmitted through the subarachnoid space to the optic nerve [63]. Several studies have shown that ONSD correlates with the intracranial blood pressure measurements [64,65] and the technique has now been standardized [66]. The patient is studied in the supine position; a layer of gel is applied over the closed eyelid and a high-frequency linear probe is gently positioned on the temporal area of the eyelid to visualize the entry of the optic nerve into the globe.…”

Section: Post-traumatic Intracranial Lesion the Optic Nervementioning

confidence: 99%

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Sofia

2013

J Ultrasound

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Objectives The aim of this review article is to present the current views and visions of the role of ultrasound (US) in the management of patients with multiple trauma. The article is divided into two parts. Part 1 (US findings and techniques) will mainly deal with the technical aspects of US imaging in trauma patients and is written also for educational purposes. Part 2 (pathophysiology and US imaging in trauma patients) will deal with integration of US in the clinical and pathophysiological management of multiple trauma patients. Methods A non-systematic review of the literature through PubMed search (restricted to the last 10 years) of original articles and review articles. Results 80 publications were selected for Part 1. Of these 80 articles, the author selected 50 according to personal criteria on the basis of their innovative or original contents (48 original articles and 2 literature review articles); 19 articles were furthermore extracted from the references of the selected publications. The information extracted from these 69 publications was organized into sections dealing with different fields of applications of US imaging in multiple trauma patients. Conclusions US imaging in trauma has evolved from the initial use, i.e., early diagnosis of peritoneal effusion (focused abdominal sonography for trauma), to a wider use known as resuscitative ultrasonography, and is today considered as an extension of physical examination to implement a more effective approach to clinical problems and increase the timeliness and safety of interventions. Keywords Trauma Á Ultrasound Á Ultrasound findings Á Ultrasound techniqueRiassunto Obiettivi L'obiettivo di questa ricerca è di presentare la visione e le opinioni correnti sul ruolo dell'ecografia nella gestione del paziente con politrauma. L'articolo è diviso in due parti: nella prima ('Semeiotica ecografica e tecnica di esecuzione dell'esame') verrà data attenzione agli aspetti prevalentemente tecnici dell'ecografia nel trauma, con intento anche didattico; nella seconda (Fisiopatologia e ecografia clinica del trauma) sarà esplorato il tema dell'integrazione dell'ecografia con la clinica e la fisiopatologia nella gestione del politraumatizzato. Metodi Revisione non sistematica della letteratura. Ricerca su PubMed (restrizione agli ultimi 10 anni) di articoli originali e revisioni. Risultati Per la Parte prima sono stati selezionati 80 articoli, tra i quali sono stati scelti con criteri personali quelli ritenuti innovativi o originali nei contenuti (48 articoli originali, 2 revisioni di letteratura). 19 articoli sono stati estratti dalla bibliografia delle pubblicazioni prescelte. I contenuti estratti dai 69 articoli sono stati organizzati in paragrafi intitolati ai singoli ambiti di applicazione dell'ecografia nel politrauma. Conclusioni L'ecografia del trauma è evoluta dalla iniziale applicazione nella diagnosi precoce del versamento peritoneale (Focused Abdominal Sonography for Trauma o FAST) all'accezione più ampia di Resuscitative Ultrasonography (RUS) e v...

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Section: Post-traumatic Intracranial Lesion the Optic Nervementioning

confidence: 99%

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Sofia

2013

J Ultrasound

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“…Enzymes and free radicals in the cells fragmented as a result of necrosis are released and enter a vicious cycle that causes more neuron destruction. Changes in the cerebral blood flow developing as a result of CVD, the breakdown of cerebral perfusion pressure due to edema that develops at the tissue level, and ineffective CSF circulation cause an increase in ICP (17,22,23). The ON is unique because it represents an extension of the central nervous system and has a cover (dura, arachnoid, and pia) (24).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it must be remembered that papillary edema, which is caused by ICP, may lead to increased ONSD (26,27). In some studies, ONSD has been reported as 4.9-5.9 mm in cases of ICP (17,20,30,31). Soldatos et al (17) determined ONSD as 6.1 mm in patients with severe brain injuries, 4.2 mm in moderate-severe injuries, and 3.6 mm in the control group.…”

Section: Discussionmentioning

confidence: 99%

Bedside measurement of the optic nerve sheath diameterwith ultrasound in cerebrovascular disorders

Yüzbaşıoğlu¹,

Yüzbaşioğlu²,

Coskun³

et al. 2018

Turk J Med Sci

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Background/aim: We aimed to show the role of determination of optic nerve sheath diameter (ONSD) by bedside ultrasonography in an emergency department in the diagnosis of cerebrovascular disorders and its correlation with the clinical picture. Materials and methods:This prospective cross-sectional study included 55 patients with cerebrovascular disorders and 53 controls. Age, sex, ONSD, comorbid disease status, and multidetector computed tomography results of all subjects and application periods and National Institutes of Health Stroke Scale (NIHSS) scores of the patient group were evaluated. Results:The ONSD of the patient and control groups was determined as a median of 5.7 mm and 3.6 mm, respectively. The ONSD of the patient group was determined to be significantly higher than that of the control group (P < 0.05). A positive relationship was determined between NIHSS scores and ONSD values (P < 0.05). The specificity and sensitivity values were determined as 98.1% and 81.8%, respectively, for a cutoff value of 5 mm and as 100% and 72.7%, respectively, for a cutoff value of 6 mm. Conclusion:This study showed that bedside measurement of ONSD is an easy, cheap, and noninvasive method that can be used to support the diagnosis and evaluation of patients with acute stroke.

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“…Noninvasive ICP Monitoring A variety of methods to measure ICP noninvasively have been studied, including transcranial Doppler ultrasonography [17,18], optic nerve sheath diameter [19][20][21], fundoscopic papillary examination [22], and tympanic membrane displacement [23]. Unfortunately, all of these techniques are subject to artifact, have been studied in relatively small numbers of patients, require significant expertise to perform, and have only limited correlation with invasively obtained ICPs.…”

Section: Invasive Icp Monitoringmentioning

confidence: 99%

ICU Management of Traumatic Brain Injury

Hallman

Joffe

2013

Curr Anesthesiol Rep

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Traumatic brain injury (TBI) is a major cause of death and disability throughout the world. Injury can be divided into primary and secondary injuries. For patients with TBI admitted to the intensive care unit (ICU), the management and prevention of secondary injury is most important. The third edition of the Brain Trauma Foundation guidelines was published in 2007 and is widely used to guide treatment of patients with severe TBI. This article reviews ICU care of patients with severe TBI, with a particular focus on recent evidence that is not incorporated in the existing guidelines.

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Optic nerve sonography in the diagnostic evaluation of adult brain injury

Cited by 259 publications

References 38 publications

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Bedside measurement of the optic nerve sheath diameterwith ultrasound in cerebrovascular disorders

ICU Management of Traumatic Brain Injury

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