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Intracranial Pressure Assessment in Traumatic Head Injury with Hemorrhage Via Optic Nerve Sheath Diameter.
J Neurotrauma 2016; 33(23):2147-2153JN

Abstract

Our purpose was to improve the technique of measuring optic nerve sheath diameter (ONSD) for intracranial pressure (ICP) monitoring in cases of traumatic head injury with hemorrhage. In a retrospective study, computed tomography (CT) data of 312 adult patients were collected and analyzed. ONSDs were measured at 3 mm and 8-10 mm distance from the globe together with the eyeball transverse diameter (ETD). The ONSD/ETD ratio was calculated. The correlation analysis was performed with gender, age, Glasgow Coma Scale score, and Glasgow Outcome Score. ONSD was enlarged in all cases when CT scans indicated hematoma. Enlarged right/left ONSDs were 6.5 ± 1.5/6.4 ± 1.3 mm at 3 mm and 6.6 ± 0.8/6.6 ± 0.6 mm at 8-10 mm from the globe (cut-off value > 5.5 mm). ONSD/ETD ratio was 0.29 ± 0.05, compared with 0.19 ± 0.02 in healthy adults (p < 0.01). We did not find a correlation between ONSD/ETD ratio and initial Glasgow Coma Scale score, but there was an inverse correlation between ONSD/ETD ratio and Glasgow Outcome Score (r = -0.83). We conclude that in cases with a traumatic head injury with hemorrhage, the ONSD is significantly enlarged, indicating elevated ICP. In ICP assessment, the most accurate results can be obtained if the ONSD is measured 8-10 mm from the globe and the ONSD/ETD ratio is calculated.

Authors+Show Affiliations

1 Department of Otolaryngology-Head and Neck Surgery, Assaf Harofe Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University , Israel .2 Department of Radiology, Assaf Harofe Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University , Israel .3 Neurology Department, Assaf Harofe Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University , Israel .2 Department of Radiology, Assaf Harofe Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University , Israel .

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27048793

Citation

Vaiman, Michael, et al. "Intracranial Pressure Assessment in Traumatic Head Injury With Hemorrhage Via Optic Nerve Sheath Diameter." Journal of Neurotrauma, vol. 33, no. 23, 2016, pp. 2147-2153.
Vaiman M, Sigal T, Kimiagar I, et al. Intracranial Pressure Assessment in Traumatic Head Injury with Hemorrhage Via Optic Nerve Sheath Diameter. J Neurotrauma. 2016;33(23):2147-2153.
Vaiman, M., Sigal, T., Kimiagar, I., & Bekerman, I. (2016). Intracranial Pressure Assessment in Traumatic Head Injury with Hemorrhage Via Optic Nerve Sheath Diameter. Journal of Neurotrauma, 33(23), pp. 2147-2153.
Vaiman M, et al. Intracranial Pressure Assessment in Traumatic Head Injury With Hemorrhage Via Optic Nerve Sheath Diameter. J Neurotrauma. 2016 12 1;33(23):2147-2153. PubMed PMID: 27048793.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intracranial Pressure Assessment in Traumatic Head Injury with Hemorrhage Via Optic Nerve Sheath Diameter. AU - Vaiman,Michael, AU - Sigal,Tal, AU - Kimiagar,Itzhak, AU - Bekerman,Inessa, Y1 - 2016/05/16/ PY - 2016/4/7/pubmed PY - 2018/1/11/medline PY - 2016/4/7/entrez KW - CT scan KW - hematoma KW - intracranial pressure KW - optic nerve sheath diameter KW - traumatic head injury SP - 2147 EP - 2153 JF - Journal of neurotrauma JO - J. Neurotrauma VL - 33 IS - 23 N2 - Our purpose was to improve the technique of measuring optic nerve sheath diameter (ONSD) for intracranial pressure (ICP) monitoring in cases of traumatic head injury with hemorrhage. In a retrospective study, computed tomography (CT) data of 312 adult patients were collected and analyzed. ONSDs were measured at 3 mm and 8-10 mm distance from the globe together with the eyeball transverse diameter (ETD). The ONSD/ETD ratio was calculated. The correlation analysis was performed with gender, age, Glasgow Coma Scale score, and Glasgow Outcome Score. ONSD was enlarged in all cases when CT scans indicated hematoma. Enlarged right/left ONSDs were 6.5 ± 1.5/6.4 ± 1.3 mm at 3 mm and 6.6 ± 0.8/6.6 ± 0.6 mm at 8-10 mm from the globe (cut-off value > 5.5 mm). ONSD/ETD ratio was 0.29 ± 0.05, compared with 0.19 ± 0.02 in healthy adults (p < 0.01). We did not find a correlation between ONSD/ETD ratio and initial Glasgow Coma Scale score, but there was an inverse correlation between ONSD/ETD ratio and Glasgow Outcome Score (r = -0.83). We conclude that in cases with a traumatic head injury with hemorrhage, the ONSD is significantly enlarged, indicating elevated ICP. In ICP assessment, the most accurate results can be obtained if the ONSD is measured 8-10 mm from the globe and the ONSD/ETD ratio is calculated. SN - 1557-9042 UR - https://www.unboundmedicine.com/medline/citation/27048793/Intracranial_Pressure_Assessment_in_Traumatic_Head_Injury_with_Hemorrhage_Via_Optic_Nerve_Sheath_Diameter_ L2 - https://www.liebertpub.com/doi/full/10.1089/neu.2015.4293?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -