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Role of serial ultrasonic optic nerve sheath diameter monitoring in head injury.
Neurochirurgie 2017; 63(6):444-448N

Abstract

OBJECTIVES

To compare optic nerve sheath diameter (ONSD) measurements in head injury patients with a group of normal subjects and investigate the significance of serial ONSD monitoring in head injury patients.

METHODS

All patients with a head injury admitted to our hospital with a program of conservative management at the time of admission were included in this prospective study. On admission, the patient was assessed using the Glasgow Coma Scale (GCS), orbital ultrasound for optic nerve sheath diameter (ONSD), and CT brain scan. CT scan findings were tabulated with Marshall and Rotterdam scores. The patient was serially assessed with ONSD every 24 to 48hours. If the patient deteriorated, repeat CT and ONSD measurements were performed. A control group consisting of normal subjects was used for comparison.

RESULTS

The case group consisted of 40 patients and the control group included 16 volunteers. The mean age of the case group was 38.9 years and the control group 36.3 years. The mean ONSD was 4.8mm in the case group as compared to 3.4mm in control group (P<0.0001). In the case group, we found a significant correlation between GCS and ONSD, GCS and radiological scores and ONSD and radiological scores. The change in serial recordings of ONSD measurements were termed ascending, descending or static. All the patients with descending trend in serial ONSD values had good outcome and required no surgical intervention.

CONCLUSIONS

Ultrasound ONSD measurement is a useful investigation tool in a setting where invasive ICP monitoring is not available. Serial recording of ONSD is valuable and provides valuable information regarding decision making.

Authors+Show Affiliations

Department of Neurosurgery, NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Guntur, 522503 Andhra Pradesh, India. Electronic address: doctoramitkumar@gmail.com.Department of Neurosurgery, NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Guntur, 522503 Andhra Pradesh, India.Department of Radiology, NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Guntur, 522503 Andhra Pradesh, India.Department of Neurosurgery, NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Guntur, 522503 Andhra Pradesh, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29122307

Citation

Thotakura, A K., et al. "Role of Serial Ultrasonic Optic Nerve Sheath Diameter Monitoring in Head Injury." Neuro-Chirurgie, vol. 63, no. 6, 2017, pp. 444-448.
Thotakura AK, Marabathina NR, Danaboyina AR, et al. Role of serial ultrasonic optic nerve sheath diameter monitoring in head injury. Neurochirurgie. 2017;63(6):444-448.
Thotakura, A. K., Marabathina, N. R., Danaboyina, A. R., & Mareddy, R. R. (2017). Role of serial ultrasonic optic nerve sheath diameter monitoring in head injury. Neuro-Chirurgie, 63(6), pp. 444-448. doi:10.1016/j.neuchi.2017.06.001.
Thotakura AK, et al. Role of Serial Ultrasonic Optic Nerve Sheath Diameter Monitoring in Head Injury. Neurochirurgie. 2017;63(6):444-448. PubMed PMID: 29122307.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of serial ultrasonic optic nerve sheath diameter monitoring in head injury. AU - Thotakura,A K, AU - Marabathina,N R, AU - Danaboyina,A R, AU - Mareddy,R R, Y1 - 2017/11/06/ PY - 2016/12/22/received PY - 2017/06/09/revised PY - 2017/06/25/accepted PY - 2017/11/11/pubmed PY - 2018/7/27/medline PY - 2017/11/11/entrez KW - ICP in head injury KW - ICP monitoring KW - Intracranial pressure KW - Non-invasive ICP monitoring KW - Optic nerve sheath diameter KW - Orbital ultrasound, ONSD measurement SP - 444 EP - 448 JF - Neuro-Chirurgie JO - Neurochirurgie VL - 63 IS - 6 N2 - OBJECTIVES: To compare optic nerve sheath diameter (ONSD) measurements in head injury patients with a group of normal subjects and investigate the significance of serial ONSD monitoring in head injury patients. METHODS: All patients with a head injury admitted to our hospital with a program of conservative management at the time of admission were included in this prospective study. On admission, the patient was assessed using the Glasgow Coma Scale (GCS), orbital ultrasound for optic nerve sheath diameter (ONSD), and CT brain scan. CT scan findings were tabulated with Marshall and Rotterdam scores. The patient was serially assessed with ONSD every 24 to 48hours. If the patient deteriorated, repeat CT and ONSD measurements were performed. A control group consisting of normal subjects was used for comparison. RESULTS: The case group consisted of 40 patients and the control group included 16 volunteers. The mean age of the case group was 38.9 years and the control group 36.3 years. The mean ONSD was 4.8mm in the case group as compared to 3.4mm in control group (P<0.0001). In the case group, we found a significant correlation between GCS and ONSD, GCS and radiological scores and ONSD and radiological scores. The change in serial recordings of ONSD measurements were termed ascending, descending or static. All the patients with descending trend in serial ONSD values had good outcome and required no surgical intervention. CONCLUSIONS: Ultrasound ONSD measurement is a useful investigation tool in a setting where invasive ICP monitoring is not available. Serial recording of ONSD is valuable and provides valuable information regarding decision making. SN - 1773-0619 UR - https://www.unboundmedicine.com/medline/citation/29122307/Role_of_serial_ultrasonic_optic_nerve_sheath_diameter_monitoring_in_head_injury_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0028-3770(17)30109-1 DB - PRIME DP - Unbound Medicine ER -