Tags

Type your tag names separated by a space and hit enter

The relationship between transorbital ultrasound measurement of the optic nerve sheath diameter (ONSD) and invasively measured ICP in children. : Part II: age-related ONSD cut-off values and patency of the anterior fontanelle.
Childs Nerv Syst. 2016 Oct; 32(10):1779-85.CN

Abstract

PURPOSE

To analyse the diagnostic accuracy of age-related optic nerve sheath diameter (ONSD) cut-off values in children for detecting raised intracranial pressure (ICP) and to assess the benefit of using patency of the anterior fontanelle in describing a different set of cut-off values.

METHODS

The ONSD measurement was performed prior to invasive ICP measurement in children under general anesthesia. The diagnostic accuracy of the ONSD measurement was compared to ICP at thresholds of 20, 15, 10, and 5 mmHg. This was further analysed in children above and below the age of 1 year, with a subgroup analysis of age at 4 years, and assessment of the anterior fontanelle (AF) as a reliable physiological marker in part II of this study.

RESULTS

Data from 174 children were analysed. In children ≤1 year old, the ONSD measurement with the best diagnostic accuracy for detecting ICP ≥ 20 mmHg was 5.16 mm, compared to 5.75 mm in children >1 year old (p < 0.001). In addition, patency of the anterior fontanelle (AF) was found to be a useful clinical marker for defining different ONSD cut-off values at ICP thresholds of 20, 15, 10 and 5 mmHg.

CONCLUSION

Transorbital ultrasound measurement of the ONSD is a reliable non-invasive marker of ICP particularly at higher thresholds of 20 and 15 mmHg. Patency of the AF is a useful clinical marker for defining different ONSD cut-off values in children.

Authors+Show Affiliations

Paediatric Neurosurgery Unit, Division of Neurosurgery, Faculty of Health Sciences, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa. llewesp@yahoo.com.Trauma Unit, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa.Paediatric Opthalmology Unit, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.Paediatric Neurosurgery Unit, Division of Neurosurgery, Faculty of Health Sciences, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27659820

Citation

Padayachy, Llewellyn C., et al. "The Relationship Between Transorbital Ultrasound Measurement of the Optic Nerve Sheath Diameter (ONSD) and Invasively Measured ICP in Children. : Part II: Age-related ONSD Cut-off Values and Patency of the Anterior Fontanelle." Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery, vol. 32, no. 10, 2016, pp. 1779-85.
Padayachy LC, Padayachy V, Galal U, et al. The relationship between transorbital ultrasound measurement of the optic nerve sheath diameter (ONSD) and invasively measured ICP in children. : Part II: age-related ONSD cut-off values and patency of the anterior fontanelle. Childs Nerv Syst. 2016;32(10):1779-85.
Padayachy, L. C., Padayachy, V., Galal, U., Pollock, T., & Fieggen, A. G. (2016). The relationship between transorbital ultrasound measurement of the optic nerve sheath diameter (ONSD) and invasively measured ICP in children. : Part II: age-related ONSD cut-off values and patency of the anterior fontanelle. Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery, 32(10), 1779-85. https://doi.org/10.1007/s00381-016-3068-4
Padayachy LC, et al. The Relationship Between Transorbital Ultrasound Measurement of the Optic Nerve Sheath Diameter (ONSD) and Invasively Measured ICP in Children. : Part II: Age-related ONSD Cut-off Values and Patency of the Anterior Fontanelle. Childs Nerv Syst. 2016;32(10):1779-85. PubMed PMID: 27659820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The relationship between transorbital ultrasound measurement of the optic nerve sheath diameter (ONSD) and invasively measured ICP in children. : Part II: age-related ONSD cut-off values and patency of the anterior fontanelle. AU - Padayachy,Llewellyn C, AU - Padayachy,Vaishali, AU - Galal,Ushma, AU - Pollock,Travis, AU - Fieggen,A Graham, Y1 - 2016/09/20/ PY - 2015/12/22/received PY - 2016/03/14/accepted PY - 2016/9/24/entrez PY - 2016/9/24/pubmed PY - 2017/2/22/medline KW - ICP monitoring KW - Non-invasive KW - Optic nerve sheath diameter KW - Ultrasound SP - 1779 EP - 85 JF - Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery JO - Childs Nerv Syst VL - 32 IS - 10 N2 - PURPOSE: To analyse the diagnostic accuracy of age-related optic nerve sheath diameter (ONSD) cut-off values in children for detecting raised intracranial pressure (ICP) and to assess the benefit of using patency of the anterior fontanelle in describing a different set of cut-off values. METHODS: The ONSD measurement was performed prior to invasive ICP measurement in children under general anesthesia. The diagnostic accuracy of the ONSD measurement was compared to ICP at thresholds of 20, 15, 10, and 5 mmHg. This was further analysed in children above and below the age of 1 year, with a subgroup analysis of age at 4 years, and assessment of the anterior fontanelle (AF) as a reliable physiological marker in part II of this study. RESULTS: Data from 174 children were analysed. In children ≤1 year old, the ONSD measurement with the best diagnostic accuracy for detecting ICP ≥ 20 mmHg was 5.16 mm, compared to 5.75 mm in children >1 year old (p < 0.001). In addition, patency of the anterior fontanelle (AF) was found to be a useful clinical marker for defining different ONSD cut-off values at ICP thresholds of 20, 15, 10 and 5 mmHg. CONCLUSION: Transorbital ultrasound measurement of the ONSD is a reliable non-invasive marker of ICP particularly at higher thresholds of 20 and 15 mmHg. Patency of the AF is a useful clinical marker for defining different ONSD cut-off values in children. SN - 1433-0350 UR - https://www.unboundmedicine.com/medline/citation/27659820/The_relationship_between_transorbital_ultrasound_measurement_of_the_optic_nerve_sheath_diameter__ONSD__and_invasively_measured_ICP_in_children__:_Part_II:_age_related_ONSD_cut_off_values_and_patency_of_the_anterior_fontanelle_ L2 - https://dx.doi.org/10.1007/s00381-016-3068-4 DB - PRIME DP - Unbound Medicine ER -