Reliability of Assessing Non-severe Elevation of Intracranial Pressure Using Optic Nerve Sheath Diameter and Transcranial Doppler Parameters

Chen, Limin; Wang, Li Juan; Shi, Lin; Chen, Hong-Xiu; Jiang, Xiao-han; Chen, Qianqian; Xing, Yingqi

doi:10.3389/fneur.2019.01091

Cited by 7 publications

(5 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The MCA-PI derived by transcranial Doppler ultrasonography is reportedly correlated with the ICP and cerebral perfusion pressure in various intracranial disorders, such as traumatic brain injury, intracranial hemorrhage, subarachnoid hemorrhage, and hypoxic brain injury after cardiac arrest. 9,10,14–17 In the present study, the increased MCA-PI in patients with intracranial lesions might reflect an increased ICP secondary to a hematoma or cerebral edema. In addition, increased peripheral vascular resistance because of ischemic stroke might have also contributed.…”

Section: Discussionmentioning

confidence: 52%

Prediction of intracranial lesions in patients with consciousness disturbance by ultrasonography in the intensive care unit

et al. 2022

View full text Add to dashboard Cite

Objective This study was performed to evaluate the correlation between parameters measured by bedside ultrasonography and detection of intracranial organic lesions in patients with impaired consciousness in an intensive care unit (ICU) setting. Methods We retrospectively reviewed the medical records of patients who were admitted to our ICU from April 2017 to July 2019. Patients who underwent computed tomography or magnetic resonance imaging examination and measurement of the flow velocity of the carotid and intracranial arteries and the optic nerve sheath diameter by ultrasonography were selected for analysis. Results In total, 64 patients were analyzed in this study. Of these, intracranial lesions were detected by computed tomography or magnetic resonance imaging in 17 (27%) patients. The left:right ratio of the end-diastolic velocity of the bilateral common carotid artery (CCA-ED ratio) and the pulsatility index of the middle cerebral artery (MCA-PI) were significantly higher in patients with than in those without intracranial lesions. The cut-off value of the CCA-ED ratio was 1.55 (sensitivity, 66.7%; specificity, 81.6%), and that of the MCA-PI was 1.21 (sensitivity, 57.1%; specificity, 76.7%). Conclusion Bedside ultrasonography is useful for predicting intracranial lesions requiring therapeutic intervention in ICU patients with impaired consciousness.

show abstract

Section: Discussionmentioning

confidence: 52%

Prediction of intracranial lesions in patients with consciousness disturbance by ultrasonography in the intensive care unit

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Measured 3 times and then averaged. Chen 2019 [ 14 ] China Prospective 29 4.53 DelicaMVU-6300 Mixed LP Mixed 3 mm behind the globe; averaged two measurements: one sagittal and the other in the transverse plane del Saz-Saucedo 2016 [ 15 ] Spain Prospective 19 6.76 Toshiba AplioXG Mixed LP IIH Transverse plane Du 2020 [ 16 ] China Prospective 49 5.7 Sonosite ICU Inv Trauma 3 mm behind the globe; transverse plane; averaged two eyes. Geeraerts 2007 [ 17 ] France Prospective 15 6.3 HP Sonos 5500 ICU Inv Trauma 3 mm behind the globe; one sagittal and one transverse Goel 2008 [ 18 ] India Prospective 73 5.8 Unspecified Mixed CT Trauma 3 mm behind the globe; one sagittal and one transverse; averaged Hanafi 2019 [ 19 ] Iran Prospective 62 ...…”

Section: Resultsmentioning

confidence: 99%

Mean value of B-mode optic nerve sheath diameter as an indicator of increased intracranial pressure: a systematic review and meta-analysis

Montorfano

Bordes

et al. 2021

Ultrasound J

View full text Add to dashboard Cite

Objectives Timely diagnosis and treatment of increased intracranial pressure can decrease morbidity and prevent mortality. The present meta-analysis aims to determine the mean value of the ONSD measured in patients with various elevated ICP etiologies under different clinical settings, as well as comparing the value of ONSD between patients with and without elevated ICP. Methods This meta-analysis complied with the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement8. PubMed, Embase, and Cochrane Library were searched to identify ONSD measured by US for patients with increased ICP from establishment to October 2020. Results A total of 779 patients with elevated ICP among 22 studies were included in the present meta-analysis. Studies were published between 2003 and 2020. Eighteen were comparative (18/22, 81.8%), and four were single-armed study (4/22, 18.2%). Twenty were prospective studies (20/22, 90.9%). There was moderate-to-high heterogeneity based on the prediction ellipse area and variance logit of sensitivity and specificity. Conclusions The mean value of the ONSD among patients diagnosed with increased ICP was 5.82 mm (95% CI 5.58–6.06 mm). Variations were observed based on etiology of intracranial hypertension, clinical settings where ONSD was measured, and standards for diagnosing intracranial hypertension. The US-ONSD among patient with elevated ICP was significantly higher than the normal control. Although a cut-off value is not clearly determined, these mean values can be implemented to evaluate the sensitivity and specificity of US-ONSD in diagnosing intracranial hypertension in future studies.

show abstract

“…However, some studies stipulate that PI is not very reliable for evaluating ICP [22,23] . Chen et al suggested that cerebral arterial hemodynamics assessed by TCD are not a su ciently reliable predictor of ICP in the early IH stages [24] , making its clinical applicability controversial. Whether or not TCD can be used to evaluate neurological disease prognosis has attracted attention.…”

Section: Discussionmentioning

confidence: 99%

Optic nerve sheath diameter as a new noninvasive marker for predicting the prognosis of patients with acute ischemic stroke in the intensive care unit

Wang

Xing

Liu

et al. 2023

Preprint

View full text Add to dashboard Cite

Objective: Intracranial hypertension is linked to poor prognosis after acute ischemic stroke (AIS). Intracranial pressure can be evaluated by using the ultrasonographic optic nerve sheath diameter (ONSD) and transcranial Doppler (TCD). This study aims to determine whether ONSD and TCD parameters could noninvasively predict the prognosis of AIS patients. Design: Prospective observational blinded study. Setting: Neurology intensive care unit (ICU). Patients: Consecutive patients with AIS. Interventions: ONSD and TCD parameters of 81 AIS patients were obtained upon admission. The Glasgow Outcome Scale scores were evaluated at the 6-month follow-up. The clinical differences between the poor and good prognosis groups were compared. The association between variables and prognosis was assessed, and the cutoff values for the Glasgow Coma Scale (GCS) score and ONSD for predicting poor prognoses were analyzed. Measurements and main results: At the 6-month follow-up, 54 patients had poor prognosis; the ONSDs of the poor and good prognosis groups were 5.45±0.38 and 4.96±0.32, respectively (P<0.001). There were no significant differences in TCD parameters between the two groups. ONSD (odds ratio [OR] 1.4; 95% confidence interval [CI], 1.2–1.7; P<0.001) and GCS score (OR, 0.7; 95% CI, 0.5–0.9; P=0.003) were independent factors influencing poor prognosis. The best ONSD cutoff value for poor prognosis was 5.21 mm; the sensitivity, specificity, and area under the curve were 87.0%, 82.1%, and 0.862, respectively. Conclusions: Ultrasonographic measurement of ONSD may be a new prognostic indicator of functional outcomes in ICU AIS patients. However, TCD parameters have no significant prognostic value for AIS patients.

show abstract

Reliability of Assessing Non-severe Elevation of Intracranial Pressure Using Optic Nerve Sheath Diameter and Transcranial Doppler Parameters

Cited by 7 publications

References 24 publications

Prediction of intracranial lesions in patients with consciousness disturbance by ultrasonography in the intensive care unit

Prediction of intracranial lesions in patients with consciousness disturbance by ultrasonography in the intensive care unit

Mean value of B-mode optic nerve sheath diameter as an indicator of increased intracranial pressure: a systematic review and meta-analysis

Optic nerve sheath diameter as a new noninvasive marker for predicting the prognosis of patients with acute ischemic stroke in the intensive care unit

Contact Info

Product

Resources

About