Tags

Type your tag names separated by a space and hit enter

Optic nerve sheath diameter as a marker for evaluation and prognostication of intracranial pressure in Indian patients: An observational study.
Indian J Crit Care Med 2014; 18(11):728-34IJ

Abstract

BACKGROUND AND AIMS

The aim was to evaluate efficacy of optic nerve sheath diameter (ONSD) by ultrasound as a noninvasive method for detecting raised intracranial pressure (ICP) in intensive care unit, to compare with computed tomography/magnetic resonance imaging (MRI) findings of raised ICP and to prognosticate ONSD value with treatment.

MATERIALS AND METHODS

We conducted a prospective, observational study on 101 adults by including 41 healthy individuals in group A as control and 60 patients in group B admitted with fever, headache, vomiting, and altered sensorium. We examined them in supine position using 10 MHz linear array probe on closed eyelid. ONSD was measured 3 mm behind the globe in each eye. A mean binocular ONSD > 4.6 mm in female and 4.8 mm in male was considered abnormal. Midline shift, edema, effacement or ONSD > 5.0 mm on T2 MRI suggestive of elevated ICP was used to evaluate ONSD accuracy.

RESULTS

Group A mean ONSD was 4.6 mm in females and 4.8 mm in males. Group B mean ONSD for 17 females was 5.103 ± 0.6221 mm (P = 0.002) and for 43 males 5.081 ± 0.5799 mm (P = 0.032). Radiological sign of raised ICP was confirmed in 35 patients (females = 11 and males = 24) with high ONSD value. Sensitivity of detecting raised ICP by ONSD was 84.6% in females and 75% in males while specificity was 100% in both genders. Out of 25 patients without radiological signs of raised ICP 10 patients showed high ONSD (females = 4.735 mm and males = 4.907 mm). ONSD was well prognosticated with treatment modalities.

CONCLUSION

Bedside ocular ultrasonography for measuring ONSD can be used an early test for diagnosing raised ICP as it is a noninvasive, cost effective bedside test, which can be repeated for re-evaluation.

Authors+Show Affiliations

Department of Critical Care Medicine and Department of Radiology, Yashoda Multi-Speciality Hospital, Somajiguda, Hyderabad, Telangana, India.Department of Critical Care Medicine and Department of Radiology, Yashoda Multi-Speciality Hospital, Somajiguda, Hyderabad, Telangana, India.Department of Critical Care Medicine and Department of Radiology, Yashoda Multi-Speciality Hospital, Somajiguda, Hyderabad, Telangana, India.Department of Critical Care Medicine and Department of Radiology, Yashoda Multi-Speciality Hospital, Somajiguda, Hyderabad, Telangana, India.Department of Critical Care Medicine and Department of Radiology, Yashoda Multi-Speciality Hospital, Somajiguda, Hyderabad, Telangana, India.Department of Critical Care Medicine and Department of Radiology, Yashoda Multi-Speciality Hospital, Somajiguda, Hyderabad, Telangana, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25425840

Citation

Shirodkar, Chetan G., et al. "Optic Nerve Sheath Diameter as a Marker for Evaluation and Prognostication of Intracranial Pressure in Indian Patients: an Observational Study." Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, vol. 18, no. 11, 2014, pp. 728-34.
Shirodkar CG, Rao SM, Mutkule DP, et al. Optic nerve sheath diameter as a marker for evaluation and prognostication of intracranial pressure in Indian patients: An observational study. Indian J Crit Care Med. 2014;18(11):728-34.
Shirodkar, C. G., Rao, S. M., Mutkule, D. P., Harde, Y. R., Venkategowda, P. M., & Mahesh, M. U. (2014). Optic nerve sheath diameter as a marker for evaluation and prognostication of intracranial pressure in Indian patients: An observational study. Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, 18(11), pp. 728-34. doi:10.4103/0972-5229.144015.
Shirodkar CG, et al. Optic Nerve Sheath Diameter as a Marker for Evaluation and Prognostication of Intracranial Pressure in Indian Patients: an Observational Study. Indian J Crit Care Med. 2014;18(11):728-34. PubMed PMID: 25425840.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optic nerve sheath diameter as a marker for evaluation and prognostication of intracranial pressure in Indian patients: An observational study. AU - Shirodkar,Chetan G, AU - Rao,S Manimala, AU - Mutkule,Dnyaneshwar P, AU - Harde,Yogesh R, AU - Venkategowda,Pradeep M, AU - Mahesh,M Uma, PY - 2014/11/27/entrez PY - 2014/11/27/pubmed PY - 2014/11/27/medline KW - Computed tomography KW - intensive care unit KW - magnetic resonance imaging KW - mannitol KW - optic nerve sheath diameter KW - raised intracranial pressure KW - ultrasonography SP - 728 EP - 34 JF - Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine JO - Indian J Crit Care Med VL - 18 IS - 11 N2 - BACKGROUND AND AIMS: The aim was to evaluate efficacy of optic nerve sheath diameter (ONSD) by ultrasound as a noninvasive method for detecting raised intracranial pressure (ICP) in intensive care unit, to compare with computed tomography/magnetic resonance imaging (MRI) findings of raised ICP and to prognosticate ONSD value with treatment. MATERIALS AND METHODS: We conducted a prospective, observational study on 101 adults by including 41 healthy individuals in group A as control and 60 patients in group B admitted with fever, headache, vomiting, and altered sensorium. We examined them in supine position using 10 MHz linear array probe on closed eyelid. ONSD was measured 3 mm behind the globe in each eye. A mean binocular ONSD > 4.6 mm in female and 4.8 mm in male was considered abnormal. Midline shift, edema, effacement or ONSD > 5.0 mm on T2 MRI suggestive of elevated ICP was used to evaluate ONSD accuracy. RESULTS: Group A mean ONSD was 4.6 mm in females and 4.8 mm in males. Group B mean ONSD for 17 females was 5.103 ± 0.6221 mm (P = 0.002) and for 43 males 5.081 ± 0.5799 mm (P = 0.032). Radiological sign of raised ICP was confirmed in 35 patients (females = 11 and males = 24) with high ONSD value. Sensitivity of detecting raised ICP by ONSD was 84.6% in females and 75% in males while specificity was 100% in both genders. Out of 25 patients without radiological signs of raised ICP 10 patients showed high ONSD (females = 4.735 mm and males = 4.907 mm). ONSD was well prognosticated with treatment modalities. CONCLUSION: Bedside ocular ultrasonography for measuring ONSD can be used an early test for diagnosing raised ICP as it is a noninvasive, cost effective bedside test, which can be repeated for re-evaluation. SN - 0972-5229 UR - https://www.unboundmedicine.com/medline/citation/25425840/Optic_nerve_sheath_diameter_as_a_marker_for_evaluation_and_prognostication_of_intracranial_pressure_in_Indian_patients:_An_observational_study_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25425840/ DB - PRIME DP - Unbound Medicine ER -