Role of serial ultrasonic optic nerve sheath diameter monitoring in head injury

Thotakura, Amit Kumar; Marabathina, Nageswara Rao; Danaboyina, Ankamma Rao; Mareddy, R.R.

doi:10.1016/j.neuchi.2017.06.001

Cited by 32 publications

(30 citation statements)

References 28 publications

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“…Toscano et al recently demonstrated the efficacy of the technique for the early identification of malignant increased ICP and brain death in neurocritical patients with daily ONSD monitoring, in order to detect potential candidates for organ donation . In head injury patients, the trend observed in ONSD values obtained by serial measurements provided useful information on decision making, more than the single evaluation …”

Section: Discussionmentioning

confidence: 99%

“…24 In head injury patients, the trend observed in ONSD values obtained by serial measurements provided useful information on decision making, more than the single evaluation. 25 In addition to ONSD ultrasonography, transcranial Doppler sonography has been proposed as another alternative noninvasive tool for raised ICP detection. 26 Whether those techniques are promising, data on diagnostic accuracy are variable and no consensus has been reached.…”

Section: Discussionmentioning

confidence: 99%

“…10 Finally, despite the increasing number of works in this field, there is still no consensus on a unique ONSD cut-off value for the identification of elevated ICP, placed between 4.5 and 6.3 mm. 3,5,25 These discrepancies may depend on various factors, including the execution technique, the subject selection, the underlying pathology and ethnicity, limiting the validation of the method for a more extensive use. Our optimal cut-off point for the detection of raised ICP was 5.6 mm, being in-line with cited previous reports and more recent findings.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasonography Monitoring of Optic Nerve Sheath Diameter and Retinal Vessels in Patients with Cerebral Hemorrhage

Naldi

Pivetta

Coppo

et al. 2019

Journal of Neuroimaging

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BACKGROUND AND PURPOSE Evaluation of the diagnostic accuracy of optic nerve sheath diameter (ONSD) and Doppler indices of central retinal arteries and veins for the detection of increased intracranial pressure (ICP) in intracerebral hemorrhage (ICH) and of the usefulness of a second assessment of these variables in the monitoring of ICH. METHODS A total of 46 acute ICH patients with (group 1, n = 25) and without (group 2, n = 21) clinical and radiological computed tomography signs of raised ICP and 40 healthy controls were recruited. The median binocular ONSD and Doppler indices of retinal vessels including resistive index (RI) and retinal venous pulsation (RVP) were compared among groups, both at admission and later during ICH monitoring. RESULTS Median binocular ONSD showed higher accuracy for the detection of increased ICP (sensitivity and specificity 100%), while Doppler indices were less accurate (sensitivity 48% and specificity 95% for RI; 80% and 62% for RVP). In ICH patients, ONSD was significantly elevated in group 1 both at admission (6.40 mm [interquartile range [IQR] = .70] vs. 4.70 [.40]) and at control time (6.00 [.55] vs. 4.55 [.40]; P < .01), as well as RI (.79 [.11] vs. .77 [.03] and .80 [.06] vs. .75 [.35]; P = .01). RVP was significantly increased in group 1 only at admission (3.20 cm/s [1.05] vs. 2.00 [1.55], P = .02). CONCLUSIONS Median binocular ONSD evaluation showed higher accuracy for the estimation of elevated ICP compared with Doppler indices of retinal vessels. The ONSD enlargement detected in the early phase of ICH persists at control time.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ultrasonography Monitoring of Optic Nerve Sheath Diameter and Retinal Vessels in Patients with Cerebral Hemorrhage

Naldi

Pivetta

Coppo

et al. 2019

Journal of Neuroimaging

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“…However, a small randomized prospective study found that ONSD correlated well with Glasgow Coma Scale score, and that lower ONSD values, as measured on ocular ultrasound, were associated with improved neurologic outcomes in the inpatient setting. 9 Similarly, in a study of post cardiac arrest patients in an intensive care unit setting, narrower ONSD post arrest day 1 measurements were associated with improved survival. 10 This is a unique case of an unstable emergency department patient where bedside ultrasound measurements demonstrated a dynamic ONSD size in response to ICP-lowering maneuvers.…”

Section: Discussionmentioning

confidence: 97%

Pearls & Oy-sters: Diagnosis and monitoring of elevated intracranial pressure through ultrasound of the optic nerve

Rosenberg

Chan

et al. 2019

Neurology

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“…The assessment of the thickness of the optic nerve sheath can be performed in patients with blunt head injuries and unconscious for unknown reasons [5,6], or for indeterminate headaches [7]. The test may be particularly useful in emergency medical conditions, including emergency medical service, where a radiological diagnosis is not available [8,9].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound assessment of the optic nerve sheath as an indirect method of diagnosis of increased intracranial pressure

Ruetzler

Dudek

Dunder

et al. 2019

Disaster Emerg Med J

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Ultrasonography is a diagnostic technique that has been used clinically for 30 years. Due to the increased availability of ultrasound machines as well as the reduction of their size and making them more mobile, ultrasound has found its place in early diagnosis in emergency medicine settings. One of the important, however, an underestimated ultrasound examination is the measurement of the thickness of the optic nerve sheath. The optic nerve is the second cranial nerve, meaning the same sheath surrounds it as the brain. At the moment of intracranial pressure increase, cerebrospinal fluid flows into the subarachnoid space causing an increase in intracranial pressure and thus increasing the diameter of the optic nerve sheath. therefore, ONSD imaging is a quick non-invasive test aimed at detecting and monitoring changes in intracranial pressure. Optic nerve sheath ultrasound is a simple, safe and inexpensive bedside diagnostic test. Ophthalmic ultrasound usually uses the frequency between 5 and 10.5 MHz to evaluate the eye and the orbit.

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Role of serial ultrasonic optic nerve sheath diameter monitoring in head injury

Cited by 32 publications

References 28 publications

Ultrasonography Monitoring of Optic Nerve Sheath Diameter and Retinal Vessels in Patients with Cerebral Hemorrhage

Ultrasonography Monitoring of Optic Nerve Sheath Diameter and Retinal Vessels in Patients with Cerebral Hemorrhage

Pearls & Oy-sters: Diagnosis and monitoring of elevated intracranial pressure through ultrasound of the optic nerve

Ultrasound assessment of the optic nerve sheath as an indirect method of diagnosis of increased intracranial pressure

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